Cochlear Implants
by Michaela Coon

Guide to Cochlear’s new expanded pediatric indication

June 26, 2020
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On March 17, 2020, Cochlear received FDA approval to lower the age of cochlear implantation from 12 months to 9 months for children with bilateral, profound sensorineural hearing loss. 

Here are four resources to further your understanding about the lowered indication:

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

AudiologyOnline course: The Evolution of Pediatric Candidacy for Cochlear Implants: A New Indication

This course discusses hearing loss treatment from a pediatric patient standpoint and provides information on pediatric candidacy for cochlear implants.

Course Details

Presented by Melissa Tribble, AuD

Pediatric Audiology Practice Manager at Stanford Children’s Health

Recording available.

New TECH Talk: Age of implantation and critical development window

Dr. Jace Wolfe, clinical audiologist and Director of Audiology and Research at the Hearts for Hearing Foundation in Oklahoma City, examines results from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) Study based out of Australia to understand the long-term impact of early access to sound.

A Review of Research: Pediatric Evidence Summary

Read key insights from significant research studies around the benefits of cochlear implants for pediatric patients. Topics include:

  • The importance of early access to sound
  • Two ears are better than one
  • Progress tracking and monitoring
  • Social communication
  • Technology to make everything easier – especially in noise

For more helpful resources, subscribe to the 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

In 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.

Related Posts
kanso 2

Expert opinion: Kanso® 2 Sound Processor first impressions

October 15, 2020

By Allison M. Biever, AuD, CCC-A, Rocky Mountain Ear Center

Background

I have been involved in the cochlear implant field for 28 years.  How fulfilling it is to be a part of someone’s hearing journey! I was initially drawn to the field of Speech and Language Pathology and enrolled in the master’s program at CU Boulder in 1989.  After switching majors, it was natural that audiology would have a special place for me, since I was raised by a mother who was born with moderate-to-severe sensorineural hearing loss. 

Why off-the-ear?

Kanso 2

During the COVID-19 pandemic, patients have frequently complained about how hard it is to keep their behind-the-ear processor on when they are also wearing a mask.  One of my cochlear implant patients wears her Nucleus® 7 Sound Processor, the bow of her eyeglasses, a mask and an oxygen tube behind her ear.  She told me, “There isn’t enough room for everything I have to wear behind my ear!”. Having an off-the-ear option for cochlear implant recipients is a big deal. 

Patients who have had a sudden hearing loss and have never had to wear a hearing aid are often very uncomfortable with the feel of something behind the ear.  Some patients have malformed pinnas or pinnas that are close to their heads, making a behind-the-ear sound processor a non-viable option.  Cochlear implant recipients who have tried both a behind-the-ear processor and an off-the-ear option will frequently tell me that the off-the-ear option is considerably more comfortable. 

Initial experience with Kanso® 2 Sound Processor

In mid-July, I was invited to participate in a controlled market release of the Kanso 2 Sound Processor. This amazing sound processor has already changed the lives of the recipients I have been seeing in our clinic.  At activation, I have been fitting both the Nucleus® 7 Sound Processor and the Kanso 2 Sound Processor to our newly implanted recipients.  Our activations are typically conducted a few weeks after surgery. Almost half of the patients returned for their follow-up visits two weeks later wearing the Kanso 2 Sound Processor.  The patients reported it was more comfortable to wear and at two weeks device retention was not an issue.

The Kanso 2 Sound Processor is the diameter of a “Loonie”, which is the Canadian one-dollar coin.  Unlike the first generation Kanso Sound Processor, Kanso 2 Sound Processor is rechargeable and can be controlled from a smartphone+ so that changes can be made to improve auditory performance if needed.  The recipient can check battery life, change volume, master volume, bass, treble or sensitivity.  Recipients can change programs or initiate streaming to an accessory simply by manipulating the app on their smartphone.+ 

Advanced connectivity and beyond

Additionally, recipients who have compatible Apple® or Android™ devices can stream directly to their Kanso 2 Sound Processor, creating an environment for easier phone conversations. Although the technology is similar between the Nucleus 7 Sound Processor and the Kanso 2 Sound Processor, more patients are finding ease of charging the device, ease of putting the device on and overall comfort to be superior with Kanso 2 Sound Processor.  I have also fit several elderly adults with fine motor difficulties and vision deficits who have reported ease of use. 

On average, the Kanso 2 Sound Processor requires less time for counseling because there are fewer parts to manipulate and discuss with the newly-activated recipient.  The entire processor can be placed in a charging case each night for ease of charging.

Smart has never been so simple

One of my favorite features of the Kanso 2 Sound Processor is the “buttonless” design.  Frequently, when patients are given multiple programs, they will inadvertently touch the button on their sound processor and change the program without being aware they have made a change. The simplicity of the Kanso 2 Sound Processor is spectacular!  The recipient can just tap the processor three times to turn it off and twice to turn it on.  I love that it has become so incredible easy for recipients to use.  If I had to choose one processor to use for many of my patients, I would choose the Kanso 2 Sound Processor because of its simplicity.

To learn more about Cochlear’s latest innovations please view this webinar and read this interview.

About the author: Dr. Allison Biever received her bachelor’s degree from the University of Alberta in 1989 and her master’s degree in Audiology at the University of Colorado in 1992, after which time she worked as a fellow in the first cochlear implant program in Colorado. In 2005 she received her Au.D. from Central Michigan University, completing a doctoral thesis that examined the impact of residual hearing on cochlear implantation in children.

Her focus at the Rocky Mountain Ear Center has been helping people regain their hearing through the miraculous technology of cochlear implants. She was awarded the LaFawn Biddle Award and the Hands & Voices Families First Award for her outstanding service to the deaf and hard of hearing community. In addition to her work in the clinic, she is also a prominent researcher in the field of cochlear implants, an instructor for Institute for Cochlear Implant Training (ICIT) and is on the board for the Listen Foundation. Allison enjoys hiking and spending time with her husband and three daughters. She is also an avid runner and Boston Marathon participant.

+The Cochlear Kanso 2 Sound Processor, Nucleus 7 Sound Processor and Nucleus Smart App are compatible with Apple and Android devices, for compatibility information visit www.cochlear.com/compatibility

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Sarah Hughes

Preventing listening fatigue this holiday season with tips from Dr. Sarah Hughes

December 20, 2021

By Sarah E. Hughes B.Sc., M.H.Sc.,Ph.D., Research Fellow, Centre for Patient Reported Outcome Research, University of Birmingham, United Kingdom

Sarah Hughes

Here are some tips to making sure your patients can be a part of the conversations and moments that they care about the most:

Tips from an expert to manage listening effort during the holidays

As cochlear implant recipients, your patients may find that they are extremely tired by the end of the day. Interestingly, recipients often fail to connect their fatigue with listening and the increased effort needed to ensure listening success.

Listening effort is a term used to describe the exertion of brain power used to pay attention and understand spoken language.

It’s important for recipients to appreciate that listening effort is a part of what it means to listen with a hearing loss. Hearing is something that happens without us being aware of it taking place. Listening, however, is active. It is something we ‘do.’ When listening conditions are favorable this happens easily and we are not aware of the effort involved.

However, when conditions are challenging, such as listening with a hearing loss, a listener is required to do additional mental work to enable them to understand speech, music or identify sounds in the environment.

If recipients expect to listen in the same way as hearing family and friends, they may be putting a lot of added pressure onto themselves. The extra pressure is stressful and can actually be counter-productive. Listening well may be possible in short periods, but over longer periods can become exhausting and can quickly lead to fatigue.

The good news is that recipients tell us when they make the effort to listen with their cochlear implant (s) that they feel a greater sense of social connectedness – the feeling of being in close personal contact with the world around them.

Cochlear™ CoPilot helps with strategies for the holidays

There are a number of strategies that can help manage your recipients’ energy levels for listening. Cochlear CoPilot is a mobile app that features information and insights from experts plus advice from other recipients.

Here are some tips for your patients from Cochlear CoPilot to get started:

  1. Recognize that listening with hearing loss requires effort.
  2. Schedule breaks in advance for times when you know that listening will be intensive or challenging.
  3. Allow yourself downtime to give your brain a listening break. Spend some time doing activities that don’t require you to listen very much – read, exercise, or meditate.
  4. Plan your day so that challenging tasks and activities are scheduled when you have the energy.
  5. Remember that good nutrition and adequate sleep play an important role in managing your energy.
  6. Take a short break when you find yourself straining to listen. This could happen at work, during meetings, social events or even when you are simply tired.
  7. Step away and tune out to reduce stimulation and help to de-stress and refresh.
  8. Prioritize activities that are most important to you during the holiday season such as family get togethers or social events. This will help ensure that you have enough energy for those listening-based activities that are special.

While it might not always be possible to fully schedule the day around upcoming listening demands, having an awareness that listening effort can impact energy level means they will be more likely to take a break from listening when applicable. Planning in advance enables your recipients to be at their best when listening really matters.

To find out more about listening effort, preventing listening fatigue at the holidays and practical tips from other recipients, download Cochlear CoPilot.

About the author: Dr. Hughes is currently a Research Fellow at the Centre for Patient Reported Outcome Research (CPROR) at the Institute of Applied Health, University of Birmingham in the UK. She received her M.H.Sc in speech-language pathology from the University of Toronto, Canada, and her PhD at Swansea University Medical School, Wales, UK where she was a James Callaghan Scholar whose research focused on the development and validation of a new patient-reported outcome measure of listening effort in adult cochlear implant recipients.  Dr. Hughes has worked on several collaborations with the Australian Hearing Hub and the Australian Institute of Health Innovation, Macquarie University, Sydney, Australia, and she is a Core Member of the Adult Rehabilitation Special Interest Group, British Society of Audiology.

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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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