Cochlear Implants
by Cochlear Guest Author

Clinical Quick Tips: Getting ready for splashing into summer with the Aqua+

July 19, 2018
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Clinical Quick Tips

By guest author: Natasha McDougald

Natasha

Are your patients getting ready for a wild wet summer?  Share the following tips with your patients for them to HearYourWay™ while getting soaked.

  • For Behind the Ear processors use rechargeable batteries while using the Cochlear™ Aqua+*
  • For Kanso®;  the LR44 battery is required for use with the Aqua+
  • Always remember to use a safety line with your processor when exploring the ocean or river since processors don’t float!
  • Want to hear coach’s instructions clearly during swim club with your Cochlear™ Nucleus® 7, Nucleus® 6 or Kanso? Have them use the MiniMicrophone 2+ while coaching from the deck.

Tips for Optimizing Sensitivity and Volume for Aqua+

  • Many recipients may prefer slightly increased volume and sensitivity while wearing their Aqua+
  • Consider having the patient bring their Aqua+ and optimizing a MAP for sensitivity and volume while they are wearing the Aqua+ to create as a manual program OR encourage recipients to utilize remote controls or the Nucleus Smart App since preferred changes are likely to be minimal and temporary.

Share this instructional video with your patients to help answer their questions about using the Aqua+ with their Nucleus 7 Sound Processor:

About our guest author:

Natasha has worked at Cochlear Americas for almost 7 years partnering with clinicians and surgeons at the University of Miami, UCSF, Stanford, UC Davis and UCSF Benioff Children’s Hospital of Oakland to bring cochlear implants to pediatric and adult patients.  Extremely passionate, Natasha is professionally and personally invested in the implantable hearing industry and strives to forward the cause of those affected by hearing loss.  She has presented numerous talks and courses on hearing loss, multiple disabilities, advocating skills and cochlear implantation to audiences in the medical-technology, educational, special needs and family support sectors.

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*Nucleus 7 with Aqua+ is water resistant to level IP68 of the International Standard IEC60529. This water protection rating means that the sound processor with the Aqua+ can be continuously submerged under water to a depth of 3 meters (9 feet and 9 inches) for up to 2 hours. This water protection only applies when you use the Aqua+ and LR44 alkaline or nickel metal hydride rechargeable batteries. The Kanso Sound Processor with the Aqua+ is water resistant to level IP68 of the International Standard IEC60529. This water protection rating means that the sound processor with the Aqua+ can be continuously submerged under water to a depth of 3 meters (9 feet and 9 inches) for up to 2 hours. This water protection only applies when you use the Aqua+ and LR44 alkaline or nickel metal hydride disposable batteries.
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Cochlear Guest Author

In an effort to keep our content fresh and reflective of a diverse industry, Cochlear Americas features a mix of employees and professional partners to contribute to Cochlear ProNews as Guest Authors.

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Related Posts
GN ReSound

Recent Innovation powering the Smart Hearing Alliance

September 7, 2020

By Natasha McDougald, Product Manager: Sound Processors, Bimodal and Connectivity

The Smart Hearing Alliance

Ears work as a team and there are advantages to hearing well with both ears. For some people with a cochlear implant, having a ReSound hearing aid on the other ear provides the best possible hearing through a bimodal solution. Bimodal hearing in general may improve speech recognition in noise, including locating where sounds are coming from, while also providing superior sound quality compared with using a cochlear implant alone.1-4

The Smart Hearing Alliance, a unique collaboration between Cochlear and ReSound, makes it easy to provide a bimodal solution for your patients.  The partnership provides connectivity solutions that work with both the ReSound hearing aid and the cochlear implant. ReSound and Cochlear share wireless technology, so your clients can stream directly to their cochlear implant and hearing aid simultaneously from compatible iOS or Android™ devices, or from a range of wireless accessories with no need for intermediary devices. With more sound to both ears and superior sound quality compared to using a cochlear implant alone4, recipients can take phone calls, enjoy music, TV or ZOOM chat with a friend in a busy chattering home environment.

The Cochlear™ Nucleus® Kanso® 2 Sound Processor

Cochlear has expanded its sound processor portfolio through a series of approvals such as the Kanso 2 Sound Processor, allowing clinicians to fit either an off-the-ear or traditional-behind-the-ear sound processor without compromising performance-enhancing algorithms or direct connectivity to smartphones.  The innovative Kanso 2 Sound Processor introduces a built-in rechargeable battery designed for all-day hearing~, paired with the highest dust and water resistance for a cochlear implant sound processor for added peace of mind for your patients.+

The ReSound ONE™ hearing aid

On August 18, 2020, GN Hearing globally unveiled ReSound ONE™ hearing aid, a new hearing aid* that solves one of the most enduring challenges for people with hearing loss. For the first time, this unique solution places an additional microphone inside the ear canal, allowing people relying on hearing aids to experience the world with their own ears while preserving the comfort of an RIE device.* Now every patient may enjoy the benefit of superior sound quality and hear conversations better in noisy environments. At launch, ReSound ONE will be bimodally compatible with the True Wireless™ accessories. Linking capabilities for direct bimodal streaming from compatible Apple and Android devices, are expected to be available with a service release of Custom Sound Pro later this year.

Complementary innovation to improve the patient experience

Cochlear and ReSound have been collaborating on technology development, product solutions, design and engineering capabilities since 2011, and these new hearing devices benefit from this complementary approach.

Bimodal built-in rechargeability:  For the first time, bimodal patients can experience the convenience and simplicity of a cochlear implant sound processor and hearing aid with integrated rechargeable batteries.

User-activated algorithms for challenging environments:   Patients wearing the Kanso 2 Sound Processor and ReSound ONE hearing aid will have the control to focus on sounds in front of them, using two pre-processing strategies: ForwardFocus^ from Cochlear and a clinician-programmed narrow beam vis Adaptive Directionality from GN Hearing.  These enhanced operating modes are designed to improve speech recognition, giving patients the control to increase hearing focus. 

Automatic setting adjustment:  Noise Tracker II, Environmental Optimizer II and Soft Switching from GN Hearing uniquely complements Cochlear’s Smart Sound IQ with SCAN#, allowing the hearing devices to automatically adjust settings and microphone directionality to improve the listening experience.

Quality care from anywhere: The impact of the COVID-19 global pandemic has irrevocably changed the healthcare landscape and has necessitated a change in how hearing healthcare services are provisioned.  The Smart Hearing Alliance has addressed these challenges through the development of hearing devices that include built-in connectivity for remote care delivery.

For example, GN Hearing pioneered the remote hearing care vision, by introducing ReSound Assist in 2017.  ReSound Assist allows varying levels of care, including Live Assistance for face-to-face video appointments, incorporating real-time feedback from patients, or Remote Fine-Tuning for sending adjustments anytime.  Cochlear has the only FDA approval for remote programming. It also received expedited approval in April 2020 for Remote Check, a convenient, at-home testing tool that allows patients to complete a hearing review with a Kanso 2 or Nucleus 7 Sound Processor using an  iPhone® or iPod touch® without having to travel to the clinic.**

Clinicians fitting Smart Hearing Alliance solutions are positioned to deliver an enhanced bimodal experience with proven hearing satisfaction, facilitating care today and in the future. 5

To learn more visit ReSound or watch this webinar on Cochlear’s latest innovations.

About the author: Graduating in Management Information Systems, Natasha McDougald began her career as a system analyst working with tech companies in the Silicon Valley.  Personal circumstances became a catalyst for career change; transitioning from desktop-based computers to tiny embedded biomedical computers known as cochlear implants.  Natasha has worked at Cochlear Americas for over 9 years partnering with clinicians and surgeons at the University of Miami, UCSF, Stanford, UC Davis and UCSF Benioff Children’s Hospital of Oakland to bring cochlear implants to pediatric and adult patients.  Extremely passionate, Natasha is professionally and personally invested in the implantable hearing industry and strives to forward the cause of those affected by hearing loss.  She has presented numerous talks and courses on hearing loss, multiple disabilities, advocating skills and cochlear implantation to audiences in the medical-technology, educational, special needs and family support sectors.

+ The Kanso 2 Sound Processor is dust and water resistant to level of IP68 of the International Standard IEC60529. The Kanso 2 Sound Processor with Aqua+ is dust and water resistant to level of IP68 of the International Standard IEC60529. This water protection rating means that the sound processor with the Aqua+ can be continuously submerged under water to a depth of up to 3 meters (9 feet and 9 inches) for up to 2 hours.  The Aqua+ accessory should be used when participating in prolonged water activities.

* Microphone in ear and two standard directional microphones, directionality features, wireless audio streaming.

^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.

#It is recommended that SNR-NR, WNR and SCAN be made available to any recipient, ages 6 and older, who is able to 1) complete objective speech perception testing in quiet and noise in order to demonstrate and document performance and 2) report a preference for different program settings.

**The Remote Check feature of the Nucleus Smart App is available on iPhone and iPod touch. For compatibility information visit www.cochlear.com/compatibility.

~All day hearing is defined as 16 hours, expected battery life is up to 18 hours. Battery life may vary by individual.

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

References

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

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

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. 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

5.  Clinical Evaluation of the Cochlear Nucleus CI532 Cochlear Implants in Adults Investigator Meeting. 2019 Apr.

Journal Club: Age-Related Changes in Temporal Resolution Revisited: Electrophysiological and Behavioral Findings From Cochlear Implant Users

January 14, 2020

By Mary Beth O’Sullivan, Professional Education Manager, Cochlear Americas

Age-Related Changes in Temporal Resolution Revisited: Electrophysiological and Behavioral Findings From Cochlear Implant Users

Bruna S. S. Mussoi and Carolyn J. Brown

Ear & Hearing (2019) 40, 1328-1344

In today’s busy clinical environment, clinicians who value research-based practice often struggle to keep up with current literature.  To help, we’re excited to offer a new ProNews Blog monthly feature – Journal Club!  Each month, rotating guest authors will present a current journal article summary.

This month’s Journal Club explores a recent 2019 study, Age-Related Changes in Temporal Resolution Revisited: Electrophysiological and Behavioral Findings From Cochlear Implant Users. Factors such as etiology and duration of deafness are well-documented influences on cochlear implant patient outcomes, but the specific role that aging plays on performance is still being investigated.

Studies have shown that older adults demonstrate similar outcomes as other age groups when testing is conducted in quiet, while performance for testing in noise resulted in significant differences.1,2 These findings could be attributed to peripheral and/or central causes, and the recent publication by Mussoi and Brown adds important details to this body of literature by evaluating aspects of both. 

What did the study investigate?

Goals of the study include to:

  1. Re-examine age-related changes in temporal resolution CI users
  2. Assess the impact of aging on the relationship between temporal resolution, cognition and perception of speech in noise in CI users

Why is this important? 

As cochlear implant clinicians, we are driven by optimizing performance for our patients. Clarifying influential factors helps to ensures best practice for counseling expectations as well as for programming older adults.  The authors point out that our understanding of the affect of aging has relied on data accumulated decades ago and deserve a fresh look with current accepted methodology and technology.

How did they do it? 

Here is your need-to-know: 

  • 20 post-lingually deafened subjects
    • 10 subjects age 18-40 years old
    • 10 subjects age 68-82 years old
  • Native English speakers
  • Cochlear Nucleus® recipients with a minimum of one year of listening experience
  • Full insertion a minimum of 19 active electrodes
  • Cognitive screening score cutoff of 27/30
  • Subjects were tested unilaterally. Bilateral CI recipients utilized the preferred better hearing ear and bimodal listeners removed the contralateral hearing aid.

Peripheral Evoked Potential Recordings: ECAP recordings of auditory nerve function were stimulated with Custom Sound® software and recorded on a mid-array electrode previously identified as a robust option. Auditory nerve function was assessed with varying intervals between a masker and probe stimuli, meaning that the nerve was in different states of recovery. The masker stimuli consisted of either a single pulse (refractory recovery paradigm) or a constant pulse train (pulse train recovery paradigm), adding to the challenge of neural recovery and more closely resembling typical CI use.

Central Evoked Potential Recordings: cortical-evoked responses were recorded using stimuli consisting of two constant pulse trains separated by a gap which varied in duration.

Perceptual Measures: Using the same stimuli as the central electrophysiological recordings, gap detection thresholds were measured by providing three presentations and requiring subjects to choose the option with the different gap interval.  Speech perception was tested via direct audio input via Quick Speech Perception in Noise (Quick SIN). 

Cognitive Measures:  Two tests of processing speed and one test of working memory were utilized.

Results and Discussion3

No significant findings were reported in peripheral or central evoked potential or the perceptual measures components of the study.  All subjects passed stringent criteria with the cognitive screening. The only significant finding was that the speed of processing was slower for the older adults, which is consistent with normative data of the general population. When relationships between the various measures was analyzed, one of the temporal resolution measures were correlated to speech in noise.  Working memory was the only measure that correlated with speech in noise.

Results of this study suggest that the effect of advancing age on temporal resolution is minimal, but changes working memory as we age appear to correlate with poorer performance in noise.  The authors acknowledge the small sample size and the possibility that the stimuli used were not challenging enough to reveal age effects. However, more challenging tasks can may become a test of decreased cognitive abilities.  According to the authors, this is only the second study of its kind in which subjects are all CI recipients.  This could be important criteria in separating the effects of age and hearing impairment. 

The older adult population is a bracket that will continue to grow in numbers and increasing need for hearing implants and successful intervention.  It will be exciting to continue to learn from studies that focus on this area.

Learn more about by accessing the publication and stay tuned for next month’s edition of Journal Club!

About our guest author: Mary Beth O’Sullivan is a Professional Education Manager at Cochlear Americas, creating educational opportunities for cochlear implant professionals using research and best practice guidance.  Mary Beth has been an audiologist for 20 years, working in clinical settings ranging from large university hospitals to private practice prior to dedicating herself to the education side of the field. 

References

1. Forli, F., Lazzerini, F., Fortunato, S., Bruschini, L., Cerrettini, S. (2019). “Cochlear implant in the elederly: Results in terms of speech perception and quality of life,” Audiology & Neurotology, 24, 77-83.

2. Lenarz, M., Sönmez, H., Joseph, G., Büchner, A., Lenarz, T. (2012). “Cochlear Implant Performance in Geriatric Patients,” Laryngoscope. 122, 1361-1365.

3. Mussoi, B. S. S., and Brown, C. J. (2019). “Age-related changes in temporal resolution revisited: Electrophysiological and behavioral findings from cochlear implant users,” Ear & Hearing. 40, 1328-1344.

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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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