August 2008: Interactive Troubleshooting, Clinic Tip

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Submitted by admin on August 1, 2008 - 1:00am

For more than 25 years, Cochlear has delivered unsurpassed hearing performance
with the most reliable implant devices on the market.

Dear Colleague,
Cochlear is pleased to bring you the August Clinic Newsletter.

Clinic-to-Clinic Tip

A cochlear implant clinic has submitted a tip that works well for their pediatric patients and families:

For pediatric patients, we program the device before sending it home after surgery.  The sound processor can have MAPs downloaded that are at 0 current levels so as not to stimulate inadvertently.  This way the parent gets used to some of the helper messages and becomes familiar with how to use the controls on the processor prior to activation.  If the incision has healed well and the surgeon approves, the child can also wear the processor without the coil before initial activation so they are used to having something on their ear.

If you have tips that you would like to share with your colleagues, please submit them to awollan@cochlear.com

Freedom Troubleshooting

Cochlear is proud to introduce its new Online Troubleshooting Guide.  This easy-to-use, interactive tool empowers recipients who wear Nucleus® Freedom™ sound processors to quickly diagnose product issues should they occur.  Using the Guide is as simple as following the step-by-step instructions and answering "Yes" or "No" to simple questions.  The Guide walks the recipient through a troubleshooting regimen that is both diagnostically comprehensive and yet, easy to follow.  The Guide is available in English and Spanish and can be found online at:  www.cochlearamericas.com/support

Research Summarized:

In the July Cochlear Newsletter, we included a summary of the Skinner et al research.  This month, we are pleased to provide a summary of Dr. Roland’s research on insertion forces with new electrode designs and insertion technique.

Summary

Roland T. Insertion and Force Evaluation: Results with a New Electrode Design and Insertion Technique. Laryngoscope, 115:1325–1339, 2005.

Objective of the Study

To evaluate the insertion characteristics of the Contour Advance® Electrode in temporal bones.

Study Design

  • Contour Advance electrodes were inserted using Advance Off-Stylet (AOS) technique into 5 cadaveric temporal bones while being viewed using fluoroscopy (video x-rays).
  • Histologic evaluation was then conducted on the 5 bones by a process involving embedding in acrylic, sectioning and inspection for trauma and electrode position.
  • Hydraulic pressure within the cochlea during insertion of the Contour Advance was measured in another bone.
  • Mechanical insertion forces were measured for Contour with Standard Insertion Technique (SIT) and Contour Advance with AOS technique.  The forces were then compared.

Key findings in the paper include

  • Fluoroscopy and histology show that Contour Advance with AOS achieves its design goals of consistent perimodiolar positioning in the Scala Tympani and an atraumatic insertion with limited outer wall forces through a smooth insertion without contact with the outer wall of the cochlea.
  • Hydraulic pressure analysis shows that the electrode size and shape allows egress of perilymph around the array, resulting in no detectable hydraulic forces in the cochlea.
  • Insertions of Contour Advance electrode with AOS are less traumatic and result in more reliable placement than the Contour electrode inserted with Standard Insertion Technique. Thus the Contour Advance with AOS is a significant improvement over the Contour electrode with Standard Insertion Technique.



Thank you for reading and for your continued support.

Cochlear