Cochlear Implants
by Ryan Lopez

The new Nucleus® 7 Sound Processor is here! Welcome to the future of hearing.

September 7, 2017
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 Welcome to the future of hearing.

The Nucleus 7 Sound Processor is the first Made for iPhone sound processor.1 This gives recipients access to connect with their technology as well as their loved ones as they stream phone calls, videos, music and entertainment directly to their sound processor(s). 

The Nucleus 7 is also the world’s smallest, lightest behind-the-ear sound processor; at 25 percent smaller and 24 percent lighter than the Nucleus 6 Sound Processor.2 Thanks to new chip technology, designed for more efficient power transfer, battery life has increased by up to 50 percent when compared to the Nucleus 6.3 The Cochlear Slimline™ Coil of the Nucleus 7 Sound Processor is a new ultra-compact all-in-one coil and cable. This coil is lighter and lower profile than previous sound processors, which provides greater comfort – even when wearing a hat or helmet. The Nucleus 7 Sound Processor is the most water resistant sound processor4 and with the addition of the Aqua+, it becomes waterproof.5

The Nucleus Smart App, designed specifically for the Nucleus 7 Sound Processor, allows your patients to control their own settings. The Nucleus Smart App contains new and exciting features like, adjusting their own volume, treble, bass and sensitivity, automatic data logging and Find my Sound Processor for locating missing or lost devices. The Nucleus 7 Sound Processor is compatible with a simple Remote Assistant, however with the introduction of the Nucleus Smart App your patient no longer has to carry around an extra device.6 For the first time, patients can take control and stream sound directly to their sound processor(s) from their Apple devices. True Wireless™ accessories are also compatible with Nucleus 7 Sound Processor in order to help patients watch TV, talk on the phone and listen clearly in noisy situations. For added convenience, patients can switch between streaming to different True Wireless accessories all on their iPhone®.

From noisy or windy conditions to quiet conversations, you can be confident your patients are hearing their best. Equipped with Cochlear’s proven SmartSound® iQ with SCAN sound management system,7 the Nucleus 7 Sound Processor constantly optimizes listening in different environments. SmartSound iQ with SCAN automatically analyses and adjusts settings without the need for multiple programs or patient interaction. For patients who may have residual hearing, the Nucleus 7 Sound Processor comes Hybrid™ ready so that they can use Hybrid Hearing. By using an acoustic component to amplify low frequency sounds, your patients can access the benefits of combined acoustic and electric hearing in a single device.8

The Nucleus 7 Sound Processor is commercially available now! Click here to see what your patients are learning on our website about the Nucleus 7 Sound Processor.

References:
1 Apple Inc. Use Made for iPhone hearing aids [Internet]. Apple support. 2017 [cited 24 February 2017]. Available from: https://support.apple.com/en-au/HT201466 (Subject to change at time of launch).
2 Cochlear Limited. D1190805. CP1000 Processor Size Comparison. 2017, Mar; Data on file.
3 Cochlear Limited. D1140877. Battery Life and Power Consumption Comparison between CP1000, CP900 Series and CP810 Sound Processors. 2017, Mar; Data on file.
4 Cochlear Limited. Nucleus 7 Sound Processor User Guide. 2017, Jan; Data on file.
5 Cochlear Limited. Nucleus 7 Aqua+ User Guide. 2016, Oct; Data on file
6 D1182081. CLTD 5620 Clinical Evaluation of Nucleus 7 Cochlear Implant System. 2017, Mar; Data on file.
7 Mauger SJ, Warren C, Knight M, Goorevich M, Nel E. Clinical evaluation of the Nucleus 6 cochlear implant system: performance improvements with SmartSound iQ. International Journey Of Audiology. 2014, Aug; 53(8): 564-576. [Sponsored by Cochlear].
8 Cochlear Limited. P130016: Nucleus® Hybrid™ L24 Implant System. 2013, Sep; Available from: https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/EarNoseandThroatDevicesPanel/UCM373793.pdf
© Cochlear Limited 2017. All rights reserved. Hear Now And Always and other trademarks and registered trademarks are the property of Cochlear Limited.
Apple, the Apple logo, iPhone,and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc.
Nucleus 7 is compatible with iPhone 7 Plus, iPhone 7, iPhone 6s Plus, iPhone 6s, iPhone 6 Plus, iPhone 6, iPhone SE, iPhone 5s, iPhone 5c, iPhone 5, iPad Pro (12.9-inch), iPad Pro (9.7-inch), iPad Air 2, iPad Air, iPad mini 4, iPad mini 3, iPad mini 2, iPad mini, iPad (4th generation), iPod touch (6th generation) and iPod touch (5th generation) using iOS 10.X or later. Apple, the Apple logo, Made for iPhone, iPhone, iPad Pro, iPad Air, iPad mini, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc., registered in the U.S. and other countries.
SNR-WR, 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: and 2) report a preference for different program settings.
Nucleus 7 with Aqua+ is water resistant to level IP68 of the International Standard IEC60529. This water protection rating means that the sound processor with the Aqua+ can be continuously submerged under water to a depth of 3 meters (9 feet and 9 inches) for up to 2 hours. This water protection only applies when you use a Cochlear Standard Rechargable Battery Module or Cochlear Compact Rechargable Battery Module.
The Nucleus® Hybrid™ Implant System is approved in the US for adults 18 and older.
The acoustic component should only be used when behavioral audiometric thresholds can be obtained and the recipient can provide feedback regarding sound quality.
Related Posts
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.

Apple, the Apple logo, Apple Watch, FaceTime, Made for iPad logo, Made for iPhone logo, Made for iPod logo, iPhone, iPad Pro, iPad Air, iPad mini, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc., registered in the U.S. and other countries.

Science Spotlight: Considerations for a revised adult cochlear implant candidacy evaluation protocol

July 26, 2021

Considerations for a revised adult cochlear implant candidacy evaluation protocol

*A. Biever, *^C. Amurao, ^M. Mears

*Rocky Mountain Ear Center, 601 E. Hampden Ave #430, Englewood, CO 80113, United States of America, ^Cochlear Americas, 10350 Park Meadows, Lone Tree, CO 80124, United States of America

Purpose

To compare two commonly utilized tests in cochlear implant candidacy evaluations, the Consonant- Nucleus-Consonant (CNC) test in quiet and the AzBio Sentences test in noise, for uniformity and appropriateness.

To recommend an updated streamlined test battery that relies on a monosyllabic word test and a self-report subjective measure of hearing capabilities.

Key messages

The CNC word test is efficient and effective in determining cochlear implant candidacy and can be used to monitor hearing performance over time.

The Speech, Spatial and Qualities of Hearing Scale (SSQ) or SSQ-12 furnishes subjective, real-world insight into an individual’s hearing difficulties and offers complementary information to objective speech understanding measures.

Methods

  • Prospective, non-randomized, multicenter controlled trial at 13 clinical sites
  • 100 experienced hearing aid users > 18 years old with postlinguistic onset of bilateral, moderate sloping to profound sensorineural hearing loss
  • Aided CNC word score < 40% in the ear to be implanted and < 50% in the contralateral ear

Preoperative speech recognition was evaluated in the sound field for unilateral (HA) and bilateral (2HA) conditions and at 6-months postoperatively for unilateral (CI) and bimodal (CI+HA) conditions. CNC words in quiet at 60 dBA and AzBio sentences at 65 dBA in background noise at +10 and +5 dB SNR (speech and noise at 0° azimuth) were presented. In addition, participants completed the subjective Speech, Spatial and Qualities of Hearing Scale (SSQ), pre-(2HA) and 6-months postoperatively (CI+HA). All assessment results are based on matched pair data.

Results

In total, 100 subjects were implanted in this study, ranging from 23 to 91 years of age with a mean age of 67 years at the time of implantation. The duration of hearing loss in the ear to be implanted ranged from 1 to 66 years with an average duration of 27 years, and all subjects were experienced hearing aid users.

Of the 100 subjects who were enrolled in the study, 96 completed the speech testing at the 6-month endpoint. In the implanted ear, subjects demonstrated an average improvement of 46 percentage points on CNC words at 6 months postoperatively, and 28 percentage points and 11 percentage points for AzBio sentences at +10 dB SNR and +5 dB SNR respectively.  The improvement on each of the three tests was statistically significant at the 6-month endpoint, and Figure 1 shows the distribution of individual scores. All results represent matched pair data.

More variation in individual outcomes for speech recognition scores for sentences in noise was observed compared to CNC words in quiet in both unilateral and bimodal listening conditions at each test interval.  Competing background noise presents the potential for additional cognitive load for hearing-impaired individuals.  The scores obtained on a complex sentence test in noise can sometimes reflect the central processing function of the patient, more so than capture their peripheral listening ability.  Administration of a monosyllabic word test in quiet can more reasonably assure that the clinician is evaluating peripheral performance, without the contribution of additional central processes.

Figure 1:  The distribution of individual speech scores preoperatively versus at the at the 6-month endpoint.  Group mean score for CNC words significantly increased by 46 percentage points ( p<0.001). Group mean score for AzBio sentences scores at +10 dB SNR significantly increased by 28 percentage points (p<0.001).  Group mean score AzBio sentences scores at +5 dB SNR significantly increased by 11 percentage points (p<0.001).  Note the increased variability in scores on the AzBio sentences, as well as the floor effect seen most prominently in the +5 dB SNR condition. CNC indicates Consonant-Nucleus-Consonant; SNR, signal-to-noise ratio.

As shown in Figure 2, the overall total score on the SSQ at the 6-month endpoint (N=95) showed a clinically significant improvement from 3.2 to 5.7 (a 2.5 point increase) with 77% of subjects reporting an overall improvement.  Results from the SSQ scenarios can be classified into pragmatic subscales that reflect self-reported difficulties associated with acoustically dynamic listening situations where binaural hearing is especially important. The mean pre-to-post speech in noise subscale change was 2.6 and the mean pre-to-post speech in quiet subscale change was 2.9 with 86% of subjects showing a significant increase. 

Figure 2:  Mean scores on the SSQ (49 questions) preoperatively with hearing aids and at 6-months postoperatively with a cochlear implant & hearing aid. Significant postoperative changes were demonstrated in each subscale as well as the total score (p<0.001).

Conclusions

Results from this multi-center study suggest that clinicians adopt CNC words as the primary candidacy evaluation instrument rather than AzBio Sentences in noise. A subjective tool, such as the SSQ-12 or SSQ, can provide important complementary information regarding how the individual feels about everyday hearing abilities.

To read more Science Spotlights visit Cochlear ProNews.

Citation: Biever A, Amurao C, Mears M. Considerations for a revised adult cochlear implant candidacy evaluation protocol, Otol Neurotol. 2021 Jan; 42; (1),159-164 doi: 10.1097/MAO.0000000000002966

This article is intended to serve as a resource for clinicians to help keep up to date with current clinical literature and is intended for professionals only. Clinical literature is based on research, which may include the experimental use of new or currently available products and technologies. Therefore, literature presented on this blog may represent use of Cochlear products that does not align with the intended use or indications approved by regulatory bodies, also known as off-label use. Cochlear does not condone any off-label use of its products, and it is not Cochlear’s intent to promote off-label use by providing this blog as a resource to clinicians.

This article summary is for education and information sharing amongst professionals and partners. Any representations made in relation to medical devices or therapeutic goods are not advertisements. The representations and views expressed in this summary are those of the authors and do not reflect the views of Cochlear. Cochlear does not endorse any particular treatment or research protocol nor off-label use.”

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