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Cochlear Ltd. Implants for Moderate to Profound Hearing Loss
Models, Features, and Reviews)
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Aktualisiert am Nov 15, 2023
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Cochlear Ltd. is the world leader in hearing implants. Founded in Australia in 1981, it was among the pioneers who commercialized cochlear implants to restore hearing for people with severe-to-profound sensorineural hearing loss. Cochlear is also a leader in bone-anchored hearing implants for people with single-sided deafness or conductive hearing loss:
Cochlear’s products include the Nucleus and Kanso cochlear implant systems, Nucleus Hybrid electro-acoustic cochlear implants, and the Baha and Osia 2 bone conduction implants.
In 2023, Oticon Medical sought to sell its Ponto bone conduction implant and Neuro Zti cochlear implant to Cochlear Ltd. But the sale of the Ponto system was objected to by the anticompetitive authorities in several countries and blocked by the UK; it's now expected that Cochlear will take on the Neuro Zti cochlear implant sometime in the first half of 2024.
Implant systems integrate a complex combination of technologies. Cochlear implants have external sound processors and internal implantable electrodes that deliver sound to the auditory nerve and brain. Bone-conduction implants, sometimes known as bone-anchored hearing aids, collect sound waves from the air and transmit them through vibrations in the skull that reach the hearing nerves in the inner ear.
Cochlear’s sound processing technology works with both its cochlear implants and its bone-conduction implants. The external sound processors for the cochlear implants look a lot like large hearing aids. But instead of amplifying sound, they convert it into digital signals that travel through an electrode to the inner ear. A powerful chipset drives advanced sound processing software that’s tuned to help users understand speech.
Cochlear has improved its sound processing technologies in lockstep with advances made by high-end hearing aid manufacturers. Its latest improvements for the Nucleus 8 (N8) are designed to provide easier management of program settings, better understanding of speech in challenging listening environments, and feature a reduction in size and weight with a new ergonomic design:
Cochlear also offers a smartphone app that makes it easy to change programs, adjust volume, bass and treble, and check battery life of the external sound processor without carrying a separate remote control.
Cochlear has stayed at the cutting edge of electrode implant technologies since its inception. It has constantly improved its electrodes in significant ways:
Cochlear’s implanted electrodes are highly reliable and are designed to be used for life. And Cochlear makes sure new generations of external sound processors are compatible with them, so patients get the benefit of new digital technologies as they become available.
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At only 3.9 mm in thickness, Cochlear’s Profile series of implantable electrodes fit snugly under the scalp on the skull. And Cochlear’s Profile Plus electrodes address the problem of magnets in their implants making it difficult for patients to undergo MRI tests, enabling access to MRI’s at 1.5 Tesla and 3.0 Tesla. The magnet can also be removed and replace in outpatient surgery if necessary.
For its cochlear implants and bone-conduction implants, Cochlear provides advanced connectivity with both hearing aids and smartphones.
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Through its alliance with GN ReSound, one of the world’s top-five hearing aid manufacturers, Cochlear also offers bimodal solutions — coordinating sound processing between a hearing aid in one ear and a cochlear implant in the other. Your ReSound hearing aid can work simultaneously with the same wireless accessories used with your cochlear implant.
Cochlear integrates all the components required for cochlear implant systems. Its Nucleus cochlear implants include an internal electrode array and an external sound processor.
The Cochlear Nucleus 8 system, introduced in November 2022, is the successor of the Cochlear Nucleus 7, which was the first Made-for-iPhone cochlear implant. Like its predecessor, it provides wireless audio streaming directly from Android phones that support the ASHA (audio streaming for hearing aids) protocol and Apple iOS 15 or later. Nucleus 8 benefits include:
Cochlear says the improved ergonomic design of the N8 Behind-the-Ear (BTE) sound processor, makes it smaller and lighter, while changing how the device sits on the ear. The company boasts the N8 sound processor is over 30% smaller (measured with a medium earhook and a compact battery) and 34% lighter than the N6—although the N7 is the previous generation of processors, not the N6. However, when comparing the length, width, and depth measurements of the N7 to the N8, the overall size reduction is approximately 5.5%, and the weight reduction is about 13%, making the N8 one of the smallest—if not the smallest—BTE sound processors on the market.
For patients who don’t want a sound processor sitting on their ear with a wire extending to a headpiece linked to the implant, Cochlear puts all the sound processing in a standalone Kanso 2 cochlear implant headpiece. Cochlear says Kanso is the smallest and lightest off-the-ear sound processor available with two microphones.
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The Kanso 2 Sound Processor, which comes in a range of eight hair-matching colors, has an all-in-one design, with no cables and nothing on the ear to worry about. It magnetically attaches to the implant sitting under the scalp, collecting and transmitting the digitally encoded sound to the implant electrode through magnetic induction.
Kanso 2 offers many of the same benefits as Cochlear's behind-the-ear Nucleus 7 Sound Processor, including direct streaming from compatible Apple or Android™ devices, dual microphones, wireless accessory compatibility, water and dust protection, and signature Cochlear features like SmartSound® iQ (with SCAN) and ForwardFocus, for improved hearing in noisy situations.
The Nucleus Hybrid System amplifies the low-pitched hearing a person still has while restoring access to high-pitched hearing that’s been lost. It combines acoustic amplification of low frequencies with the electrical stimulation of high frequencies in one device.
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Cochlear’s hybrid hearing system combines two technologies. The first is the same kind of acoustic amplification found in a hearing aid. An acoustic component attached to the end of the Nucleus 7 Sound Processor amplifies the low-frequency natural hearing you may retain after cochlear implant surgery. At the same time, the hybrid sound processor delivers high-frequency digitally encoded sound waves through a special electrode designed to preserve low-frequency hearing.
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Cochlear’s Baha Bone Conduction Implant System is a solution for conductive hearing loss, which occurs when sound waves fail to reach the healthy hearing cells in the cochlea. When organs in the outer or middle ear are damaged or deformed, they sometimes fail to transmit sound waves from the air to the inner ear. A bone-anchored implant can bypass the outer and middle ear organs by transmitting sound waves through the skull directly to the cochlea in the inner ear.
The Baha system is also for people with single-sided deafness (SSD). By placing the implant on the side of the head with no hearing and having it transmit sound through the skull to the ear with healthy hearing cells, it enables the 360-degree perception of sound.
How does Baha work? Your skull bone is a very efficient conductor of sound waves to the hearing cells in the cochlea. A bone-conduction hearing system collects sound with an external processor and converts the sound waves into vibrations that travel through the skull to the cochlea in the inner ear. When the hearing cells in the cochlea are working well, they convert the vibrations into the electrical pulses carried by the auditory nerve to the brain, which recognizes the pulses as sound.
The Baha® 6 Max Sound Processor, released in 2021, is the newest bone anchored hearing solutions speech processor from Cochlear and will fit up to a 55 dB HL (Hearing Level as shown on your audiogram) sensorineural hearing loss (SNHL). It replaces the Baha 5, introduced in 2015, and Baha 5 Power. Cochlear continues to offer the Baha 5 SuperPower Sound Processor which, although an older generation, can accommodate up to a 65 dB HL and may be a better option for those with more significant hearing loss.
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Baha 6 offers several upgrades over its predecessor, including the new Xidium chip platform that gives it faster processing speeds, increased frequency range, and the ability to stream both Apple and Android devices. It also has an IP68 rating, which is the industry standard for moisture and debris resistance. The LowPro™ coupling system—the connection point between the processor and the abutment or magnet—also lessens the implant projection and allows it to sit closer to the head, thus improving its cosmetics.
Like Baha, the Osia® 2 bone conduction implant system is also designed for people with conductive or mixed hearing loss or those with single-sided deafness (SSD), as well where a traditional air-conduction hearing aid won't work well (e.g., chronic ear infections, malformation, etc.). However, the active implant component of the Osia 2 sits entirely underneath the skin; in other words, no abutment protrudes from the head, and the processing unit affixes to the implanted unit via a magnet.
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Osia 2 also features a smaller, lightweight sound processor. Unlike the Baha system which uses an electromagnetic mechanical system to drive the vibrations (much like a speaker system in a stereo), Osia 2 utilizes a piezoelectric transducer to vibrate the implant. The system is designed to provide more stability and make it less prone to acoustic feedback (squeal). Being smaller, it also can be located closer and more in line with the ear opening, providing better cosmetics.
Osia 2 is Apple MFi compatible, but you need an accessory to connect to most Android devices and it does not provide hands-free calling. It has a dust and moisture rating of IP57 which is less than Baha 6, but the Aqua+ accessory bumps it up to IP68.
Cochlear’s True Wireless accessories connect to cochlear implant and Baha sound processors using Bluetooth technology. They are compatible with the Nucleus 7 and Nucleus 6 sound processors, the Kanso 2 sound processor, and the Baha 5 sound processors.
The Cochlear Mini Microphone 2 and 2+ extend the hearing range of Cochlear’s sound processors and improve comprehension of speech in challenging listening situations. By optimizing signal-to-noise ratio in public settings or for one-on-one conversations, the wireless clip-on microphones transmit speech and sound directly to the sound processor.
The Cochlear Wireless TV Streamer sends stereo sound from a TV or other audio device directly to one or both sound processors. 2.4 GHz wireless technology also lets you connect it to multiple computers, music players and other audio devices.
The Cochlear Phone Clip enables wireless streaming of phone calls and music from your smartphone to your implant processor. It’s small enough to clip to your clothing or keep in your handbag or pocket.
The Nucleus Smart App works with the Cochlear Wireless Phone Clip to adjust the sound processor settings across a range of different environments directly from an iPhone or iPod touch, or from compatible Android devices. You can raise or lower volume, view battery life, adjust the mix between wireless audio from the phone and environmental sound, and perform other monitoring and control functions. It also has a “find-my-sound-processor” function that locates your implant processor if you don’t know where it is.
David Copithorne ist ein langjähriger Blogger zum Thema Hörverlust und regelmäßiger Mitwirkender bei Hearing Tracker. Im Jahr 2002 erlitt er eine plötzliche und schwere Hörverlust. Seitdem hat er sich der Weitergabe wertvoller Informationen gewidmet, die er auf seinem Weg gelernt hat.
Dr. Chad Ruffin ist ein Hals-Nasen-Ohren-Arzt in Seattle, der sich auf Höherstellung und Ohrenchirurgie spezialisiert. Er gehört zu den ersten Menschen mit angeborener schwerer Hörverlust, die als Chirurg mit Cochlea-Implantaten tätig sind. Er führt Cochlea-Implantationen und Höherstellungschirurgie durch und lehrt seine Patienten, wie sie trotz Hörverlust das Leben in vollen Zügen genießen können. Neben der Behandlung von Patienten in der Klinik forscht und entwickelt er auch Technologien für Hörverlust.
