Cochlear Implants
by Michaela Coon

NEW Cochlear™ Nucleus® Profile™ Plus Series Cochlear Implant: How it Works

August 7, 2019
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Nucleus System

You may have heard about our new Nucleus® Profile™ Plus Series Cochlear Implant’s thin design, unrivaled reliability and easier access to MRI¹…but let’s get technical!

How does the Profile Plus Implant’s design work?

Based upon the design of our Profile Series, the Profile Plus offers a range of features that may be beneficial to your patients.

  • Slim and smooth external geometry

The Profile Plus maintains the Profile Series’ slim design that follows the natural curvature of the head, which may result in less surgery time and an improved aesthetic outcome.

Its smooth external geometry minimizes biofilm formation.² These biofilm resistance properties  are the same as found on the Profile Series.

  • Diametric magnet

diametric magnetThe implant’s diametrically polarized magnet rotates and aligns with the magnetic field of the MRI machine, reducing the torque experienced by the implant, which contrasts axial magnets.

How can I identify the Profile Plus compared to other implants?

Compared to other products in the Profile Series, the Profile Plus includes a different magnet cassette shape. Please refer to the MRI Guidelines for further direction.¹

How will my patients benefit from the Profile Plus?

  • Easier access to MRI

With the Profile Plus MRI at 1.5 and 3.0 Tesla is possible without magnet removal or head wrap, giving recipients easier access to MRI scans.¹

  • Easy-to-remove magnet cassette

If magnet removal is necessary to prevent distortion to a patient’s MRI, the Profile Plus continues Cochlear’s longstanding history of magnet removal. While magnet removal is not needed for most scans, Profile Plus is designed to provide options for personalized healthcare.

Although it’s easy to remove, the magnet will not loosen or dislodge through normal use.

Tricks of the trade:

  • Magnet is easy to access without lifting the coil or excessive implant handling
  • No proprietary tools are needed – magnet removal can be completed using standard forceps
  • Removal requires only a small incision, which may reduce the risk of pain and infection
  • Compatibility

Profile PlusThe Profile Plus continues to offer patients choice for comfort and wear-ability with compatibility to both the Nucleus 7 and Kanso® sound processors.

Note that because the magnet design is different to the one included in previous Cochlear Implant models (diametric vs. axial), the sound processor requires the appropriate compatible magnet. For daily use, a magnet designated with an (I) should be used for Profile Plus recipients.

Profile Plus is available in the following electrode array configurations: Slim Modiolar (CI632), Slim Straight (CI622) and Contour Advance (CI612).

To learn more about new Nucleus Profile Plus Implant, check out our press release and webinar.

References

  1. MRI Guidelines D774756.
  2. Data on file: Cochlear™ Nucleus® Profile™ Plus (CI600) Series Implant FAQ
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Yellow ear

What is Normal Hearing? Why a simple and consistent answer is needed

October 29, 2020

By Patti Trautwein, MA, AuD, Vice President, Product Management & Marketing, Cochlear Americas

Less than 25% of people get their hearing screened annually and more than 37 million (15%) Americans have hearing loss.1-2  Less than 30% of people who can benefit from hearing aids1, 2 and approximately 8% from cochlear implants have them.3 

As an audiologist, this data can be frustrating. There have been tremendous advancements in technology in the last few decades, including more treatment options with devices that are smaller, smarter and deliver better outcomes. Despite these advances, why haven’t the growing number of people with hearing loss accessed treatment?  Recent clinical and market investigations have identified awareness, acceptance, cost and stigma as primary obstacles to adopting hearing devices.4

A recent article by Christopher Spankovich reviewed the history of defining hearing loss using the audiogram versus other measures such as speech or objective measures, explaining how the past five decades encapsulated the rationale for 15- 25 dB HL as the limit for normal hearing.5 Importantly, the author noted strong correlation between pure tone average and perceived hearing difficulty. Most interesting, Spankovich reported that when asking audiologists what normal hearing is, “not surprisingly, you get a variety of responses.” 

How does the variability across clinicians transcend to the general population’s understanding of normal hearing? 

For example, Cochlear’s industry research highlights how people described hearing and noted the variability. Some used words such as mild, moderately severe, significant or deaf, while others used percentages of loss or percentages of hearing remaining.

So, do people know what is normal hearing? The team decided to go out on the street to find out:

Raising awareness of a simple metric, such as 20 dB PTA, for normal hearing may help the general population understand hearing health. Further, it may provide guidance on when to seek clinical evaluation, treatment and even what type of treatments to consider. This becomes increasingly important as the options expand to include over-the-counter devices in addition to hearing aids or hearing implants, making it more important for consumers to get the support of an audiologist or ENT. A simple and consistent metric streamlines to the process for consumers and allied health providers to monitor and act on hearing health, as they are likely to do with other health considerations such as vision or cholesterol.  

Is this a call to action for hearing health care providers to align on the simple answer that the general public can understand?  Please share the video with your colleagues and start the conversation so we can work together to improve access to appropriate hearing healthcare.

To learn more, subscribe to Cochlear ProNews.

About the author: Patricia’s 25 years in the hearing healthcare industry includes roles in research and clinical studies, product management, education and training, sales and marketing. As Cochlear America’s VP of Marketing, Patricia is responsible for the marketing strategy, communications and public relations, brand ambassador program and product management. Her organization is responsible for positioning Cochlear Americas growth strategy, cultivating opportunities in new and existing customer markets and growing demand for Cochlear’s hearing solutions in the region.

References:

1. Abrahms, H and Kihm, J (2015) MT9 reveals renewed encouragement as well as obstacles for consumers with hearing loss. Hearing Review https://www.hearingreview.com/practice-building/marketing/introduction-marketrak-ix-new-baseline-hearing-aid-market (accessed on Sept 14, 2020)  

2. Quick Statistics About Hearing. (2020, October 2). NIDCD. https://www.nidcd.nih.gov/health/statistics/quick-statisticshearing#:~:text=One%20in%20eight%20people%20in,based%20on%20standard%20hearing%20examinations.&text=About%202%20percent%20of%20adults,54%20have%20disabling%20hearing%20loss.

3. Holder, J., Reynolds, S., Sunderhaus, L., Gifford, R. (2018) Current Profile of Adults Presenting for Preoperative Cochlear Implant Evaluation Trends in Hearing Jan-Dec.

4. Kochin, S. (2007) MarkeTrak VII: Obstacles to adult non-user adoption of hearing aids, he Hearing Journal: April 2007 – Volume 60 – Issue 4 – p 24-51

5. Spankovich, C. (2020) Some observations on normal hearing and hearing loss.  Audiology Today Sep/Oct 2020 pgs. 32-41.

young girl playing with bubbles

Journal Club – Use of Neural Response Telemetry for Pediatric Cochlear Implants: Current Practice

March 16, 2020

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

Use of Neural Response Telemetry for Pediatric Cochlear Implants: Current Practice

Galit Almosnino, MD1 , Samantha Anne, MD2, and Seth R. Schwartz, MD, MPH1

Annals of Otology, Rhinology & Laryngology

2018, Vol. 127(6) 367–372

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 Cochlear ProNews monthly feature – Journal Club! Each month, rotating guest authors will present a current journal article summary.

This month’s Journal Club explores a 2018 study, Use of Neural Response Telemetry for Pediatric Cochlear Implants: Current Practice. Successful management of medical practices today requires the ability to prioritize both patient outcomes and clinic efficiency.  Cochlear implant programs that work with young children and other special needs populations may feel this even more acutely due to time spent testing and additional unbillable time spent counseling families. 

The availability of electrically evoked compound action potentials (ECAP) measurements as a clinical tool revolutionized pediatric cochlear implant management by providing objective responses to auditory stimuli.  For example, neural response telemetry (NRT) is a version of ECAP.  NRT data has become increasingly fast and easy to collect in the operating room (OR) with the development of remote management capability.  Clinics may obtain this data to confirm function of electrodes and electrode placement in the OR, and this information is also helpful during the initial activation.  Very young children may not respond to the traditional programming stimuli on the first day, leaving the clinician unsure where to set parameters and causing worry for the family regarding device function.  

The authors noted highly variable use of ECAP tools across the country and took the initiative to work toward developing best practice guidelines by first establishing current practice across the country.

What did the study investigate?

The authors developed a 12-question survey that was sent to 110 cochlear implant clinic directors to investigate use and benefit of the ECAP tool.

Why is this important? 

Establishing best practice guidelines is an ideal means of ensuring consistent and positive outcomes for patients.  It is particularly important when working with medical devices in children and other vulnerable populations.  The authors determined that the first step in developing best practice guidelines was to identify current practices across various regions and practice settings.

How did they do it? 

Here is the need-to-know:

  • Survey sent to 110 CI center directors
  • 32 invited participants (29%) completed the survey

Results and Discussion1

  • >80% reported that test time took less than 15 minutes
  • 72% use intraoperative ECAP with pediatric patients
  • >50% use this tool to confirm placement and to assist with post-operative programming
  • 63% report improved ability to program at IA
  • 50% report that results improve satisfaction with initial activation
  • <50% report results prompted different management during cochlear implantation
  • 78% report testing occurred from a remote location
  • 47% reported that data collected in the OR makes the initial activation more efficient, while 44% said it did not have any effect

Since the OR is a costly place to perform tests, any additional beneficial test results must be reliable, provide useful clinical information and also be fast and easy-to-use. The results also give the family information on what to expect at the initial activation, which is both reassuring and time-saving on a day that can be loaded with emotion.  NRT uniquely uses the subtraction method to reduce stimulus artifact.  The ability for clinics to collect data remotely adds to the efficiency and usability of the data collection as a tool.

Results suggest that the greatest benefit of NRT is for clinic efficiency post-operatively rather than as a primary tool for confirming device placement intraoperatively.  Used in combination with imaging such as X-ray or CT scan will provide a higher confidence for that purpose.  The authors recognize the limitations of a survey as a research tool, pointing out that additional data correlating the data to outcomes would be extremely useful.  However, the survey strongly argues that the ability to quickly and easily start the initial activation with a viable map is a cost-saving benefit that also provides significant reassurance for the audiologist as well as the family. 

Learn more 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. Almosnino, G., Anne, S., Schwartz, S.A. (2018). Use of neural response telemetry for pediatric cochlear implants: current practice. Annals of Otology, Rhinology & Laryngology 127(6) 367-372.
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