Cochlear Implants
by Cochlear Guest Author

Cochlear™ remains #1 in implant reliability according to latest report

May 28, 2019
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By Wade Colburn, Product Manager, Cochlear Implants at Cochlear Americas

For almost 40 years, Cochlear has partnered with professionals across the globe to guide individuals with hearing loss into the world of sound.

Today, the Cochlear™ Nucleus® system is the most implanted cochlear implant device with more than 379,000 implants globally1, keeping people connected to the world, and each other, through sound.

During the initial stages of the patient journey, choosing an implant system is an important decision and product reliability is a primary consideration. While candidates seek a device that delivers high sound quality performance and cutting-edge technology for connectivity, they also want the peace of mind that their implant will stand the test of time.

To demonstrate Cochlear’s ongoing commitment to a lifetime of sound, device reliability reporting is completed and published annually according to the European and Global Consensus Statement on Cochlear Implant Failures and Explantations2. This widely recognized resource established the seven principles of best practice reporting and details how device failures and reliability should be reported to maintain uniformity and consistency across manufacturers.

The most recent Cochlear implant reliability report (Volume 17) is now available and maintains consistently high ratings across the product portfolio.  The Cochlear Profile Series demonstrates a cumulative survival percentage (CSP) of 99.82% within 5 years of implantation, while the Cochlear Freedom Series remains at 99.00% within 14 years1.  These market-leading results validate that Cochlear continues to be not only the most implanted manufacturer, but also the most reliable. Applying the globally sanctioned quality reporting standards to devices from other cochlear implant manufacturers demonstrates this fact:

  • Cochlear Profile: 1 in 556 devices fail within 5 years1
  • Advanced Bionics® HiRes™ 90K Advantage: 1 in 141 devices fail within 5 years3
  • MED-EL® SYNCHRONY: 1 in 55 devices fail within 3 years4

Constantly striving to improve reliability is a cornerstone of Cochlear’s implant design process and is among the most important features patients consider when selecting a cochlear implant. Our consistent best-in-class reliability rating illustrates our commitment to supporting a lifetime of hearing for our recipients, so they may Hear now. And always

View the latest report and learn more about Cochlear implant reliability.

About our guest author:

Wade ColburnWade Colburn is the Product Manager for the Cochlear™ Implant product portfolio within Cochlear Americas.  Wade’s responsibilities include product positioning and messaging, life-cycle management, new product launches and surgical support and training. Wade has recently joined Cochlear and comes from an engineering background within the medical device field, including previous otology experience.

 

References:
1. Cochlear Nucleus Implant Reliability Report. Volume 17 | December 2018. D1593476. Cochlear Ltd; 2018
2.  European Consensus Statement on Cochlear Implant Failures and Explantations. Otol Neurotol. 26: 1097-1099, 2005.
3. 2018 Global Reliability Report. 027-N025-02 Rev B. Advanced Bionics AG and Affiliates.; 2018.
4. Hearing Implant Reliability Reporting | MEDEL [Internet]. MedEl.com. 2018 [cited 24 Oct 2018]. Available from: https://www.medel.com/us/reliabilityreporting.
© Cochlear Limited 2019. 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.

 

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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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Nucleus 7 Sound Processor

New research shows benefits of using advanced technology

January 27, 2022

Give your patients access to significantly better sound

Hearing in a noisy world remains one of the biggest challenges for cochlear implant recipients. Speech recognition nearly always involves listening in background noise, often with dynamic sources and different presentation levels.1

In a new real-world study, recipients found speech to be significantly clearer in everyday listening environments when they upgraded their current Cochlear™ SPrint™, ESPrit™, Freedom®, Nucleus® 5 or Nucleus 6 Sound Processor to the Nucleus 7 Sound Processor.2

Superior speech recognition benefits

In real-world acoustic environments, where competing dynamic noise originates from the sides and behind the listener, the Nucleus 7 Sound Processor with ForwardFocus† enabled, provided on average a 7.54 dB superior speech recognition benefit^ compared to the participants’ current sound processor, when used with their preferred program for listening in noise every day.2

Significant self-perceived benefits

The Speech, Spatial and Qualities of Hearing Scale3-5 (SSQ-12*) questionnaire self-perceived results showed that the Nucleus 7 Sound Processor provided significant benefit compared with the participants’ existing sound processors in their daily listening environments.2

Our most advanced sound processing technology

The Nucleus 7 Sound Processor features:

  • SmartSound® iQ with SCAN using dual microphone technology, designed to help your patients automatically hear better in a range of challenging environments. ∞
  • ForwardFocus is designed to reduce distracting noise from behind, making it easier for your patients to focus on face-to-face conversation. †

By accessing a next generation Nucleus 7 Sound Processor, your patients can benefit from advances in technology that help them enjoy clearer conversation, even in challenging and noisy listening environments.

To find out more about the patient benefits of upgrading to the Nucleus 7 Sound Processor, visit our website.

1 Hey M, Hocke T, Böhnke B, Mauger SJ. ForwardFocus with cochlear implant recipients in spatially separated and fluctuating competing signals – introduction of a reference metric. Int J Audiol. 2019;58(12):869-878.

2 Zhang J, Morgan C, Deng XC, Wang Y, Lee M.  Hearing Performance Outcomes in Cochlear Implant Users after Nucleus® 7 Sound Processor Fitting. ACI Alliance Conference Poster. April 2021.

3 Gatehouse S, Noble W. The Speech, Spatial and Qualities of Hearing Scale (SSQ). Int J Audiol. 2004;43(2):85–99.
4 Noble W, Jen-sen NS, Naylor G, Bhullar N, Akeroyd MA. A short form of the Speech, Spatial and Qualities of Hearing scale suitable for clinical use: the SSQ12. Int J Audiol. 2013 Jun; 52(6): 409–412.
5 Liu J, Zhang J, Wang N, Li H, Fu X, Guo X, Fu L. Validation of the Chinese Translation of Speech, Spatial and Other Qualities of Hearing Scale for Parents. CN J. Otol. 2021; April In press. DOI: 10.3969 / j. issn. 1672-2922.2018

* Adults used Adult SSQ-12 and Children used P-SSQ-12. References 3-5.

^ Measured as a group mean SRT improvement.

† 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.

In this study, Mandarin-speaking Chinese recipients were assessed using their current sound processor (ESPrit™, Sprint™, Freedom®, Nucleus 5 and Nucleus 6) then again after up to one-month use with the Nucleus 7 Sound Processor.

Group on the summit of a mountain after a hike

Journal Club: Matched Cohort Comparison Indicates Superiority of Precurved Electrode Arrays

February 10, 2020

By Wade Colburn, Biomedical Engineer and Product Manager – Implants, Cochlear Americas

Matched Cohort Comparison Indicates Superiority of Precurved Electrode Arrays

JT Holder, RJ Yawn, AM Nassiri, RT Dwyer, A Rivas, RF Labadie, RH Gifford

Otology Neurotology (2019) 40(9): 1160 – 1666

In today’s busy clinical environment, clinicians who value research-based practice often struggle to keep up with current literature.  To help, we offer a 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 from Vanderbilt University, Matched Cohort Comparison Indicates Superiority of Precurved Electrode Arrays. Researchers analyzed the two primary types of electrode arrays within the marketplace: lateral wall or straight array and pre-curved or perimodiolar.  Very seldomly are the array types compared using matched groups.

Historical studies have suggested the benefits of placing the electrode closer to the nerve, but often did not contain a comparison group.  This article explores the comparison between pre-curved and lateral wall electrode design and demonstrates the superiority of pre-curved.

What did the study investigate?

Goals of the study:

  1. Better understand how electrode type affects programming parameters and patient outcomes to choose the best device for an individual
  2. Compare a newer generation precurved electrode with a straight electrode utilizing matched groups

Why is this important? 

In the cochlear implant industry there are multiple electrode variants and choices between manufacturers. With that comes various evidence showing how implant technology, surgical technique and placement of the device can impact the outcome. Specifically, the authors call out that electrode design, intrascalar location, surgical approach and atraumatic insertion technique could impact performance.  Various studies in the marketplace highlight the benefits of both lateral wall and precurved electrode types, but few draw a direct comparison using matched groups.

Straight arrays have a history of atraumatic insertions and greater potential for structural preservation, while precurved arrays have the outcome benefit of stimulation specificity.1 Due to recent changes in electrode design, this study aimed to compare a new perimodiolar array to a straight array. Authors hypothesized that the arrays would show similar hearing preservation rates, while the perimodiolar array would show better speech understanding scores and preferable programming parameters due to the lower electrode-to-modiolus distance.

How did they do it? 

Here is your need-to-know: 

  • 29 precurved array patients
    • 17 male/ 12 female
  • 29 straight array patients
    • 19 male/ 10 female
  • Retrospectively reviewed aggregate clinical database and matched CI532 electrode recipients with CI422/CI522 recipients, controlling age and preoperative hearing thresholds
  • Standard cochlear implantations via round window (RW), extended round window (ERW) and cochleostomy (C)
    • CI422/CI522 Group: RW=23, ERW=3 and C=3
    • CI532 Group: RW=18, ERW=5, C=6
  • Speech recognition scores (CNC Word Recognition, AzBio Sentence Recognition in quiet, AzBio Sentence Recognition in +5 dB SNR), residual acoustic hearing thresholds (LFPTA at 125, 250, 500 Hz) and quality of life questionnaire data (Speech Spatial Qualities -SSQ) were obtained for patients both pre-operatively and post-operatively (6 months).
  • Programming software parameters (pulse duration, maxima and datalogging) were also analyzed
  • Matching controlled for age, preoperative LFPTA, preoperative CNC scores and daily processor usage

Results1

Age, preoperative LFPTA, preoperative CNC scores and daily processor usage were matched within the study to determine significance in the outcome measures and software parameters.  The study found that impedances and pulse duration were significantly lower for the CI532 group, but there was no difference in overall charge between groups. Further, the study found that the CI532 group had significantly better post-operative CNC and LFPTA.

Table 1, provided below, outlines the parameters that were matched and analyzed within the study.

The study compared the speech outcomes directly. While only CNC had a significant difference, Figure 2 from the publication outlines the performance of the devices in CNC, AzBio Quiet and AzBio +5 dB.

The authors call out that “the most notable finding of the current study is that the CI532 group had significantly better post-operative acoustic LFPTA.”  They continue, “This difference in results could be explained by lower rates of translocation for the CI532, which suggests less trauma of the cochlear structures”.

Further investigation shows that the observations regarding lower impedances and differences in pulse duration allow for the center to implement greater maxima, which has been known to have a positive impact on speech understanding in complicated listening situations.1

Results of this study indicate that there are many advantages to a perimodiolar array including closer proximity to the modiolus and decreased translocation rates. More research will be conducted in regards to this new perimodiolar array to assess the performance benefit and the potential for equivalent or better preservation rates, historically associated with lateral wall arrays.

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

About our guest author: Wade Colburn is the Product Manager, Cochlear Implants at Cochlear Americas. Wade is responsible for managing product lifecycle and providing technical support to customers.  Wade is a biomedical engineer from North Carolina State University with extensive experience within otology prior to joining Cochlear.

References:

  1. Holder, J. T., Yawn, R. J., Nassiri, A. M., Dwyer, R. T., Rivas, A., Labadie, R. F., & Gifford, R. H. (2019). Matched Cohort Comparison Indicates Superiority of Precurved Electrode Arrays. Otology & Neurotology, 40(9), 1160–1166. doi: 10.1097/mao.0000000000002366

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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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