Cochlear Implants
by Michaela Coon

4 hearing preservation conversations to consider

January 29, 2020
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Although hearing preservation may not yet fully be defined, recent research developments have spurred a movement in the cochlear implant industry to more routinely consider the implications of hearing preservation in the hearing implant journey.

Have you joined in the conversation on this hot topic? Check out these 4 hearing preservation discussion resources:

TECH Talk: Improvements in hearing preservation research

Dr. David Friedmann, Neurotologist at NYU, explains how the movement to routinely consider hearing preservation has helped to progress the cochlear implant from solely a communication device to a more holistic, natural auditory experience.  He also discusses the surgical, audiological and patient-oriented perspectives and outcomes associated with the topic.

Cochlear NEXT CI532 Clinical Study Insights – Is hearing preservation possible with CI532?

In Spring 2019, sixty-five otology and audiology professionals came together for Cochlear NEXT, a program focused on learning and discussion regarding Cochlear’s CI532 Clinical Study and the respective implications of this emerging and impactful data. This proceedings summary reviews the primary talking points and output from the day’s third and final topic of hearing preservation.

Read more now!

Cochlear NEXT: Is preservation possible with the CI532 electrode?

Group Product Manager for Cochlear Nucleus® Systems Ryan Lopez explores the clinical data from Cochlear’s multi-center trial on the CI532 as well as recently published data on the CI532 Slim Modiolar electrode. Lopez highlights the various aspects of measurable, structural and functional preservation.

ProNews Blog: Preservation is possible

As we become more confident in cochlear implant outcomes, more patients with residual hearing after surgery are being evaluated for cochlear implant candidacy.  How do we manage these patients? What electrodes should be used to preserve and maximize acoustic hearing after surgery? This blog examines if the Slim Modiolar electrode’s atraumatic design and consistent scala tympani placement impact the ability of Slim Modiolar to preserve residual hearing in some patients.

Learn more!

To stay updated with the latest hearing preservation discussions, subscribe to the ProNews Blog and visit our TECH Talks page.

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Sarah Hughes

Preventing listening fatigue this holiday season with tips from Dr. Sarah Hughes

December 20, 2021

By Sarah E. Hughes B.Sc., M.H.Sc.,Ph.D., Research Fellow, Centre for Patient Reported Outcome Research, University of Birmingham, United Kingdom

Sarah Hughes

Here are some tips to making sure your patients can be a part of the conversations and moments that they care about the most:

Tips from an expert to manage listening effort during the holidays

As cochlear implant recipients, your patients may find that they are extremely tired by the end of the day. Interestingly, recipients often fail to connect their fatigue with listening and the increased effort needed to ensure listening success.

Listening effort is a term used to describe the exertion of brain power used to pay attention and understand spoken language.

It’s important for recipients to appreciate that listening effort is a part of what it means to listen with a hearing loss. Hearing is something that happens without us being aware of it taking place. Listening, however, is active. It is something we ‘do.’ When listening conditions are favorable this happens easily and we are not aware of the effort involved.

However, when conditions are challenging, such as listening with a hearing loss, a listener is required to do additional mental work to enable them to understand speech, music or identify sounds in the environment.

If recipients expect to listen in the same way as hearing family and friends, they may be putting a lot of added pressure onto themselves. The extra pressure is stressful and can actually be counter-productive. Listening well may be possible in short periods, but over longer periods can become exhausting and can quickly lead to fatigue.

The good news is that recipients tell us when they make the effort to listen with their cochlear implant (s) that they feel a greater sense of social connectedness – the feeling of being in close personal contact with the world around them.

Cochlear™ CoPilot helps with strategies for the holidays

There are a number of strategies that can help manage your recipients’ energy levels for listening. Cochlear CoPilot is a mobile app that features information and insights from experts plus advice from other recipients.

Here are some tips for your patients from Cochlear CoPilot to get started:

  1. Recognize that listening with hearing loss requires effort.
  2. Schedule breaks in advance for times when you know that listening will be intensive or challenging.
  3. Allow yourself downtime to give your brain a listening break. Spend some time doing activities that don’t require you to listen very much – read, exercise, or meditate.
  4. Plan your day so that challenging tasks and activities are scheduled when you have the energy.
  5. Remember that good nutrition and adequate sleep play an important role in managing your energy.
  6. Take a short break when you find yourself straining to listen. This could happen at work, during meetings, social events or even when you are simply tired.
  7. Step away and tune out to reduce stimulation and help to de-stress and refresh.
  8. Prioritize activities that are most important to you during the holiday season such as family get togethers or social events. This will help ensure that you have enough energy for those listening-based activities that are special.

While it might not always be possible to fully schedule the day around upcoming listening demands, having an awareness that listening effort can impact energy level means they will be more likely to take a break from listening when applicable. Planning in advance enables your recipients to be at their best when listening really matters.

To find out more about listening effort, preventing listening fatigue at the holidays and practical tips from other recipients, download Cochlear CoPilot.

About the author: Dr. Hughes is currently a Research Fellow at the Centre for Patient Reported Outcome Research (CPROR) at the Institute of Applied Health, University of Birmingham in the UK. She received her M.H.Sc in speech-language pathology from the University of Toronto, Canada, and her PhD at Swansea University Medical School, Wales, UK where she was a James Callaghan Scholar whose research focused on the development and validation of a new patient-reported outcome measure of listening effort in adult cochlear implant recipients.  Dr. Hughes has worked on several collaborations with the Australian Hearing Hub and the Australian Institute of Health Innovation, Macquarie University, Sydney, Australia, and she is a Core Member of the Adult Rehabilitation Special Interest Group, British Society of Audiology.

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Surgical Outcomes of CI532 Clinical Study: Does electrode placement impact hearing performance?

July 8, 2019

In the spring of this year, sixty-five otology and audiology professionals came together for Cochlear NEXT – a program focused on learning and discussion regarding Cochlear’s CI532 Clinical Study and the respective implications of this emerging and impactful data.

The following information reviews the primary talking points and output from the day’s first topic.

 Surgical Outcomes of CI532 Clinical Study: Does electrode placement impact performance?

Presenters:

  • Wade Colburn, Biomedical Engineer and Product Manager, Cochlear Implants, Cochlear Americas
  • Jonathan McJunkin, MD, Surgeon and CI532 study Investigator, Washington University in St. Louis

A review of published (non-CI532) evidence demonstrates prevailing thought regarding the relationship between electrode placement and hearing performance, prior to the CI532 study:

  • Pre-curved arrays may be less likely to be placed in scala tympani 1
  • ERW and RW may lead to more consistent scala tympani placement 1, 2, 3
  • Electrode placement within scala tympani significantly impacts patient performance 4

When asked in a pre-event survey, only 66% of surgeons agreed that consistent placement in the scala tympani is as likely to occur with CI532 as it is with lateral wall electrode arrays. There was also some difference of opinion on the importance of electrode placement, with only 64% of surgeons agreeing that proximity of the array to the modiolus has an impact on hearing performance.

However, CI532 clinical study results demonstrate that rates of scala tympani placement of the CI532 electrode are on par with previously cited studies using lateral wall electrodes, with 89% of electrodes being successfully inserted in the scala tympani 5. A mean wrapping factor of 59.6% – which describes the proximity of the electrode to the modiolus – further illustrates the consistency of surgical outcomes using the Slim Modiolar electrode5.  For reference, Holden et al. showed that patients with a wrapping factor closer to 60% positively correlated with better hearing performance6.

 Following presentation of the data and dynamic group discussions, participant consensus shifted considerably according to the post-event survey, with now 86% of surgeons agreeing that consistent placement in the scala tympani is as likely to occur with CI532 as it is with lateral wall electrode arrays. Further, 82% supported that proximity of the electrode array to the modiolus has an impact on hearing performance.

Additional discussion focused on the topic of surgical approach, as one of the key design goals of CI532 was an electrode that is indicated for round window (RW), extended round window (ERW), and cochleostomy – allowing surgeons to utilize flexibility and preference when determining surgical technique.  Live polling during the NEXT program demonstrated a strong preference for the RW and ERW approaches confirming a perceived industry shift away from cochleostomy as surgeons strive to limit structural trauma caused by implant insertion.

In summary, a review of current and historical data, combined with dynamic large and small group discussions, drove a measurable change in participant perception regarding the positive correlation between electrode placement and hearing performance.

Don’t miss the next installment of our Cochlear NEXT proceedings: Clinical Outcomes of CI532 Clinical Study: A new clinical care approach. Subscribe to our ProNews Blog using the panel to the left to ensure you receive future updates!

 

© Cochlear Limited 2019. All rights reserved. Hear now. And always and other trademarks and registered trademarks are the property of Cochlear Limited or Cochlear Bone Anchored Solutions AB. The names of actual companies and products mentioned herein may be the trademarks of their respective owners.

 References

  1. O’Connell BP, Hunter JB, Wanna GB. The importance of electrode location in cochlear implantation. Laryngoscope Investig Otolaryngol. 2016;1(6):169–174. Published 2016 Nov 29. doi:10.1002/lio2.42
  2. Wanna GB, Noble JH, Carlson ML, et al. Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes. Laryngoscope. 2014;124 Suppl 6(0 6):S1–S7. doi:10.1002/lary.24728
  3. Briggs RJ1, Tykocinski M, Stidham K, Roberson JB. Cochleostomy site: implications for electrode placement and hearing preservation. Acta Otolaryngol. 2005 Aug;125(8):870-6.
  4. Shaul C, Dragovic AS, Stringer AK, O’Leary SJ, Briggs RJ. Scalar localization of peri-modiolar electrodes and speech perception outcomes. J Laryngol Otol 2018; 1- https://doi.org/10.1017/S0022215118001871
  5. Preliminary Data on File: US Multicenter CI532 Study. 2018.
  6. Holden et al. Factors affecting open-set word recognition in adults with cochlear implants. Ear and Hearing. 2013; 34:342-60. https://www.ncbi.nlm.nih.gov/pubmed/23348845

 

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