The next generation of Nucleus® fitting: A multiplatform approach towards universal cochlear implant management

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Abstract

Objective:

This article provides a detailed description and evaluation of the next Nucleus ^® cochlear implant fitting suite. A new fitting methodology is presented that, at its simplest level, requires a single volume adjustment, and at its advanced level, provides access to 22-channel fitting. It is implemented on multiple platforms, including a mobile platform ( Remote Assistant Fitting) and an accessible PC application ( Nucleus Fitting Software). Additional tools for home care and surgical care are also described.

Design:

Two trials were conducted, comparing the fitting methodology with the existing Custom Sound™ methodology, as fitted by the recipient and by an experienced cochlear implant audiologist.

Study sample:

Thirty-seven subjects participated in the trials.

Results:

No statistically significant differences were observed between the group mean scores, whether fitted by the recipient or by an experienced audiologist. The lower bounds of the 95% confidence intervals of the differences represented clinically insignificant differences. No statistically significant differences were found in the subjective program preferences of the subjects.

Conclusions:

Equivalent speech perception outcomes were demonstrated when compared to current best practice. As such, the new technology has the potential to expand the capacity of audiological care without compromising efficacy.

Related collections

Most cited references 37

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Revised CNC lists for auditory tests.

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The relationship between EAP and EABR thresholds and levels used to program the nucleus 24 speech processor: data from adults.

Charmayne M L Hughes, B Luk, John W S Brown … (2000)

The objective of this study was to determine the relationship between electrically evoked whole nerve action potential (EAP) and electrical auditory brain stem response (EABR) thresholds and MAP threshold (T-level) and maximum comfort level (C-level) for subjects who use the Nucleus 24 cochlear implant system. Forty-four adult Nucleus 24 cochlear implant users participated in this study. EAP thresholds were recorded using the Neural Response Telemetry System developed by Cochlear Corporation. EABR thresholds were measured for a subset of 14 subjects using standard evoked potential techniques. These physiologic thresholds were collected on a set of five electrodes spaced across the cochlea, and were then compared with behavioral measures of T-level and C-level used to program the speech processor. EAP thresholds were correlated with MAP T- and C-levels; however, the correlation was not strong. A technique for improving the correlation by combining measures of T- and C-levels made on one electrode with the EAP thresholds was presented. Correlations between predicted and measured T- and C-levels using this technique were 0.83 and 0.77, respectively. Similar results were obtained using the EABR thresholds for a smaller set of subjects. In general, EABR thresholds were recorded at levels that were approximately 4.7 programming units lower than EAP thresholds. Either EAP or EABR thresholds can be used in combination with a limited amount of behavioral information to predict MAP T- and C-levels with reasonable accuracy.

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Predictive models for cochlear implantation in elderly candidates.

Nae-Yuh Wang, W. Loren Francis, Stephen Bowditch … (2005)

An aging American population carries a high prevalence of profound sensorineural hearing loss. We examined the performance of multichannel cochlear implant recipients in a large database of adult subjects. Nonconcurrent prospective study of a national cohort with multivariate regression analysis of preoperative and postoperative performance variables in multichannel cochlear implant recipients. We applied models of prediction established in previous studies to the observed results. Referral centers with active cochlear implant programs. Adolescents and adults with profound hearing loss (N = 749; age range, 14-91 years). Postoperative monosyllabic word recognition. The population 65 years and older demonstrated a clinically insignificant 4.6%-smaller postoperative word score compared with the population younger than 65 years. When duration of deafness exceeded 25 years, elderly recipients demonstrated higher word scores than their younger counterparts. A more significant factor affecting outcomes is the ratio of duration of deafness to age at implantation. Age at implantation carried relatively little predictive value for postoperative performance in subjects 65 years and older. Although a small decrement in mean speech recognition scores was evident, the clinical significance of this difference is questionable when all of the results observed in elderly patients are considered. A shorter percentage of life spent in severe-to-profound sensorineural hearing loss suggests a foundation of acoustic/auditory processing in the elderly cohort that may mitigate potential physiological effects associated with advanced age. This study confirms and extends previous observations that duration of profound deafness and residual speech recognition carry higher predictive value than the age at which an individual receives an implant.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Audiol

Journal ID (iso-abbrev): Int J Audiol

Journal ID (publisher-id): IJA

Title: International Journal of Audiology

Publisher: Informa Healthcare

ISSN (Print): 1499-2027

ISSN (Electronic): 1708-8186

Publication date (Print): July 2013

Publication date (Electronic): 25 April 2013

Volume: 52

Issue: 7

Pages: 485-494

Affiliations

*Cochlear Limited , Sydney, Australia

^†The University of New South Wales , Sydney, Australia

Author notes

Correspondence: Saji Maruthurkkara, Cochlear Limited, 1 University Avenue, Macquarie University , Sydney, NSW 2109, Australia. E-mail: smaruthurkkara@ 123456cochlear.com

Article

DOI: 10.3109/14992027.2013.781277

PMC ID: 3696341

PubMed ID: 23617610

SO-VID: 87156ffc-5c4a-4878-ae8d-d1e37bc1be37

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.