Multicenter clinical trial of the Nucleus Hybrid S8 cochlear implant: Final outcomes

Gantz, Bruce J.; Dunn, Camille; Oleson, Jacob; Hansen, Marlan R.; Parkinson, Aaron; Turner, Christopher W.

doi:10.1002/lary.25572

Cited by 124 publications

(131 citation statements)

References 32 publications

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“…While there continues to be some risk of loss of residual hearing with surgical implantation and also after activation of the device, it appears that shorter arrays preserve more hearing than longer ones 3,17,18 . The present case study is an example of the dilemma that can be encountered when residual hearing is preserved, but the implant fails.…”

Section: Introductionmentioning

confidence: 99%

Successful Hearing Preservation After Reimplantation of a Failed Hybrid Cochlear Implant

Dunn

Etler²,

Hansen³

et al. 2015

Otology &Amp; Neurotology

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Section: Introductionmentioning

confidence: 99%

Successful Hearing Preservation After Reimplantation of a Failed Hybrid Cochlear Implant

Dunn

Etler²,

Hansen³

et al. 2015

Otology &Amp; Neurotology

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“…The Hybrid S12 CI is also 10 mm long but with 10 intracochlear electrodes. Successful preservation of acoustic hearing has been possible with all three versions of the Nucleus Hybrid CI, though results of clinical trials have only been published for two versions [Hybrid S8: Gantz et al, 2009; 2016; Hybrid L24: Roland et al, 2015]. In-house unpublished data also indicates successful hearing preservation for Hybrid S12 CI users who have been seen in our clinic.…”

Section: Introductionmentioning

confidence: 96%

“…Success with a Hybrid CI depends, however, on how much acoustic hearing can be preserved. The data suggest that most Hybrid CI users experience a relatively mild hearing loss of approximately 12 dB in the implanted ear immediately after surgery (Gantz et al, 2009, 2016; Gifford et al, 2008; Podkarbi-Fayette et al, 2010). This loss is likely a direct result of insertion trauma.…”

Section: Introductionmentioning

confidence: 96%

“…Specifically, they show improved performance on measures of speech perception in background noise and music perception when listeners use a combination of acoustic and electric stimulation versus acoustic or electric stimulation alone (Turner et al, 2004; Gfeller et al 2006; Gantz et al, 2009, 2016; Lenarz et al 2009; Brockmeier et al, 2010; Roland et al, 2015). Success with a Hybrid CI depends, however, on how much acoustic hearing can be preserved.…”

Section: Introductionmentioning

confidence: 99%

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Using Neural Response Telemetry to Monitor Physiological Responses to Acoustic Stimulation in Hybrid Cochlear Implant Users

et al. 2017

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Objective This report describes results of a series of experiments where we use the neural response telemetry (NRT) system of the Nucleus cochlear implant (CI) to measure the response of the peripheral auditory system to acoustic stimulation in Nucleus Hybrid CI users. Our objectives were to determine whether we could separate responses from hair cells and neurons, and to evaluate the stability of these measures over time. Design Forty-four CI users participated. They all had residual acoustic hearing and used a Nucleus Hybrid S8, S12, or L24 CI or the standard lateral wall CI422 implant. The NRT system of the CI was used to trigger an acoustic stimulus (500 Hz tone burst or click), which was presented at a low stimulation rate (10, 15 or 50 per second) to the implanted ear via an insert earphone and to record the cochlear microphonic (CM), the auditory nerve neurophonic (ANN) and the compound action potential (CAP) from an apical intracochlear electrode. To record acoustically evoked responses, a longer time window than is available with the commercial NRT software is required. This limitation was circumvented by making multiple recordings for each stimulus using different time delays between the onset of stimulation and the onset of averaging. These recordings were then concatenated offline. Matched recordings elicited using positive and negative polarity stimuli were added off line to emphasize neural potentials (SUM) and subtracted off line to emphasize potentials primarily generated by cochlear hair cells (DIF). These assumptions regarding the origin of the SUM and DIF components were tested by comparing the magnitude of these derived responses recorded using various stimulation rates. Magnitudes of the SUM and DIF components were compared to each other and to behavioral thresholds. Results SUM and DIF components were identified for most subjects, consistent with both hair cell and neural responses to acoustic stimulation. For a subset of the study participants, the DIF components grew as stimulus level was increased, but little or no SUM components were identified. Latency of the CAPs in response to click stimuli was long relative to reports in the literature of recordings obtained using extracochlear electrodes. This difference in response latency and general morphology of the CAPs recorded was likely due to differences across subjects in hearing loss configuration. Use of high stimulation rates tended to decrease SUM and CAP components more than DIF components. We suggest this effect reflects neural adaptation. In some individuals, repeated measures were made over intervals as long as 9 months. Changes over time in DIF, SUM and CAP thresholds mirrored changes in audiometric threshold for the subjects who experienced loss of acoustic hearing in the implanted ear. Conclusions The Nucleus NRT software can be used to record peripheral responses to acoustic stimulation at threshold and supra-threshold levels, providing a window into the status of the auditory hair cells and the primary afferent nerve f...

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“…When hearing preservation is achieved postoperatively, these CI recipients listen with a combination of acoustic and electric technologies in 1 ear, known as electric-acoustic stimulation (EAS). Patients who use EAS also report a significant improvement in quality of life postoperatively as compared to a preoperative baseline with conventional amplification [Skarzynski et al, 2006;Gstoettner et al, 2008;Santa Maria et al, 2013;Gantz et al, 2016].…”

Section: Experiments Ii: Quality Of Life Comparison Between CI Recipiementioning

confidence: 99%

Effect of Cochlear Implantation on Quality of Life in Adults with Unilateral Hearing Loss

et al. 2017

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Objective: Patients with moderate-to-profound sensorineural hearing loss in 1 ear and normal hearing in the contralateral ear, known as unilateral hearing loss (UHL) or single-sided deafness (SSD), may experience improved quality of life with the use of a cochlear implant (CI) in the affected ear. Quality of life assessment before and after implantation may reveal changes to aspects of hearing beyond those explicitly evaluated with behavioral measures. Methods: The present report completed 2 experiments investigating quality of life outcomes in CI recipients with UHL. The first experiment assessed quality of life during the 1st year of device use with 3 questionnaires: the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Tinnitus Handicap Inventory. Twenty subjects were evaluated preoperatively and 1, 3, 6, 9, and 12 months post-activation. Quality of life results were compared over the study period using traditional scoring methods and the SSQ pragmatic subscales. Subscales specific to localization and speech perception in noise were compared to behavioral measures at the preoperative and 12-month intervals. The 2nd experiment evaluated quality of life preoperatively and at the 12-month interval for CI recipients with UHL and CI recipients with bilateral hearing loss, including conventional CI users and those listening with electric-acoustic stimulation (EAS). The 3 cohorts differed in CI candidacy criteria, including the amount of residual hearing in the contralateral ear. Results: For subjects with moderate-to-profound UHL, receipt of a CI significantly improved quality of life, with benefits noted as early as 1 month after initial activation. The UHL cohort reported less perceived difficulty at the pre- and postoperative intervals than the conventional CI and EAS cohorts, which may be due to the presence of the normal-hearing ear. Each group experienced a significant benefit in quality of life on the APHAB with CI use. Conclusions: Cochlear implantation in cases of substantial UHL may offer significant improvements in quality of life. Quality of life measures revealed a reduction in perceived tinnitus severity and subjective improvements in speech perception in noise, spatial hearing, and listening effort. While self-report of difficulties were lower for the UHL cohort than the conventional CI and EAS cohorts, subjects in all 3 groups reported an improvement in quality of life with CI use.

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Multicenter clinical trial of the Nucleus Hybrid S8 cochlear implant: Final outcomes

Cited by 124 publications

References 32 publications

Successful Hearing Preservation After Reimplantation of a Failed Hybrid Cochlear Implant

Successful Hearing Preservation After Reimplantation of a Failed Hybrid Cochlear Implant

Using Neural Response Telemetry to Monitor Physiological Responses to Acoustic Stimulation in Hybrid Cochlear Implant Users

Effect of Cochlear Implantation on Quality of Life in Adults with Unilateral Hearing Loss

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