Week 4 Cochlear Flashcards
1
Q
IP ratings
A
Ingress protection
- a rating scale for how electric devices tolerate solids (first number) and liquid (second number)
- 68 is the highest rating
2
Q
Cochlear basics
A
- new South Wales, Australia
- 9 generations
- all devices use sequential stimulation and have titanium implants
- have 22 electrodes
- electrodes numbered 1-22 from base to apex
3
Q
Nucleus 22
A
Cochlears 1st internal device
- FDA approved in 1985 for adults, 1999 for 24 months
- nonremovable magnet
- cannot do impedance telemetry or ECAP
- electrode:
- –22 full bands spaced 0.45mm with 10 stiffening rings outside the cochlea to help surgeon insert
- –can use bipolar and common ground stimulation
- –has one extracochlear electrode on the casing for grounding
- sound processor:
- –wearable sound processor (WSP)
- –mini sound processor for children (MSP)
- –spectra 22 which is ear level processor compatable with all 22 things
4
Q
Nucleus CI24M
A
- Cochlear’s 2nd generation of internal device
- approved in 1998 for 18 months and up
- removable magnet that can do MRI up to 1.5 Tesela with it out, and a thinner case
- can do impedance telemetry and ECAP
- electrode:
- –22 full band with 0.45mm spacing and 10 stiffening rings
- –started creating 2 extracochlear electrodes (MP1 which is the lead and is a ball electrode under the temporalis muscle and MP2 which is the one on the casing)
- –extra electrode allowed for monopolar stimulation, but can also do bipolar and common ground
- –released with a double array which one can be in the bottom half of cochlear and 1 in the top in cases of ossification
- prosessor:
- –SPrint is body worn
- –ESPrint is the 1st ear level processor and is compatable with recent processors listed
5
Q
Nucleus CI24R
A
- 3rd generation of internal device from Cochlear
- approved in 2000 for 12 months and up
- removable magnet and can do MRI of 1.5T with it out
- can do impedance telemetry and ECAP
- smaller than CI24M and has 3 electrode arrays
- –CI24R(CS)= half band and is a contour stylet
- –CI24R(ST)= full-band and is a straight array
- –CI24R(CA)= half-band and is a contour advanced
- —-no more stiffening rings
- sound processor:
- –SPrint, ESPrint
- –ESPrint 3G (2002)
- –Freedom, Nucleus 5, Nucleus 6, and Kanso
6
Q
Nucleus CI24RE “Freedom”
A
- 4th generation of internal device from Cochlear
- Approved in 2005 for ages 12 months and older
- removable magnet can can do 1.5T MRI with it in and 3.0T MRI with it out
- Chip has been change to consume less power and be faster
- can do impedance telemetry and ECAP
- dual-electrode stimulation is used to create virtual channels (just 1 because no current steering)
- MP1 and MP2 electrodes
- electrode:
- –CI24RE(ST)
- –CI24RE(CA)
- sound processor:
- –Freedom
- –Nucleus 5,6,7, and Kanso
7
Q
Nucleus CI512 “Nucleus 5”
A
- 5th generation of internal device from Cochlear
- later know as “Profile Implant”
- approved in 2009 for 12 months and up
- removable magnet (1.5T in and 3.0T out MRI)
- thinner and redesigned MP1 to be more of a pin instead of a ball (compared to Freedom)
- impedance telemetry and ECAP as well as dual electrode stimulation
- electrode= CI512(CA)
- sound processor:
- –Nucleus 5,6,7 and Kanso
- withdrawn in 2011 because 7.1% fail rate as compared to 0.7% for freedom within 5 yrs
- –when it went thinner, a layer of protection from fluid and other stuff was lost and when fluid got into the device, it stopped working
8
Q
Nucleus CI422
A
- 6th generation of internal device from cochlear
- approved 2012
- is the Freedom with a modified electrode to replace the CI512
- –is the CI422(ST) which is thinner, with a shallower insertion to preserve the low frequencies
- removable magnet so 1.5T MRI with it in and 3.0T with it out
- impedance telemetry, ECAP, and dual electrode stimulation
- sound processor is the Nucleus 5,6,7 and Kanso
9
Q
Nucleus L24 Hybrid CI (CI24REH)
A
7th generation internal device from Cochlear
- approved March 2014, is a modified Freedom
- removable magnet so 1.5T with it in and 3.0T with it out
- impedance telemetry, ECAP, and dual electrode stim
- electrode is L24 and is a little shorter at 16mm with 22 half band electrodes
- –designed to be only in the basal turn and not in the apex so low freq can be stimulated with HA component
- sound processor is Nucleus 6 or 7
10
Q
Profile Series
A
8th generation internal device from Cochlear
- is CI512 (CA)released again in 2015
- –also CI522(straight) in 2016 and CI532(slim modiolar) in 2017
- —–note called profile series because these three electrodes were released (512 is contour advanced, 522 was attempt to protect cochlear structure, and 532 is pre-curved without stylet, it is in a little tube and when the surgeon pulls the tube off it curves and allows the electrode to be thinner, this is becoming the default electrode
- everything is the dame as Nucleus 5 in terms of electronic components, but different electrodes
11
Q
profile plus series
A
- 9th generation internal device from Cochlear
- CI600 series: Profile plus was released in June 2019
- –everything the same a profile
- –redesigned magnet (dimetric) meaning north and south pole are on either side of the magnet instead of top and bottom so the magnet will just rotate to align with magnetic field of MRI instead of flipping or coming out
- –can do MRI of 3.0T without removing
- idea from MED-EL
- has same electrode family (CI612 which is CA, CI622 which is straight, and CI632 which is slim modiolar
12
Q
peri-modiolar vs lateral wall electrode placement
A
peri-modiolar curves around the modiolus while lateral-wall is away from the modiolus
=straight array has a better chance or protecting the cochlear structure, peri-modiolar can be a bit more damaging
*insertion force with precurved is less because it follows the turns of the cochlea without much resistance, the straight array will get to lateral wall of the cochlea then will need to start being pushed a bit to turn and damage could occur at this point
*location of electrode will dictate how stimulation will work, the further from the neurons, the more current needed to stimulate them
—this could cause battery drain and channel interaction
13
Q
Freedom processor
A
- from Cochlear (2005)
- –compatible with all internal devices
- –2 omni-mic, t-coil, and display
- –4 options for programs, VC, and sensitivity control
- –uses 675 rechargeable or Zinc-air
- –IP44
- –electroacoustic stimulation (EAS) is an option
- –no remote
- –no wireless compatibility but FM compatibility
14
Q
Nucleus 5 processor
A
CP810 which is from 2009
- –compatible with all internal devices except nucleus because this is too small to provide enough power
- –2 omni mics and a T-coil
- –4 programs, VC and sensitivity control
- –rechargeable or zinc-air batteries
- –IP of 57 for rechargeable, 44 for zinc-air, and 68 with Aqua+
- –remote assistant CR110 (CR=cochlear remote)
- –no wireless compatibility, but FM compatible
15
Q
Nucleus 6 processor
A
CP910 and CP920 from 2013
- –compatible with all internal devices
- –CP910 has DAI which is direct audio input, but CP920 does not which makes it a little smaller
- –2 omni mics which allow for SCAN algorithm and auto-T
- –4 programs, VC, sensitivity control, and T-coil
- –batteries are rechargeable or zin-air
- –IP rechargeable is 57, Zinc-air is 44, and Aqua+ is 68
- –remote assistant CR230 and remote control CR210
- GN ReSound technology means they used their tech for electroaudio stimulation and thus have their accessories too (mini-mic 2+, phone clip+, TV streamer 2
- –FM compatable
- connects to a RIC with a dome or mold
- –special purpose average (SPA) OSPL90=117.1
- –SPA full on gain @ 50=50.6
- –reference gain at 60=41.4
- –frequency range=200-1781Hz
- –equivalent input noise level (EIN)=27.1
