Cochlear Ltd. Implants for Profound Hearing Loss

Models, Features, and Reviews
Expert review by Chad Ruffin, MD

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:

  • For people with sensorineural hearing loss – caused by damage to the hearing cells in the inner ear – the company’s cochlear implants process external sound, bypass the damaged cells, and deliver it to the auditory nerve and brain.
  • For people with conductive hearing loss – when the hearing cells are healthy but organs in the outer or middle ear are not working properly – Cochlear’s bone conduction implants transmit sound waves through the skull directly to healthy hearing cells in the inner ear.

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.

Cochlear Implants from Cochlear Ltd.

Nucleus 7 sound processors and headpieces from Cochlear Ltd.

Cochlear Ltd. product milestones

Implant and sound processing technologies

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.

Sound processing technology

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 are designed to provide easier management of program settings and better understanding of speech in challenging listening environments:

  • SmartSound iQ enables dual microphones to capture speech and work together to filter out background noise.
  • SCAN, the cochlear implant industry’s first automatic scene classifier, analyzes your surrounding and identifies the listening environment as one of six scenes, enabling SmartSound IQ to automatically optimize the sound and adjusts the program setting for that scene.
  • ForwardFocus activates directional hearing with your Cochlear smartphone app when you want to decrease noise coming from behind you and focus on the face-to-face conversation in front of you.

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.

Implantable electrode technology

Cochlear has stayed at the cutting edge of electrode implant technologies since its inception. It has constantly improved its electrodes in significant ways:

  • It has made the electrodes thinner and easier to insert into the cochlea to minimize damage to the delicate internal structures of the inner ear.
  • It has constantly improved surgeons’ ability to place the electrode precisely where nerve stimulation will be most effective to provide access to a full range of sound.
  • And in 2014 it introduced the first hybrid electrode, providing electronic stimulation only at high frequencies while enabling patients to continue using their natural hearing at low frequencies.

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.

Cochlear Ltd. Implant Electrode

Cochlear Profile Plus implantable electrode

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.

Wireless connectivity

For its cochlear implants and bone-conduction implants, Cochlear provides advanced connectivity with both hearing aids and smartphones.

  • It was the first implant maker to provide wireless Made-for-iPhone audio streaming directly to cochlear implant and bone-conduction processors, without the need for an intermediate streaming accessory.
  • In 2019, through a technology-sharing alliance with top-five hearing aid maker GN ReSound, Cochlear implemented the ASHA protocol (Audio Streaming for Hearing Aids utilizing Bluetooth Low Energy technology) to enable direct audio streaming from Android smartphones.
  • The ReSound alliance also enables Cochlear to offer bimodal solutions, with sound processing balanced between a Cochlear sound processor on one ear and a ReSound hearing aid on the other ear.
  • And since 2014, it has been offering 2.4 GHz wireless audio connectivity through streaming accessories, including remote Mini Microphones, a TV Streamer, and a Phone Clip.
Cochlear Ltd. Wireless Accessories

Bimodal hearing technology

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.

Nucleus cochlear implants

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 internal electrode array is implanted on the skull under the scalp, with a filament that extends through the skull into the cochlea in the inner ear. The electrode generates the same kinds of electrical signals that the dead hearing cells previously transmitted to the auditory nerve and brain.
  • The external sound processor has multiple microphones and is connected to a headpiece with a magnet that couples with the electrode array under the scalp. It looks similar to a large, behind-the-ear hearing aid, but instead of amplifying sound waves, it converts them into electrical pulses that the implant sends to the auditory nerve.

The Cochlear Nucleus 7 system, introduced in 2017, was the first Made-for-iPhone cochlear implant. It also provides wireless audio streaming directly from Android phones that support that ASHA (audio streaming for hearing aids) protocol. Nucleus 7 benefits include:

  • Superior sound processing, with automatic adjustments to various listening environments via Cochlear’s SmartSound IQ with SCAN.
  • Hands-free audio streaming, with Cochlear’s 2.4 GHz True Wireless streaming accessories.
  • Smartphone connectivity, including wireless streaming of phone calls and music from Apple iPhones and compatible Android phones, without the need for an intermediary streaming accessory.

Cochlear says the Nucleus 7 is the industry’s smallest and lightest behind-the-ear cochlear implant processor. And a new chip platform enables improved sound processing and 50% more battery life – providing a full day of use – than the previous Nucleus 6 sound processing system.

Dr. Cliff Reviews the Nucleus 7 Sound Processor

Dr. Cliff Olson, Audiologist and founder of Applied Hearing Solutions in Anthem Arizona, reviews the Cochlear Nucleus 7 Sound Processor from Cochlear.

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Kanso 2 cochlear implant sound processor

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.

Cochlear Ltd. Kanso Implant Processor

The external Kanso 2 sound processor sits on the head next to the electrode implant that is just under the scalp. under the skin. It captures and processes sound, digitally encodes it, and transmits it through magnetic induction to the implant, which sends the audio signals to the inner ear.

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.

Nucleus Hybrid implant system

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.

Cochlear Ltd. Nucleus Hybrid Implant System

Cochlear’s Nucleus Hybrid implant system: half cochlear implant, half acoustic hearing aid. (Source: Cochlear Ltd.)

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.

Cochlear Ltd. Hybrid Hearing System

How Cochlear's Hybrid hearing system works: (1) Microphones on the Nucleus 7 Sound Processor pick up the sound and convert it into digital information. (2) The acoustic hearing-aid component amplifies low frequency sound and sends it down the ear canal through the normal pathway of hearing. (3) The high frequency information is transferred via the coil to the Nucleus Cochlear Implant just under the skin. (4) The Nucleus Cochlear Implant sends electrical signals down the electrode into the cochlea. (5) The hearing nerve fibers in the cochlea pick up the electrical signals, combine them with the amplified sounds and send them to the brain where they are interpreted as sound. (Source: Cochlear Ltd.)

Baha bone-conduction hearing systems

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. 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 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.

Baha 5 sound processors come in three different versions – standard, power, and super-power – for people with different levels of hearing loss. The standard Baha 5 is a small component that sits discreetly on the head, above and behind the ear. The Baha 5 Power version is slightly larger and provides amplification up to 55 dB. And the Baha 5 Super Power version comes with an over-the-ear processor that connects to the headpiece with a wire; it provides up to 65 dB amplification.

Implant accessories

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.

Remote wireless mics

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.

  • Mini Microphone 2 has a range of up to 80 feet with a clear line of site. Cochlear says it’s the smallest wireless microphone option for an implant sound processor. It has a directional microphone that helps you understand speech in noise, and its rechargeable battery operates up to 10 hours before recharging.
  • Mini Microphone 2+ is slightly larger and more powerful but still fits snugly in your pocket or clips to your collar; it has an omnidirectional microphone for use in groups or on a conference table, and its rechargeable battery delivers 11 hours of service between charges.

TV streamer

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.

Phone Clip

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.

Smartphone app

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.