Cochlear Implants
by Michaela Coon

5 tools to expand your knowledge on the Slim Modiolar Electrode

December 4, 2019
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1. Cochlear NEXT Video Series

In Spring 2019, sixty-five of your peers came together to discuss Cochlear’s CI532 Clinical Study and the implications of this emerging and impactful data.

The Cochlear NEXT video series captures the highlights of the day’s presentations with a focus on the surgical and clinical outcomes of the CI532 Clinical Study. It also discusses opportunities for hearing preservation with the Slim Modiolar electrode.

2. Audiology Online Course: Setting a New Benchmark with the Slim Modiolar Electrode

Did you miss Audiology Online’s webinar on the recent clinical evidence surrounding the Slim Modiolar electrode and its impact on performance? Watch the course now!

After attending this course you’ll be able to:

  • Explain the clinical evidence supporting the use and performance of perimodiolar electrode arrays
  • List audiological considerations with the Slim Modiolar array
  • Understand the outcomes of the new multicenter trial and bimodal benefits of the Nucleus® 7 system with Slim Modiolar

3. Educational Webinar: CI532 Best Practices – A Surgeon’s Perspective

Join NYU’s Dr. Thomas Roland in his March 2019 webinar as he discusses his experiences and best practices with the CI532 Slim Modiolar Electrode.

Topics include:

  • NYU surgical and speech performance outcomes
  • Surgical best practices
  • Case management
  • When to use CI532

4. TECH TALK: The CI532 Slim Modiolar Electrode Advantage

Dr. Anil Lalwani, Vice Chair of Research in Otolaryngology, Head, Neck and Surgery at Columbia University Medical Center, prefers the Slim Modiolar electrode above the rest.

In this TECH Talk, he outlines the many advantages to the Slim Modiolar Electrode including its small size, proximity to the modiolus and atraumatic properties. Further, his experience demonstrates that the Slim Modiolar electrode may preserve hearing and protects the electrode through the sheath function, preventing chances of getting stuck. Because the Slim Modiolar minimizes variation in surgical technique and chances of intracochlear trauma, it takes the lead as the safer option with a focus on patient outcomes.1

Watch now:

5. Journal Club: Speech recognition as a function of the number of channels in perimodiolar electrode recipients

This Journal Club explores a recent study by the team at Vanderbilt University Medical Center in a March 2019 publication, Speech recognition as a function of the number of channels in perimodiolar electrode recipients. This study revealed that increasing the number of electrodes resulted in improved performance and sound quality. Findings were statistically significant in demonstrating that the subjects with the electrodes closest to the modiolus had the best performance.

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References:

  1. Roland JT, A Model for Cochlear Implant Electrode Insertion and Force Evaluation: Results with a New Electrode Design and Insertion Technique, Laryngoscope 115: August 2005
Related Posts

FDA approves Cochlear’s Nucleus 8 Sound Processor, smaller, smarter, better connected cochlear implant technology

November 1, 2022

The Nucleus 8 Sound Processor is the world’s first cochlear implant sound processor ready for Bluetooth LE Audio technology

Lone Tree, Colo. (November 1, 2022) — Cochlear Limited (ASX: COH), the global leader in implantable hearing solutions, receives U.S. Food and Drug Administration (FDA) approval for the CochlearTM Nucleus® 8 Sound Processor. The Nucleus 8 Sound Processor is now the smallest and lightest behind-the-ear cochlear implant sound processor available in the industry. 1-3 It is also the world’s first cochlear implant sound processor ready to provide direct audio connectivity to everyday consumer electronics using the next generation LE Audio technology from Bluetooth®.1-3,#

The Nucleus 8 Sound Processor features Cochlear’s latest and most innovative hearing technology that can sense changes in a person’s environment and automatically adjust their listening settings.4-7* It also includes an enhanced ForwardFocus+ feature, which effectively reduces distracting background noise to make face-to-face conversations clearer, especially in noisy environments.8,^ Cochlear continues its commitment to reduce the size of each processor generation with the new behind-the-ear sound processor being 15 percent smaller and 13 percent lighter than its predecessor.9, ± 

For more on the Nucleus 8 Sound Processor, visit www.Cochlear.US/Nucleus8.

“Cochlear’s goal is to help people feel empowered to connect with their world and make it easier to hear and be heard,” said Lisa Aubert, President, Cochlear Americas. “In a restaurant, at work, at school, or spending time with family and friends – life’s full of opportunities to engage with others. The Nucleus 8 Sound Processor is our smallest, lightest and smartest behind-the-ear sound processor yet and is designed to help people hear conversations more clearly and comfortably, wherever life may take them.”

Smaller, smarter and better connected

The Nucleus 8 Sound Processor builds on the direct streaming capabilities available in Cochlear’s latest sound processors. With access to next-generation Bluetooth LE Audio, it will be easier than ever to directly connect to everyday technology in more places and from more devices than ever before.10-12,# People will be able to conveniently connect directly to broadcasts at public venues such as airports, conference centers, sport stadiums and gyms that support Bluetooth’s next generation Auracast™.

“Cochlear continues to lead in innovation that matters most, delivering smaller and smarter sound processors to improve hearing performance that’s comfortable and easy to use,” said Ryan Lopez, Director, Nucleus Product Management & Marketing, Cochlear Americas. “The Bluetooth LE Audio connectivity in the Nucleus 8 Sound Processor will provide those with hearing loss new, more convenient ways to stream audio to their sound processor, including making it easier for children and adults to engage in the world around them. From the classroom to the conference room, we want to help reduce the stress of life’s interactions with the Nucleus 8 Sound Processor.”

In addition to the Nucleus 8 Sound Processor, Cochlear is expanding its Connected Care solutions for Nucleus Implant System recipients. Building upon the ability to let cochlear implant recipients adjust their own processor settings and access Remote Care** options from their mobile phone, enhancements to the Nucleus Smart App will enable future improvements to the bimodal control experience and provide access to Remote Firmware updates, so patients can conveniently access the latest technology without a trip to the clinic.   

For those living with severe to profound sensorineural hearing loss, cochlear implants are a proven medical treatment option. Cochlear implants are the most appropriate option to treat hearing loss when it has reached the level of severe to profound. However, conservative estimates suggest that only 1 in 20 adults worldwide who could benefit from a cochlear implant has one.13,14 Better hearing can help people reach their full potential.

The Nucleus 8 Sound Processor will be commercially available across the United States and Canada by the end of 2022. The Nucleus 8 Sound Processor has been approved by Health Canada.

About Cochlear Limited (ASX: COH)

People have always been Cochlear’s inspiration, ever since Professor Graeme Clark set out to create the first multi-channel cochlear implant after seeing his father struggle with hearing loss. Since 1981, Cochlear has provided more than 700,000 devices in more than 180 countries, helping people of all ages around the world to hear. As the global leader in implantable hearing solutions, Cochlear connects people with life’s opportunities, and welcomes them to the world’s largest hearing implant community.

Cochlear has a global workforce of more than 4,500 people, with a passion for progress, who strive to meet the needs of people living with hearing loss. The company continually innovates to anticipate future needs, investing more than AUD$2 billion to date in research and development to push the boundaries of technology and help more people hear.

www.cochlear.com/us

References

  1. [cited 2022 Feb 28]. Available from: https://www.advancedbionics.com/
  2. [cited 2022 Feb 28]. Available from: https://www.medel.com/
  3. [cited 2022 Feb 28]. Available from: https://www.oticonmedical.com/
  4. Cochlear Limited D1864200 SCAN-X Design Description. Apr 2022.
  5. Mauger SJ, Warren C, Knight M, Goorevich M, Nel E. Clinical evaluation of the Nucleus 6 cochlear implant system: performance improvements with SmartSound iQ. International Journey Of Audiology. 2014, Aug; 53(8): 564-576. [Sponsored by Cochlear]
  6. Mauger S, Jones M, Nel E, Del Dot J. Clinical outcomes with the Kanso™ off- the-ear cochlear implant sound processor. International Journal Of Audiology. 2017, Jan 9; 1-10. [Sponsored by Cochlear]
  7. Wolfe J, Neumann S, Marsh M, Schafer E, Lianos L, Gilden J, O’Neill L, Arkis P, Menapace C, Nel E, Jones M. Benefits of Adaptive Signal Processing in a Commercially Available Cochlear Implant Sound Processor. Otol Neurotol. 2015 Aug;36(7):1181-90. [Sponsored by Cochlear]
  8. Cochlear Limited. D1964109 Clinical Investigation Report CLTD5804. Feb 2022.
  9. Cochlear Limited. D1190805, Processor Size Comparison. May 2022.
  10. Hunn N. Introducing Bluetooth® LE Audio [Internet]. [cited 2022 Jan]. Available from: https://www.bluetooth.com/learn-about-bluetooth/recent-enhancements/le-audio/.
  11. Cochlear Limited. D1631375 Nucleus 8 Sound Processor Product Definition.
  12. A Technical Overview of LC3 [Internet]. Bluetooth® Technology Website. [cited 2022 Feb 28]. Available from: https://www.bluetooth.com/blog/a-technical-overview-of-lc3.
  13. Sorkin D. Cochlear implantation in the world’s largest medical device market: utilization and awareness of cochlear implants in the United States. Cochlear Implants Int 2013;14(Suppl 1):S1.
  14. De Raeve L. Cochlear implants in Belgium: Prevalence in paediatric and adult cochlear implantation. Eur Ann Otorhinolaryngol Head Neck Dis 2016;133(Suppl 1):S57–60.

Disclaimers

# When the technology becomes available for the Cochlear Nucleus 8 Sound Processor, a firmware update to your sound processor will allow you to connect to Bluetooth LE Audio compatible devices.

* Compared to Nucleus 6 and 7 Sound Processors.

+ ForwardFocus can only be enabled by a hearing implant specialist. It should only be activated for users 12 years and older who are able to reliably provide feedback on sound quality and understand how to use the feature when moving to different or changing environments. It may be possible to have decreased speech understanding when using ForwardFocus in a quiet environment.

^Compared to Nucleus® 7 Sound Processor with ForwardFocus on.

±Comparison made using the Compact Battery Module for Nucleus 8 Sound Processor and the Compact Rechargeable Battery for Nucleus 7 Sound Processor.

**Remote Check and Remote Assist are intended for ages 6 and older. Remote Check and Remote Assist features are only visible and accessible if they are enabled by a clinician. Clinicians should consider the suitability of the feature before enabling Remote Check and Remote Assist.

The Bluetooth® and AuracastTM word mark and logos are registered trademarks owned by Bluetooth SIG, Inc., and any use of such marks by Cochlear Limited is under license.

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 follow the directions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

© Cochlear Limited 2022. All rights reserved.

Dr. Sakaan

Reliability reporting with Madison Sakaan, AuD

October 25, 2021

Madison Sakaan, Cochlear Implant Program Director at Johnson Audiology, describes the importance of reliability and reliability reporting from a clinician’s perspective. 

Dr. Sakaan

Tell us a little bit about yourself, Dr. Sakaan. What’s your favorite part about being an audiologist?

I have been with Johnson Audiology in Chattanooga, Tennessee for just over two years. I received my Doctorate degree from East Tennessee State University in 2019. I completed my externship at the University of Kentucky Otolaryngology Clinic. The University of Kentucky has quite an extensive cochlear implant program and it provided wonderful clinical experience. My love for cochlear implants really blossomed at that time.

Working with patients who have severe to profound hearing loss is my passion. There is something very special about working with and interacting with cochlear implant patients. As a clinician, I feel I connect with these patients on a deeper level, because their cochlear implant journey is unique and personal. I am always grateful for the opportunity to take part in their hearing journey.

Let’s talk about reliability. Do you discuss long term reliability when counseling patients?  If so, why?

I do discuss long term reliability with patients. I feel it is important to be transparent when discussing reliability and longevity of the internal as well as external device. I always put myself in the patient’s shoes and try to give them access to all information I myself would want access to when making such a life altering decision. It is important for them to know their options.

What impact does reliability have on you as a clinician with regard to patient care?

Reliability has a significant impact on patient care. In terms of the implant, all audiologists want their patients to have reliable devices that will last a lifetime. We want our patients to have confidence in their device. Therefore, when an internal device failure does occur, it is very discouraging for both the patient and the clinician. Even though the device failure is no fault of the clinician, it is still easy to feel as if you let your patient down.

Considering external equipment, I feel I can speak for most audiologists when I say that there is nothing more frustrating than sitting down with your patient to address their complaint and a piece of equipment is not functioning correctly. This could be anything from programming software, programming cables, wireless accessories, Bluetooth®, sound processors, coil/headpieces, batteries, etc. Since beginning my career, I’ve learned that if something can go wrong, it likely will at some point. That is why it is important to have resources at your disposal. No implant company is immune to software and equipment malfunction. Therefore, customer service, tech/software support and Audiology on Call is incredibly important and I consider them to be another layer of a company’s reliability.

Reliability also affects the patient experience in daily life. When a patient’s sound processor is functioning intermittently or ceases to function all together, it can completely derail their plans for the day. As a two-processor center, most of my patients have a back-up processor ready to use when necessary, but for some patients, they only have one functioning processor. In a perfect world, all patients would keep back up parts such as cables, batteries and coils ready to use when current equipment fails. Unfortunately, we do not live in such a world. This is when accessible and efficient customer services, such as signHEAR, are critical. Most patients will receive their replacement equipment in one to two days, enabling them to return to their daily activities.

Why is reporting standardization vital to the industry? 

In the past, the Cochlear Nucleus® Implant Reliability Report was produced following the guidelines of International Standard ISO 5841-2, the European Consensus Statement on Cochlear Implant Failures and Explanations and the International Classification of Reliability for Implanted Cochlear Implant Receiver Stimulators. More recently in 2017, the ANSI/AAMI CI86 Standard outlined requirements for the reporting of implant reliability; this includes the internal device as well as the external sound processor.

Therefore, Cochlear now has two reliability reports. There are three major differences between the European Consensus Statement Report and the ANSI/AAMI CI86 Reliability Report.

  • First, the ANSI/AAMI CI86 Reliability Report uses the Cumulative Removal Percentage (CRP) as the reporting measurement. This means that all implants removed are reported, even those removed due to infection while the internal device is still functioning properly. This differs from the European Consensus Statement Reliability Report in that it uses Cumulative Survival Percentage (CSP) which reports the percentage of functioning implants. This is an important difference to keep in mind when comparing the reports.
  • Second, the ANSI/AAMI CI86 Reliability Report defines a child as age of <10 years old at time of implantation. The European Consensus Statement Reliability Report defines a child as age of <18 years old at time of implantation.
  • Lastly, the European Consensus Statement Reliability Report only reports on implant reliability. The ANSI/AAMI CI86 Standard also requires reporting of external sound processor reliability; therefore, this is included in the ANSI/AAMI CI86 Reliability Report.

When considering reporting on the reliability of cochlear implants, clinicians need to be able to make equivalent comparisons between factors for the data to have any value. In other words, we want to make sure we are comparing apples to apples.

To run through a scenario, let’s say Company A is reporting a 1% Cumulative Removal Percentage (CRP) and company B is reporting a 4% Cumulative Removal Percentage (CRP). On the surface, Company A seems like the obvious choice for good reliability. However, we later realize that Company A only reported data on its newest internal device which was released just two years ago while Company B reported data from all previous devices, including legacy devices. Again, we have to compare apples to apples for the data to be meaningful and useful in clinician and patient decision making. All manufacturers should be using the same criteria when reporting reliability. This is why standardization of reporting is critical.

Read the latest reliability report to learn more!

About the author:

Dr. Madison Sakaan attended undergraduate school at University of Tennessee Knoxville where she earned her Bachelor of Science in Education. She attended graduate school at East Tennessee State University where she earned her Doctor of Audiology. Dr. Sakaan specializes in cochlear implants and bone conduction hearing devices at Johnson Audiology. She currently lives in Chattanooga, Tennessee with her husband, Dan, who is an Emergency Medicine resident physician. She is an avid runner who also enjoys hiking, traveling and biking in her free time.

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©Cochlear Limited 2024. All rights reserved. ACE, Advance Off-Stylet, AOS, Ardium, AutoNRT, Autosensitivity, Baha, Baha SoftWear, BCDrive, Beam, Bring Back the Beat, Button, Carina, Cochlear, 科利耳, コクレア, 코클리어, Cochlear SoftWear, Contour, コントゥア, Contour Advance, Custom Sound, DermaLock, Freedom, Hear now. And always, Hugfit, Human Design, Hybrid, Invisible Hearing, Kanso, LowPro, MET, MP3000, myCochlear, mySmartSound, NRT, Nucleus, Osia, Outcome Focused Fitting, Off-Stylet, Piezo Power, Profile, Slimline, SmartSound, Softip, SoundArc, True Wireless, the elliptical logo, Vistafix, Whisper, WindShield and Xidium are either trademarks or registered trademarks of the Cochlear group of companies. The names of actual companies and products mentioned herein may be the trademarks of their respective owners.

 

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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