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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Artificial Intelligence – Use in Healthcare by Brian Kaplan, MD

August 31, 2018

Research updates

 

By guest author: Brian Kaplan, M.D. – Chair, Department of Otolaryngology-Head and Neck Surgery at Greater Baltimore Medical Center Director, Cochlear Implant Program at Greater Baltimore Medical Center

Artificial Intelligence (AI) has been around for some time. Every day we see another story about the use of artificial intelligence, machine learning or big data in the news. Advances in medicine have often relied on new discoveries in science and now healthcare is being transformed by the use of these advanced technologies.

In 1959, Arthur Samuel was credited with being the first person to realize that we could not teach a computer everything we know in order to complete given tasks. We needed to teach computers how to learn for themselves1. This discovery, along with the advent of the internet, set into motion the ability for computers to take the next step into current state-of-the-art AI and machine learning. In the 1960s, researchers developed the first problem-solving systems in organic chemistry, which is considered the first application of artificial intelligence. By the 1970s, researchers moved from basic science to applications in medicine with attempts to automate diagnosis2. Today, most AI employed in healthcare revolves around classification using deep learning technologies. It is not that AI systems cannot diagnose certain conditions, but the requirement for machine learning has changed from high cognitive function to classifications tasks. This step in the use of technology requires convincing humans that the classifications are accurate, consistent and repeatable. In a recent study, AI systems were found to be able to identify melanomas (through classification) at a higher rate than expert dermatologists and with greater sensitivity and specificity3. However, the most successful AI solutions are those that augment human action rather than replace it.

There was a time when some experts predicted the use of robots in all areas of healthcare, specifically in surgery. Granted there are some rote aspects of surgery that a robot can certainly handle, but the state-of-the-art techniques employed today are robot-assisted surgery. In LASIK surgery, a skilled surgeon uses a robotic device to complete most of the procedure. The surgeon is still responsible for all of the measurements and calculations required during the surgical procedure and is certainly the crucial asset in the case of an emergency or unexpected anatomy. Machines have an innate advantage during rote tasks of being fast, accurate and operate with a lack of bias, but human discernment provides a successful outcome when unanticipated events occur. Robotic capabilities in surgery may eventually allow remote-robotic surgery. This could change clinical care by providing care to patients who may not otherwise receive advanced care. This increase in access to care is beneficial to remote patients and the clinicians who care for them.

New AI tools help medical professionals change their clinical practice and to standardize care. Allowing AI systems to assist professionals can not only standardize care, it can increase productivity. The key to successful use of AI systems is to ensure the human factor never fades from the healthcare appointment. In the study mentioned previously, once the dermatologists were provided with additional information from the patients, their diagnostic accuracy increased and the article concludes that there was no substitute for a thorough clinical examination to provide a full healthcare picture for patients and their providers.

AI is integrated into many aspects of our lives and we should expect that to continue. Growth in the healthcare sector continues to be strong with one source estimating that artificial intelligence in US healthcare will continue at 35% rate for the next eight years4. Many predictors bemoan the hurdles needed to fully integrate AI into mainstream healthcare. Using AI to standardize care provides assistance to professionals, which allows for enhancing the lives of patients and healthcare professionals.

See the references below for more information.

About our guest author: Brian Kaplan, M.D. – Chair, Department of Otolaryngology-Head and Neck Surgery at Greater Baltimore Medical Center Director, Cochlear Implant Program at Greater Baltimore Medical Center

Dr. Kaplan was born and raised in Boston, Massachusetts. He attended Cornell University before enrolling at the University of Virginia for both medical school and residency training. He currently serves as the Chairman of the Department of Otolaryngology, and Director of the Cochlear Implant Program, at the Greater Baltimore Medical Center.

Past research interests have included cartilage and inner ear hair cell regeneration. Clinical studies have involved various ototopical agents, along with hybrid and traditional cochlear implantation.

Dr. Kaplan spent over ten years consulting in the medical device and services space, working with venture, public and private equity. In 2013 he cofounded the technology company Everseat, providing a novel, mobile platform optimizing scheduling efficiency for medical practices, hospitals and health systems. He was a consultant for several years for Cochlear before becoming the Global Head of Clinical Innovation, focusing on modernizing the delivery mechanism and creating the standard of care for cochlear implantation.

He currently resides in Baltimore, Maryland, USA, with his wife and three children.

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  1. https://en.wikipedia.org/wiki/Arthur_Samuel
  2. Uchan, S. February 8th, 2018, blogpost “AI in Medicine – A Historical Perspective” https://rowanalytics.com/blog-post/ai-in-medicine-a-historical-perspective/
  3. Welch, A. May, 29, 2018, CBS NEWS “AI better than dermatologists at detecting skin cancer, study finds” https://www.cbsnews.com/news/ai-better-than-dermatologists-at-detecting-skin-cancer-study-finds/
  4. Taylor, Phil April 13th, 2018, PMLive “Artificial intelligence in healthcare ‘set for 40% growth to 2024’” https://www.pmlive.com/pharma_news/artificial_intelligence_in_healthcare_set_for_40_growth_to_2024_1231723?es_p=6544595
kanso 2

Expert opinion: Kanso® 2 Sound Processor first impressions

October 15, 2020

By Allison M. Biever, AuD, CCC-A, Rocky Mountain Ear Center

Background

I have been involved in the cochlear implant field for 28 years.  How fulfilling it is to be a part of someone’s hearing journey! I was initially drawn to the field of Speech and Language Pathology and enrolled in the master’s program at CU Boulder in 1989.  After switching majors, it was natural that audiology would have a special place for me, since I was raised by a mother who was born with moderate-to-severe sensorineural hearing loss. 

Why off-the-ear?

Kanso 2

During the COVID-19 pandemic, patients have frequently complained about how hard it is to keep their behind-the-ear processor on when they are also wearing a mask.  One of my cochlear implant patients wears her Nucleus® 7 Sound Processor, the bow of her eyeglasses, a mask and an oxygen tube behind her ear.  She told me, “There isn’t enough room for everything I have to wear behind my ear!”. Having an off-the-ear option for cochlear implant recipients is a big deal. 

Patients who have had a sudden hearing loss and have never had to wear a hearing aid are often very uncomfortable with the feel of something behind the ear.  Some patients have malformed pinnas or pinnas that are close to their heads, making a behind-the-ear sound processor a non-viable option.  Cochlear implant recipients who have tried both a behind-the-ear processor and an off-the-ear option will frequently tell me that the off-the-ear option is considerably more comfortable. 

Initial experience with Kanso® 2 Sound Processor

In mid-July, I was invited to participate in a controlled market release of the Kanso 2 Sound Processor. This amazing sound processor has already changed the lives of the recipients I have been seeing in our clinic.  At activation, I have been fitting both the Nucleus® 7 Sound Processor and the Kanso 2 Sound Processor to our newly implanted recipients.  Our activations are typically conducted a few weeks after surgery. Almost half of the patients returned for their follow-up visits two weeks later wearing the Kanso 2 Sound Processor.  The patients reported it was more comfortable to wear and at two weeks device retention was not an issue.

The Kanso 2 Sound Processor is the diameter of a “Loonie”, which is the Canadian one-dollar coin.  Unlike the first generation Kanso Sound Processor, Kanso 2 Sound Processor is rechargeable and can be controlled from a smartphone+ so that changes can be made to improve auditory performance if needed.  The recipient can check battery life, change volume, master volume, bass, treble or sensitivity.  Recipients can change programs or initiate streaming to an accessory simply by manipulating the app on their smartphone.+ 

Advanced connectivity and beyond

Additionally, recipients who have compatible Apple® or Android™ devices can stream directly to their Kanso 2 Sound Processor, creating an environment for easier phone conversations. Although the technology is similar between the Nucleus 7 Sound Processor and the Kanso 2 Sound Processor, more patients are finding ease of charging the device, ease of putting the device on and overall comfort to be superior with Kanso 2 Sound Processor.  I have also fit several elderly adults with fine motor difficulties and vision deficits who have reported ease of use. 

On average, the Kanso 2 Sound Processor requires less time for counseling because there are fewer parts to manipulate and discuss with the newly-activated recipient.  The entire processor can be placed in a charging case each night for ease of charging.

Smart has never been so simple

One of my favorite features of the Kanso 2 Sound Processor is the “buttonless” design.  Frequently, when patients are given multiple programs, they will inadvertently touch the button on their sound processor and change the program without being aware they have made a change. The simplicity of the Kanso 2 Sound Processor is spectacular!  The recipient can just tap the processor three times to turn it off and twice to turn it on.  I love that it has become so incredible easy for recipients to use.  If I had to choose one processor to use for many of my patients, I would choose the Kanso 2 Sound Processor because of its simplicity.

To learn more about Cochlear’s latest innovations please view this webinar and read this interview.

About the author: Dr. Allison Biever received her bachelor’s degree from the University of Alberta in 1989 and her master’s degree in Audiology at the University of Colorado in 1992, after which time she worked as a fellow in the first cochlear implant program in Colorado. In 2005 she received her Au.D. from Central Michigan University, completing a doctoral thesis that examined the impact of residual hearing on cochlear implantation in children.

Her focus at the Rocky Mountain Ear Center has been helping people regain their hearing through the miraculous technology of cochlear implants. She was awarded the LaFawn Biddle Award and the Hands & Voices Families First Award for her outstanding service to the deaf and hard of hearing community. In addition to her work in the clinic, she is also a prominent researcher in the field of cochlear implants, an instructor for Institute for Cochlear Implant Training (ICIT) and is on the board for the Listen Foundation. Allison enjoys hiking and spending time with her husband and three daughters. She is also an avid runner and Boston Marathon participant.

+The Cochlear Kanso 2 Sound Processor, Nucleus 7 Sound Processor and Nucleus Smart App are compatible with Apple and Android devices, for compatibility information visit www.cochlear.com/compatibility

Apple is a service mark of Apple Inc., registered in the U.S. and other countries.

Android and Google Play are registered trademarks of Google Inc.The Android robot is reproduced or modified from work created and shared by Google and used according to terms described in the Creative Commons 3.0 Attribution License.

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This material is intended for health professionals. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

 

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