Upgrade to Nucleus® 6 in Previous Generation Cochlear™ Sound Processor Recipients

Abstract

The Nucleus® 6 sound processor is now compatible with the Nucleus® 22 (CI22M)—Cochlear’s first generation cochlear implant. The Nucleus 6 offers three new signal processing algorithms that purportedly facilitate improved hearing in background noise.These studies were designed to evaluate listening performance and user satisfaction with the Nucleus 6 sound processor.The research design was a prospective, single-participant, repeated measures designA group of 80 participants implanted with various Nucleus internal implant devices (CI22M, CI24M, Freedom® CI24RE, CI422, and CI512) were recruited from a total of six North American sites.Participants had their external sound processor upgraded to the Nucleus 6 sound processor. Final speech perception testing in noise and subjective questionnaires were completed after four or 12 weeks of take-home use with the Nucleus 6.Speech perception testing in noise showed significant improvement and participants reported increased satisfaction with the Nucleus 6.These studies demonstrated the benefit of the new algorithms in the Nucleus 6 over previous generations of sound processors.

Wertigkeit von Patient-Reported Outcome Measures zur Bewertung des Versorgungsvorteils der Sprachprozessorumversorgung bei Patient/-innen mit Cochleaimplantaten

“…The majority of studies to date have evaluated the benefit of a specific processor from one implant company. For example, clinical studies have confirmed the advantage of the upgrade to the CP810 [ 18 ], the C910 [ 4 , 20 , 22 , 25 ], the CP1000 [ 27 ], the Rondo [ 17 ], and the Opus 2 [ 14 , 24 ]. By contrast, individual studies explicitly evaluate individual technological innovations of a new speech processor in the context of reprovisioning, for example, the effect of specific directional microphone modes [ 19 ], signal processing strategies [ 21 ], or the speech processor’s connectivity to external devices [ 27 ].…”

“…Due to the divergent measurement methodology in the individual studies with regard to the speech material used and the test sound pressure levels used, a cross-study evaluation of the benefit of speech processor conversion is hardly possible. Based on the current state of studies, an average improvement of 3–15% is found for monosyllabic test words at 60–65 dB SPL [ 4 , 14 , 18 , 23 , 24 ]. When measuring with multisyllabic numbers, previous studies have not found a significant improvement related to the upgrade, which at this point can be attributed to a ceiling effect [ 14 ].…”

“…New speech processor developments often focus on ergonomic improvements, such as smaller processor size, improved usability through enhanced controls, or connectivity for external devices [ 27 ]. By optimizing speech-coding strategies, signal processing, and microphone technologies, new speech processors can also help to improve auditory performance [ 4 , 9 , 21 , 24 ]. This includes, for example, the introduction of new directional microphone options but also possibilities for automatic adaptation to special listening situations or noise reduction [ 18 – 20 , 25 ].…”

“…Once new speech processors are approved, they will become standard processors for future CI patients. However, long-time CI users can also benefit from an upgrade to a new speech processor, as these are almost always compatible with the previous implants [ 4 , 18 ]. Therefore, patients who are already fitted with a CI can be re-evaluated for a new speech processor every 6 years.…”

Speech Understanding and Subjective Listening Effort in Noise With Different OTEs and Sound Processing Technologies

“…In both loaned processors, the T and C levels of the participants' favorite everyday program were used and adjusted if required. The signal processing algorithms automatic sensitivity control (41), adaptive dynamic range optimization (41), SNR-based noise reduction (42), and wind noise reduction (42) were enabled, and the automatic scene classification (SCAN, 42) was disabled in all programs. One program using the adaptive directional microphone Beam was uploaded to the OTE1 (condition OTE1-Beam).…”