by Ryan Lopez

5 reliability reporting considerations

August 11, 2021

By Ryan Lopez, Director of Nucleus® Product Management & Marketing

With more than two decades of reporting on reliability, cochlear implants have set the bar high, and the data and information can be interpreted in different ways. Having access to and understanding the complete data and information is important. Transparency in reporting and the importance of reliability over time, to name a few, help patients and professionals have access to the full picture of implant reliability.

Here are 5 things to remember when reading a Reliability Report:

All implant generations are reported

Are all device generations represented and how many years from each generation are being reported?

Total number of registered devices over time

Are the number of implants included for each of those generations?

Reports reliability by children and adult

Does the report separate out pediatrics versus adult?

Cumulative survival rate and device removals

In addition to our standard report, in 2019 Cochlear was the first to comply with an industry-driven partnership that developed reporting guidelines compliant with ANSI/AAMI standards. As a result, our reporting has further increased in transparency in implant reliability reporting based on Cumulative Survival Rate (Cochlear Annual Report) and implant reliability report based on device removals (ANSI/AAMI Report).

External reliability

Does the report include sound processor reliability reporting in addition to implant reliability?

Read the 2021 Reliability Report now!

New evidence supports the performance benefits of ForwardFocus

September 19, 2019

By Amy Donaldson, Professional Education Manager

Your patients now have the freedom to focus on what matters – connecting with others.

Incorporated as a standard feature on the Nucleus® 7, ForwardFocus* is a revolutionary setting that goes beyond the state-of-the art scene analysis and adaptive directional microphones of SmartSound iQ® and allows users to enable maximum focus on what matters most to them. It is specially designed for the most challenging listening environments, such as listening to speech in a busy restaurant.

ForwardFocus is intelligently designed to attenuate distracting noise from behind the listener, making it easier to enjoy face-to-face conversation and maximizing understanding of speech from the front.¹ It differs from the automated directionality in SmartSoundiQ by providing a more focused listening experience. In an internal study using roving background noise, an average improvement of 2.9 dB was seen for speech recognition thresholds in noise over the default SCAN** program.¹ In that same study, 88% of Nucleus 7 recipients recommended ForwardFocus for use in cafes and restaurants.

Evidence supporting the use of ForwardFocus in challenging listening environments is emerging beyond Cochlear’s internal studies. A recent study from Germany compared ForwardFocus to BEAM (the directional microphone utilized within SmartSound iQ).² A significant improvement of 5.8 dB was seen using the ForwardFocus program in 3-talker babble (noise presented from fixed positions of 90°, 180° and 270°), bringing performance closer to normal than with BEAM.

Using ForwardFocus, recipients demonstrated statistically significant improvement in both conditions of spatially separated noise.¹This can result in an improved and controlled listening experience as rear-facing noise is reduced.

ForwardFocus must be enabled in Custom Sound fitting software before it can be used by the recipient. This is because in certain situations (for example, if the recipient needs to hear sound from behind), ForwardFocus is not the best option. Recipients must be instructed on the use of ForwardFocus and should be able to manually enable and disable this feature, something made even easier with the introduction of the Nucleus Smart App for Apple Watch®. This new feature allows for convenience control at their fingertips with a discreet tap. Patients can change programs, see battery status, adjust volume and select audio source, making it easier to use than ever before!

For more information about using ForwardFocus with your patients, please consult the ForwardFocus Clinician Quick Guide.

Encourage your patients to download the Nucleus Smart App now from Apple® App Store or on Google Play!

About the author: Amy Donaldson is an Audiologist and Professional Education Manager for Cochlear Americas. She received her Master’s Degree in Audiology from the State University of New York at Buffalo and her AuD from the University of Florida. She was privileged to begin her career as a pediatric audiologist and gain extensive clinical experience in implantable hearing devices at the University of Michigan in Ann Arbor and at the Manchester Cochlear Implant Programme in the United Kingdom. After working for several years as an Educational Audiologist and Technical Support Audiologist in the hearing aid industry, she returned to hearing implants and Cochlear in 2011.

References

Cochlear Limited. D1376556.CLTD5709 Acceptance and Performance with the Nucleus 7 Cochlear Implant System with Adult Recipients. 2018 Jan; data on file.
Hey M, Hocke T, Böhnke B, Mauger SJ (2019) ForwardFocus with cochlear implant recipients in spatially separated and fluctuating competing signals – Introduction of a reference metric. Int J Audiol, 57(2).

*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.

**SNR-NR, WNR and SCAN are approved for use with any recipient ages 6 years and older who is able to 1) complete objective speech perception testing in quiet and in noise in order to determine and document performance 2) report a preference for different program settings.

The Cochlear Nucleus Smart App is available on App Store and Google Play. For compatibility information visit www.cochlear.com/compatibility
The Cochlear Nucleus 7 Sound Processor is compatible with iPhone, iPad and iPod touch. Apple, the Apple logo, FaceTime, Made for iPad logo, Made for iPhone logo, Made for iPod logo, iPhone, iPad Pro, iPad Air, iPad mini, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries.

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

Android is a trademark of Google LLC. 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.

Google Play and the Google Play logo are trademarks of Google LLC.

New TECH Talk: Age of implantation and critical development window

May 11, 2020

Dr. Jace Wolfe, clinical audiologist and Director of Audiology and Research at the Hearts for Hearing Foundation in Oklahoma City, uses his 22 years of cochlear implant experience to examine results from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) Study based out of Australia to understand the long-term impact of age at implantation. The March 2020 FDA approval to expand pediatric indications to nine months further reinforces the urgency to give pediatric patients early access to sound, especially as they reach hearing and language milestones.

Moreover, the LOCHI study observed children from the age of hearing loss identification until early adulthood to explore speech, language, literacy, auditory, educational, vocational, social and pragmatic outcomes. Wolfe further recaps the factors that may influence hearing outcomes such as age of implantation.

Key finding of the LOCHI Study:

For every 6-month delay in implantation there’s a ½ standard deviation (about seven points from the mean score for a standardized measure of language ability) reduction in their language outcomes.^1,2

This suggests the presence of a critical window for language development and auditory stimulation. Through partnership, together we can reach further to give pediatric patients early access to sound.

“Every moment within that critical period counts,” Wolfe concludes.

To learn more about early implantation visit our TECH Talks page or website.

References:

Ching, T.Y., Dillon, H., Leigh, G., & Cupples, L. (2018). Learning from the longitudinal outcomes of children with hearing impairment (LOCHI) study: summary of 5-year findings and implications. International Journal of Audiology, 57(2), S105-S111.
Ching, T.Y., Dillon, H., Button, L., Seeto, M., Buynder, P.V., Marnane, V., Cupples, L., & Leigh, G. (2017). Age at Intervention for Permanent Hearing Loss and 5-Year Language Outcomes. Pediatrics, 140 3.

In the US, the cochlear implant system is intended for use in children 9 to 24 months of age who have bilateral profound sensorineural deafness and demonstrate limited benefit from appropriate binaural hearing aids. Children two years of age or older may demonstrate severe to profound hearing loss bilaterally. In the Canada, the cochlear implant system is intended for use in children 12 to 24 months of age who have bilateral profound sensorineural deafness and demonstrate limited benefit from appropriate binaural hearing aids. Children two years of age or older may demonstrate severe to profound hearing loss bilaterally.