Conversion of adult Nucleus® 5 cochlear implant users to the Nucleus® 6 system

Abstract

ObjectivesCochlear's new sound processor system (Nucleus® 6) features a new noise reduction algorithm called SNR-NR (signal-to-noise ratio), and an environmental classifier called SCAN, which activates the appropriate sound coding algorithms for a given listening environment. In addition, the sound processors (CP910 and CP920) have a data logging feature with data visually summarized using clinical programing software and come with two remote controls, CR210 and CR230. The objective of this clinical study was to conduct a field acceptance study comparing the user experience with the Nucleus® 6 to the Nucleus® 5 system and to evaluate the benefits of Nucleus® 6 in an adult population currently equipped with the previous generation Nucleus® 5 sound processor. Our primary objective was to compare speech recognition in speech-weighted noise using Nucleus® 6 with SCAN (activating SNR-NR) with the default Nucleus® 5 ‘Noise’ Program. Secondary objectives included comparisons of speech recognition in quiet, subjective performance feedback via questionnaires and diaries, and recipient preference for device and program type.MethodsA prospective controlled trial was conducted with 30 adult Nucleus CI recipients using the Nucleus® 5 sound processor (condition A). The Nucleus® 6 sound processor (condition B) was evaluated in a within-subject ABBA design, with repeated speech in noise (S0N0, LIST sentence test), and speech in quiet testing (S0, NVA words). The remote controls were randomly given during the two B intervals. In addition, recipients had to complete questionnaires and diaries on the use of their current as well as new sound processors and remotes.ResultsThe group mean speech reception threshold in noise (SRT50) with Nucleus® 6 SCAN was significantly better (1.2 dB SNR) than with the Nucleus® 5 ‘Noise’ Program. Mean speech recognition scores in quiet were not significantly different between the processors. Subjective performance feedback (APHAB) did not show a significant difference between Nucleus® 6 and Nucleus® 5 with high satisfaction scores being reported for both sound processors. Recipients preferred the SCAN program in noise and reported a clear overall preference for the Nucleus® 6 system. Clinicians were satisfied with the conversion process from Nucleus® 5 to Nucleus® 6.Discussion and conclusionSNR-NR provides a significant benefit in noise. Recipients were easily converted from Nucleus® 5 to Nucleus® 6 requiring little or no sound quality adjustment period. The Nucleus® 6 SCAN program was well accepted by the majority of recipients for use during their daily life.