Cochlear Implants
by Parri Tantillo

Bringing Ease and Convenience to Bimodal Control

August 9, 2023
Share

Since 2011, Cochlear™ and ReSound have collaborated in the Smart Hearing Alliance to provide hearing solutions for people with all types of hearing loss. Whether the need is for hearing aids, hearing implants, or a combination of the two, our solutions work together seamlessly. Through the Smart Hearing Alliance, we are committed to improving bimodal hearing care in partnership with you. Our solutions are evidence-based and designed to help you effectively meet the changing needs of your patients over time.  

For many people, a bimodal hearing solution with a cochlear implant (CI) on one ear and a hearing aid (HA) on the other is the combination that provides them with their best hearing.1-7

Introducing bimodal control in the Nucleus® Smart App

Every day your bimodal patients are exposed to a range of different hearing environments. If they find themselves in a new environment and want to change their volume, program, or manage a True Wireless™ accessory, controlling two hearing devices requires careful attention to how their hearing devices are connected to and controlled by their Bluetooth® connected device. As a result, patients may choose to only adjust one hearing device.

To help your patients get the most out of their hearing in everyday moments, Cochlear has introduced bimodal control in the Nucleus Smart App. Bimodal control is designed to help your patients quickly and easily manage their compatible ReSound ONE™ or ReSound OMNIA™ hearing aid and compatible Cochlear Sound Processor* in the same app. When a patient chooses to set up bimodal control within the Nucleus Smart App, they will be able to make volume adjustments, change programs, and manage wireless accessories for both devices. Additional device features will continue to be available through the Nucleus Smart App and the ReSound Smart 3D™ app, including Find my Hearing Aid.

With bimodal control in the Nucleus Smart App, it’s never been easier or more convenient for your bimodal patients to make common adjustments to help achieve their best possible hearing experience.

Because when both the hearing aid and CI sound processor are delivering the best possible sound, known bimodal benefits are optimized.

Cochlear’s Bimodal Hearing Evidence Summary summarizes some key insights from research studies about the benefits of bimodal hearing solutions for adult CI users.

Bimodal hearing benefits for speech understanding in quiet and noise

The studies here show that for unilateral cochlear implant users with residual hearing in the non-implanted ear, access to these benefits is possible by fitting a hearing aid to that ear. In addition to hearing better in noise, bimodal hearing is also shown to improve the range and quality of the sound being heard.

  • Kelsall D, Lupo J, Biever A. Longitudinal outcomes of cochlear implantation and bimodal hearing in a large group of adults: A multicenter clinical study. 2021 Am J Otolaryngol. 2021 Jan-Feb; 42(1):102773. doi: 10.1016/j.amjoto.2020.102773 Epub 2020 Oct 22. PMID: 33161258.
  • Hoppe U, Hocke T, Digeser F. Bimodal benefit for cochlear implant listeners with different grades of hearing loss in the opposite ear. Acta Oto-Laryngol 2018, 138, 713–721.
  • Gifford RH, Dorman MF. Bimodal hearing or bilateral cochlear implants? Ask the patient. Ear Hear. 2019 ; 40(3): 501–516.

Bimodal hearing benefits for quality of life

The studies here assess quality of life outcomes using a variety of established self-report scales. They examine the overall well-being of participants in several health-domains including daily hearing function and its impact on everyday life. The evidence shows on average, statistically significant benefits for bimodal hearing users on quality-of-life measures compared to their daily listening condition when using one or two hearing aids or a cochlear implant alone.

  • Buchman CA, Herzog JA, McJunkin JL, et al. Assessment of speech understanding after cochlear implantation in adult hearing aid users: A nonrandomized controlled trial. JAMA Otolaryngol Head Neck Surg. Published online August 27, 2020. doi:10.1001/jamaoto.2020.1584.
  • Sanhueza I, Manrique-Huarte R, Calavia D, Huarte A, Manrique M. Hearing impairment and quality of life in adults with asymmetric hearing loss: Benefits of bimodal stimulation. J Int Adv Otol. 2019 Apr;15(1):62-69. doi: 10.5152/iao.2019.6224. PMID: 31058597; PMCID: PMC6483429.
  • Sladen DP, Carlson ML, Dowling BP, Olund AP, DeJong MD, Breneman A, Hollander S, Beatty CW, Neff BA, Driscoll CL. Cochlear implantation in adults with asymmetric hearing loss: Speech recognition in quiet and in noise, and health related quality of life. Otol Neurotol. 2018 Jun;39(5):576-581. doi: 10.1097/MAO.0000000000001763. PMID: 29683995.

Bimodal hearing delivers functional hearing benefits and improved satisfaction with daily hearing

The evidence shows that a significantly higher number of bimodal hearing users report being satisfied or very satisfied with their hearing ability during a variety of daily listening activities, compared to their satisfaction when using hearing aids. In addition to reduced listening fatigue, the studies below also demonstrated significant and clinically important improvements for hearing speech in daily life, quality of sound, and localization of sounds for bimodal hearing users, compared to when they used one or two hearing aids.

  • Plant K, van Hoesel R, McDermott H, Dawson P, Cowan R. Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation. Int J Audiol. 2016 Aug;55(8):472-82. doi: 10.1080/14992027.2016.1178857. Epub 2016 May 23. PMID: 27216386.
  • Neuman AC, Waltzman SB, Shapiro WH, Neukam JD, Zeman AM, Svirsky MA. Self-Reported Usage, Functional Benefit, and Audiologic Characteristics of Cochlear Implant Patients Who Use a Contralateral Hearing Aid. Trends Hear. 2017 Jan;21:2331216517699530. doi: 10.1177/2331216517699530. PMID: 28351216; PMCID: PMC5435367.
  • Lupo JE, Biever A, Kelsall DC. Comprehensive hearing aid assessment in adults with bilateral severe-profound sensorineural hearing loss who present for Cochlear implant evaluation. Am J Otolaryngol. 2020 Mar-Apr;41(2):102300. doi: 10.1016/j.amjoto.2019.102300. Epub 2019 Sep 11. PMID: 31761407.

Bimodal hearing benefits from direct audio streaming

The studies here demonstrate the advantages of direct audio streaming for bimodal users when compared to using a cochlear implant alone. Results indicate wireless audio streaming accessories may offer further improvement in speech understanding in noisy situations when used with bimodal hearing compared to the cochlear implant alone. Performance with direct audio streaming of phone calls to bimodal devices was also shown to improve communication ability on the phone compared when using only an implant.

  • Vroegop JL, Dingemanse JG, Homans NC, Goedegebure A. Evaluation of a wireless remote microphone in bimodal cochlear implant recipients. Int J Audiol. 2017 Sep;56(9):643-649. doi: 10.1080/14992027.2017.1308565. Epub 2017 Apr 10. PMID: 28395552.
  • Wolfe J, Morais M, Schafer E. Speech recognition of bimodal cochlear implant recipients using a wireless audio streaming accessory for the telephone. Otol Neurotol. 2016 Feb;37(2):e20-5. doi: 10.1097/MAO.0000000000000903. PMID: 26756151.

Bimodal hearing benefits for sound localization

In these studies, the degree of binaural benefit for an individual in terms of sound localization is reported. The benefits obtained may be influenced by the level of hearing in each ear and the resulting degree of asymmetry between the ears.

  • Firszt JB, Reeder RM, Holden LK, Dwyer NY; Asymmetric hearing study team. Results in adult cochlear implant recipients with varied asymmetric hearing: A prospective longitudinal study of speech recognition, localization, and participant report. Ear Hear. 2018 Sep/Oct;39(5):845-862. doi: 10.1097/AUD.0000000000000548. PMID: 29373326; PMCID: PMC6103899.
  • Jang JH, Lee JH, Chang SO, Oh SH. Effect of aided hearing in the nonimplanted ear on bimodal hearing. Otol Neurotol. 2014;35: e270-6.

Bimodal hearing benefits for music appreciation

The studies below found that when listening to music, on average bimodal hearing users achieved better hearing performance when wideband frequency amplification was used in the hearing aid compared to narrower frequency bands. Furthermore, recognition of musical instruments was superior with bimodal configuration compared with using either a cochlear implant or hearing aid alone.

  • D’Onofrio KL and Gifford RH. Bimodal benefit for music perception: Effect of acoustic bandwidth. JSLH; 2021, 64: 1341–1353.
  • Duret S, Bigand E, Guigou C, Marty N, Lalitte P, Bozorg Grayeli A. Participation of Acoustic and Electric Hearing in Perceiving Musical Sounds. Front Neurosci. 2021 May 5;15:558421. doi: 10.3389/fnins.2021.558421. PMID: 34025335; PMCID: PMC8131516.
  • Shukor NFA, Lee J, Seo YJ, Han W. Efficacy of Music Training in Hearing Aid and Cochlear Implant Users: A Systematic Review and Meta-Analysis. Clin Exp Otorhinolaryngol. 2021 Feb;14(1):15-28. doi: 10.21053/ceo.2020.00101. Epub 2020 Jul 11. PMID: 32646208; PMCID: PMC7904420.

* For compatibility information and devices visit www.cochlear.com/compatibility and for more information regarding the compatibility of ReSound hearing aids, visit resound.com/compatibility

For more information regarding ReSound hearing aids, visit pro.resound.com.

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

The Cochlear Nucleus Smart App is available on App Store and Google Play. For compatibility information visitwww.cochlear.com/compatibility.

1. Farinetti A, Roman S, Mancini J, et al. Quality of life in bimodal hearing users (unilateral cochlear implants and contralateral hearing aids). Eur Arch Otorhinolaryngol (2015 Nov); 272, 3209–3215.

2. Ching TY, Incerti P, Hill M. Binaural benefi ts for adults who use hearing aids and cochlear implants in opposite ears. Ear Hear (2004 Feb); 25, 9–21.

3. Potts LG, Skinner MW, Litovsky RA., et al. Recognition and localization of speech by adult cochlear implant recipients wearing a digital hearing aid in the nonimplanted ear (bimodal hearing). J Am Acad Audiol (2009 Jun); 20, 353–373.

4. Morera C, Cavalle L, Manrique M, et al. Contralateral hearing aid use in cochlear implanted patients: Multicenter study of bimodal benefi t. Acta Otolaryngol (2012 Jun); 132, 1084–1094.

5. Giff ord RH, Dorman MF, McKarns SA, Spahr AJ. Combined electric and contralateral acoustic hearing: Word and sentence recognition with bimodal hearing. Journal of Speech, Language, and Hearing Research. (2007 Aug) 1;50(4):835-43.

6. Sucher CM, McDermott HJ. Bimodal stimulation: benefi ts for music perception and sound quality. Cochlear Implants International. (2009 Jan); 1;10(S1):96-9.

7. Buchman CA, Herzog JA, McJunkin JL, et al. Assessment of Speech Understanding After Cochlear Implantation in Adult Hearing Aid Users: A Nonrandomized Controlled Trial. JAMA Otolaryngol Head Neck Surg. Published online (2020 Aug). doi:10.1001/jamaoto.2020.1584

Related Posts
Kanso2

5 valuable reads on Cochlear’s latest innovations

December 21, 2020

Professional perspectives: A closer look at remote care solutions

During a recent live webinar, a panel of audiology professionals shared their experiences with Cochlear’s remote service solutions. The panel discussion is now available as a standalone downloadable audio file.

AudiologyOnline interview: Introducing Custom Sound® Pro – Cochlear’s next generation CI fitting software

Kyle Longwell, Product Manager of Software and Clinical Care at Cochlear Americas, explores technicalities of Cochlear’s new fitting software and its assessment features.

Expert opinion: Kanso® 2 Sound Processor first impressions

Dr. Allison Biever, AuD at Rocky Mountain Ear Center, shares her initial experiences with the new Kanso 2 Sound Processor. She discusses benefits of off-the-ear sound processors and connectivity considerations.

AudiologyOnline interview: Expanding Possibilities for Pediatrics: A New Indication for the Cochlear™ Nucleus® Implant System

Megan Mears, audiologist and Clinical Project Manager at Cochlear Americas, discusses the implications of the new indication for professionals and recipients, such as positively impacting spoken language outcomes.1,2

Recent innovation powering the Smart Hearing Alliance

The Smart Hearing Alliance, a unique collaboration between Cochlear and ReSound, highlights the ease of providing a bimodal solution for your patients. The partnership provides connectivity solutions that work together with both the ReSound hearing aid and the Nucleus cochlear implant.

For more helpful resources, subscribe to Cochlear ProNews.

References:

1. Ching TYC, Dillon H, Leigh G, Cupples L. Learning from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study: summary of 5-year findings and implications. Int J Audiol. (2018 May); 57(sup2).

2. Ching TYC and Dillon H. Major Findings of the LOCHI study on children at 3 years of age and implications for audiological management. Int J Audiol. (2013 Dec); 52:sup2, S6-S68

For compatibility information and devices visit www.Cochlear.com/compatibility and resound.com/compatibility

For a list of compatible ReSound hearing aids visit www.Cochlear.com/nucleus/compatibility

young girl playing with bubbles

Cochlear Clinical Quick Tips: Confirming the Auditory Response Intra-Operatively

May 4, 2017

Providing peace of mind and additional confirmation during cochlear implant surgery with the Nucleus CR220 Intraoperative Remote Assistant.

 

For a new Cochlear™ recipient and their family, knowing that the cochlear implant is functioning as their surgeon and audiologist expected, and that the auditory nerve is responding to stimulation, can be reassuring. For the audiologist and surgeon, knowing that electrode impedances are appropriate, and that AutoNRT® thresholds were measured provides confidence that the surgical procedure was successful. In the past, a laptop with Custom Sound®, a programming pod, and associated cables were required to obtain this information – and it was typically in the purview of the audiologist to take time out of his or her schedule to complete the testing. To address these challenges, Cochlear partnered with surgeons and clinicians to expand the capabilities of the industry-first bidirectional remote assistant to provide this valuable information more quickly, and by anyone in the operating room. Using the CR220 Intraoperative Remote Assistant means obtaining confidence that all electrodes are functioning, and that the auditory nerve is responding to stimulation, has never been easier, faster or more efficient!

 Below is some helpful information to know when working with the CR220 Intraoperative Remote Assistant:

  1. Before using the CR220 in the operating room for the first time, you can learn how it works via the onboard Practice Mode. Simply press and hold the OK button, press the down arrow to highlight Practice Mode, and press OK. Be sure to explore the screens accessed by pressing the right side arrow before, during and after testing. You may wish to turn off the Beeps on Remote under Settings before starting your practice session.
  2. The operating range between the CR220 Remote Assistant and the CP810 processor is up to 6 feet.
  3. For simplicity, the CR220 uses the same intraoperative AutoNRT® parameters as Custom Sound®
    1. Stimulation rate of 250Hz
    2. Measurement starts at 170 current level (CL), after a conditioning stimulus of 230 CL for each electrode.
    3. All 22 intracochlear electrodes are measured starting with Electrode 22, followed by Electrode 1, 11, 6, 16 and so on.

Note: AutoNRT has a high success rate of obtaining threshold NRT (T-NRT) on 93 percent of electrodes, which is better than any other cochlear implant objective measure.1

  1. The CR220 Intraoperative Remote Assistant has clear, simple messages to inform you of any actions you may need to take during testing. Below are just two examples.

          a. If the connection to the internal device is lost, the following will be shown on the CR220’s display screen:

  • A prompt to ‘Reconnect coil to Implant.’ You will have five minutes to reconnect, otherwise the test session will conclude.  If this occurs, you can initiate a new session to collect your data.

          b. After pressing the OK button to pause AutoNRT while it is running you will see:

  • Resume AutoNRT: the device will simply continue testing from where it was paused.
  • View Results: use the arrow keys to see the acquired NRT profile or individual NRT traces.
  • Either Cancel AutoNRT or Finish AutoNRT If you cancel AutoNRT before three electrode measurements are completed, the Auto NRT Cancelled screen will display. Press the OK button to return to the NRT: Electrodes screen to re-start. If you stop AutoNRT after three or more electrode measurements are completed, you will have the option to Finish AutoNRT.

We hope that using the CR220 Intraoperative Remote Assistant enhances your confidence in surgery, reduces your clinical load and complexity, and enhances your clinic efficiency.

If you would like to learn more about the CR220, please visit our one-hour (CEU available) Audiology Online course using the following link:

*van Dijk, B., Botros, A., Battmer, R., Begall, K., Dillier, N., Hey, M., Lai, W., Lenarz, T., Laszig, R., Morsnowski, A., Muller-Deile, J., Psarros, C., Shallop, J., Weber, B., Wesarg, T., Zarowski, A. & Offeciers, E. (2007) . Clinical results of AutoNRT: A completely automatic ECAP recording system for cochlear implants. Ear and Hearing. 28:4, 558-570

©Cochlear Limited 2017. 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.

Cochlear logo - white

©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.

 

Cochlear ProNews is monitored Monday through Friday, excluding some holidays. Questions and inquiries submitted over the weekends or holidays may see a delay in response. For immediate assistance please contact us directly. You are solely responsible for your interactions with other members of our Websites. Cochlear reserves the right, but has no obligation, to monitor disputes or communications between you and other members of our Websites. For a full list of Cochlear’s terms of use, click here.