Cochlear Implants
by Cochlear Guest Author

The Perimodiolar advantage with the Cochlear CI532 Slim Modiolar Electrode

July 17, 2018
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By guest author: Wade Colburn

Wade Colburn

The Cochlear™ Nucleus® CI532 Slim Modiolar electrode is the latest offering within the Cochlear™ Nucleus® implant portfolio.  The CI532 Slim Modiolar electrode is a thin atraumatic electrode that can be successfully placed within scala tympani in a perimodiolar position to maximize performance outcomes.  In fact, in a large independent multicenter study, 100% of the Slim Modiolar electrodes were successfully placed in the scala tympani.1  Another institution that assessed electrode placement with the Slim Modiolar also found results that show highly consistent scala tympani location.2

Research describes the rationale on why perimodiolar placement within the scala tympani provides advantages over other electrode placements:

Increased Number of Electrode Contacts in Scala Tympani:

Berg et al3 looked at the performance of cochlear implant recipients in relation to the number of electrodes in the cochlea and found that the greater the number of electrodes in scala tympani, the better the performance. When testing in words in quite (CNC), and sentences in quiet and +5dB noise (AzBio), they found that 22 electrode contacts were significantly better than recipients with only 4, 6, 8, 10, and 12 electrodes.

Proximity to the Modiolus:

Perimodiolar position

The CI532 electrode was designed to reduce the distance to the modiolus, which has shown to improve performance5,6 and allow for more focused stimulation7,8. In a study conducted at Washington University by Holden et al4, they showed a correlation between the position of the electrode with respect to the modiolus (often referred to as the “Wrapping Factor”) and CNC word score. The group showed that those electrodes with perimodiolar placement had a lower wrapping factor and improved performance.

The CI532 electrode delivers on the three principles of the Cochlear™ Nucleus® electrode portfolio: preservation, performance and preference. The Slim Modiolar Electrode is designed with 22 electrode contacts, reduces the likelihood of translocation from the scala tympani, reduces the proximity to the modiolus, and minimizes insertion forces through a consistent sheath-based insertion.  These advantages translate into improved speech performance 1,2,4, structural preservation 9, more focused stimulation 7,8 and lower electrical stimulation thresholds 10,11.

Visit our website to learn more about the benefits of the CI532 Electrode or by reaching out to your local Cochlear representative.

Download the CI532 X-Ray Brochure.

CI532 X-ray brochure

About our guest author:

Wade is the Product Manager for 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, but comes from an engineering background with the medical device field, including previous otology experience.

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References:
  1. Aschendorff et al. Clinical investigation of the Nucleus Slim Modiolar Electrode. Audiology & Neurotology. 2017; 22:169-179.
  2. McJunkin, J. L, et al. Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array. Otology & Neurotology. 2018; 39(1):e28-e33.
  3. Berg et al. Number of electrode needed for optimal speech and auditory perception. Poster Presentation at American Auditory Society (AAS). 2017.
  4. Holden LK, Finley CC, Firszt JB, Holden TA, Brenner C, Potts LG, et al. Factors affecting open-set word recognition in adults with cochlear implants. Ear Hear. 2013; 34(3):342-60
  5. Lazard D. S, et al. Pre-, per- and postoperative factors affecting performance of postlinguistically deaf adults using cochlear implants: a new conceptual model over time. PloS one. 2012; 7:e48739
  6. Blamey P, et al. Factors affecting auditory performance of postlinguistically deaf adults using cochlear implants: An update with 2251 patients. Audiology & neuro-otology. 2013; 18:36-47.
  7. Hughes, ML, Abbas, PJ. Electrophysiological channel interaction, electrode pitch ranking, and behavioral threshold in straight versus perimodiolar cochlear implant electrode arrays. J Acoustic Soc Am. 2006; 119(3):1538-47.
Author

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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Cochlear obtains FDA approval of Kanso 2 Sound Processor, first off-the-ear cochlear implant sound processor with direct smartphone connectivity

July 6, 2020

We are excited to announce that Cochlear has received the U.S. Food and Drug Administration’s (FDA) approval of the new Cochlear™ Nucleus® Kanso® 2 off-the-ear Sound Processor (CP1150). We have also obtained approval to extend our Nucleus® 7 Sound Processor to Nucleus® 22 implant recipients and will be introducing our next generation CI fitting software, Custom Sound® Pro. 

Kanso 2

Kanso® 2: Smart has never been so simple.

Compatible with our Nucleus 24 Implant Series forward~, the Kanso® 2 Sound Processor combines the latest connectivity and proven hearing performance technology1-4 features of our Nucleus 7 Sound Processor in a small, all-in-one, off-the-ear design. The Kanso 2 Sound Processor also introduces a built-in rechargeable battery for all day hearing5*, direct streaming from compatible smartphones# and improved dust and water resistance for added peace of mind.+

Nucleus® 7 for Nucleus® 22 implant recipients: Hearing has never been so smart.

Our Nucleus 22 implant recipients have been part of the Cochlear Family since 1982, and we are delighted to now offer the only behind-the-ear cochlear implant sound processor to offer direct streaming, connectivity and control from a compatible Apple® or Android™ device#.  With this built-in connectivity, patients can answer their smartphone and enjoy direct connection in both ears,‡ conveniently control and monitor their sound processor, improve their hearing in noise6, and enjoy the peace of mind that comes from being able to locate their sound processor. All of this is available without additional attachments or additional intermediary devices.

Custom Sound® Pro: Designed by clinicians for clinicians.

Alongside these two product approvals, Cochlear is delighted to also introduce Custom Sound® Pro fitting software – our next generation of CI fitting software. With an intuitive new design layout and guided workflows, Custom Sound® Pro has been designed to enhance the fitting process for you and your patients, today and into the future. A new patient dashboard with integrated patient goals promotes additional patient engagement and facilitates more effective tracking of progress between appointments. Additionally, new adjustment screens help support clinical efficiencies while allowing you access to all the same power and flexibility that suits you.

Cochlear family commitment.

Cochlear is always considering the needs of our recipients. We also understand that when we introduce new sound processor technology, there are recently implanted Cochlear recipients who were unable to select this latest technology. As part of our Technology Exchange Program, newly implanted patients who have been activated from FDA approval date forward until the commercial release of the Kanso 2 sound processor are eligible to exchange one of their sound processors in the activation kit for the new Kanso 2 sound processor.  If desired, eligible recipients will be able to begin processing this exchange at commercial launch.

For current Nucleus recipients who have recently qualified for an upgrade, Cochlear will be offering a 90-day return and exchange period on all upgrade orders based upon shipping date. Within this period, upgrades can be returned for full credit, or exchanged for another compatible sound processor.  If you have current recipients who are interested in upgrading their Nucleus device, remember Cochlear is here to support them, and you. Directing recipients to Cochlear’s Reimbursement and Insurance Support Center is one way to help alleviate some of the work for your staff. Our team of support specialists are here to support your patients through every step of their hearing journey.

Key Dates:

July 6, 2020 Upgrade Pre-orders availableCochlear will begin processing upgrade pre-orders for the Kanso 2 Sound Processor and Nucleus 7 Sound Processor for Nucleus 22 recipients
August 2020 Custom Sound Pro Software releaseCustom Sound Pro fitting software is required and must be used to program these new sound processor innovations. To schedule a Software Support session, please book time here: https://calendly.com/cochlear-software-support/cs-software-support.

What Should I Do Next?

  • Join us on Wednesday, July 8 at 5pm ET or Tuesday, July 14th at 12 pm ET for a live, in-depth introduction to our latest innovations! Watch the recording here.
  • Read the complete press release here!
  • Contact your local Cochlear representative for more information.

Thank you for helping our recipients Hear Now. and Always

60/60

New considerations for recommending a cochlear implant evaluation

March 11, 2021

Every patient’s hearing loss journey is unique, and each patient may require a different treatment option. The continuum of care for hearing loss isn’t a linear pathway so being aware of all technologies to manage your patient’s hearing loss can help you find the best solution for them.

Hearing loss is seen by many to be a communication disorder; it is now known to have much wider-ranging consequences that can significantly impact a person’s quality-of-life. Age-related hearing loss has been shown to also lead to increased accidental falls, hospitalizations, loneliness and social isolation.1 A multi-faceted approach to the treatment of hearing for patients is needed from a collaborative network of providers to meet the needs of your patients.

Innovations in hearing health care have made the way for over-the-counter (OTC) hearing devices and personal sound-amplification products (PSAP’s) enabling patients access outside of the traditional clinical practice. However, hearing care providers are the best professionals to speak to the different hearing solutions for their patients. As a hearing care provider, you have the unique ability to

differentiate your practice by counseling on all hearing loss treatment options and providing comprehensive services to support optimal performance.

If hearing aid technology is not providing your patient the ability to hear and understand speech, a cochlear implant may be the next step. Traditionally, cochlear implants have been considered a treatment option only for those who have lost all of their hearing. Health benefits and improved hearing outcomes2 support the need to shorten the duration of hearing loss and consider cochlear implantation before hearing loss progresses to profound. For patients with hearing losses greater than or equal to 60 dB HL (pure tone average 0.5, 1k, 2kHz) and speech understanding less than or equal to 60%,3 referral for a cochlear implant evaluation should be pursued.

To learn more read this Journal Club or visit www.cochlear.us/THJ

* This provides a recommendation of when an adult may be referred for a cochlear implant

evaluation, but does not guarantee candidacy based on indications. For the approved Cochlear

Nucleus Indications, please refer to the important information booklet or physician’s guides.

References:

1. Deal JA, Reed NS, Kravetz AD, et al. Incident Hearing Loss and Comorbidity: A Longitudinal

Administrative Claims Study. JAMA Otolaryngol Head Neck Surg. 2019;145(1):36–43. doi:10.1001/

jamaoto.2018.2876.

2. Derinsu U, Yüksel M, Geçici CR, Çiprut A, Akdeniz E. Effects of residual speech and auditory deprivation

on speech perception of adult cochlear implant recipients.

3. Zwolan TA, Schvartz-Leyzac KC, Pleasant T. Development of a 60/60 guideline for referring adults for

a traditional Cochlear implant candidacy evaluation. Otol Neurotol 2020;41:895-900.

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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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