Cochlear Implants
by Michi Diller

Quick Tips: Cochlear Nucleus Depth Gauges

September 21, 2023
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Welcome to Cochlear™ Quick Tips.  The purpose behind Quick Tips is to give you “bite-sized” information that you can use when working with our products.  In this first edition, we will discuss Cochlear™ Nucleus® Depth Gauges.

What is a depth gauge?

  • Depth gauges are surgical components that utilize the same materials and have the same handling characteristics as “live” electrode arrays

When should a Depth Gauge be considered?

  • To aid in assessing the patency of the cochlea lumen if pre-operative imaging is inconclusive or unavailable
  • To assess if insertion depth is adequate
  • To assist in determining the most appropriate implant model
  • During explant/re-implant procedures

What Depth Gauges are available?

  • Cochlear has two types of depth gauges: the Contour Advance Depth Gauge and Straight Depth Gauge
  • The Contour Advance Depth Gauge is more commonly used of the two depth gauge options. This is due to its benefits in obstruction/fibrosis/ossification, common cavity, incomplete partition, and cochlear hypoplasia cases

Can I see an example of how this can be used?

Anything else I should know?

  • Depth gauges are not approved for use as an implant or stent. 
  • Monopolar electrocautery should not be performed with a depth gauge in position.
  • The Straight Depth Gauge DOES NOT have the same the same dimensions or handling characteristics as the Slim Straight electrode and does not have a smooth lateral surface or basal support​.  Size differential between slim straight and straight electrode arrays may create false-positive or false-negative feedback with use​. 
  • For more information, please reach out to your local Cochlear representative or call Cochlear’s Surgical-on-Call at (877) 279-5411.

To learn more about Cochlear™ Nucleus® Implants, visit our website. 

Related Posts
pediatric cochlear implant

Guide to Cochlear’s new expanded pediatric indication

June 26, 2020

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.

Expanding Insurance Coverage of Cochlear Implants for Single-Sided Deafness

July 13, 2023

On January 10, 2022, the FDA approved an expansion of the Cochlear™ Nucleus® System indications to include Single Sided Deafness and Unilateral Hearing Loss (SSD/UHL) for individuals 5 years and older. 

Every year, about 60,000 people in the United States acquire SSD. 1  UHL/SSD can impact an individual’s quality of life, including mental fatigue because of increased listening effort, as well as impacting understanding of speech in noise and localizing where sounds are coming from.2,3,4,5,6 

Aligning with our company mission, a goal of the Cochlear Market Access team is to help more people hear by removing barriers to accessing implantable hearing solutions. We are pleased to announce a major milestone within the commercial payer landscape for CI for SSD/UHL:

Policy adoption begins with clinical providers who are willing to passionately advocate for coverage on behalf of their patients. Communicating to payers the need to expand coverage policies occurs in various ways not the least of which is the need that is emphasized with every prior authorization request, peer to peer conversation, and completed level of appeal. The collaborative effort of providers across the nation who embraced the cause emphasized an unmet need and accelerated the time from the Cochlear FDA approval to policy adoption at both the national and local levels. Below is a sample of the commercial payer landscape which recently expanded coverage to their members.*

Reaching this milestone in coverage does not conclude our effort in closing the gap in coverage. Cochlear’s Market Access team invites and welcomes all providers to partner with us on the journey to help more people hear.  Please visit the Reimbursement HUB for your local Regional Reimbursement Manager’s contact information and additional resources.

*Coverage may vary by specific plan.  Providers and members should contact their insurance plans to determine coverage according to their benefit plan design.

Information provided by Cochlear Americas regarding insurance coverage or reimbursement is provided as guidance only and is not intended as reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding such information or its completeness, accuracy, fitness for a particular purpose, or that following such guidance will result in any form of coverage or reimbursement from any insurer. Information presented is subject to change at any time. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own experts and seek your own legal advice regarding your reimbursement needs. In all cases, products or services billed must be medically necessary, actually performed and appropriately documented in the medical record.

1. Weaver, J. (Web. 28 April 2017). “Single-Sided Deafness: Causes, and Solutions, Take Many Forms.”. Hearing Jornal, 68.3 (2015).

2. Buss E, Dillon MT, Rooth MA et al. Effects of Cochlear Implantation on Binaural Hearing in Adults with Unilateral Hearing Loss. Trends Hear 2018; 22:2331216518771173

3. Firszt JB, Reeder RM, Holden LK, Dwyer NY, Asymmetric Hearing Study T. Results in Adult Cochlear Implant Recipients with Varied Asymmetric Hearing: A Prospective Longitudinal Study of Speech Recognition, Localization, and Participant Report. Ear Hear 2018; 39:845-862.

4. Tavora-Vieira D, Rajan GP, Van de Heyning P, Mertens G. Evaluating the Long-Term Hearing Outcomes of cochlear Implant Users with Single-sided Deafness. Otol Neurotol 2019;40:e575-e580.

5. Dillon MT, Buss E, Anderson MLet al. Cochlear Implantation in Cases of Unilateral hearing loss: Initial Localization Abilities. Ear Hear 2017; 38-611-619.

6. Dillon MT, Buss E, Rooth MA et al. Effect of Cochlear Implantation on Quality of Life in Adults with Unilateral Hearing Loss. Audiol Neurootol 2017; 22:259-271.

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