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Clinical & Recipient Experience With Off The Ear And Behind The Ear Processors
Allison Biever, Au.D. Emily Lundberg, B.A.
Rocky Mountain Cochlear Ear Center Colorado Neurological Institute
Disclosure
*serve on Cochlear’s Audiology Advisory Board
Background
◦ CI manufacturers have offered different styles of processors
to patients, specifically Off-The-Ear (OTE) and Behind-The-Ear (BTE) wearing options.
◦ Some centers are single processor centers; it is sometimes difficult to know which style would work best for a patient.
◦ Potential benefits of an OTE processor might include discretion, ease of use and placement, as well as comfort. Potential benefits of a BTE processor might include familiarity, retention, better battery life.
Clinical Research Questions
What are the subjective benefits reported of users of both processors? Is there a difference in auditory performance between the two processors?
Study Design
◦ Retrospective study design ◦ Speech perception and processor preference data was
gathered for 133 subjects who received a CI532, CI522, CI512 or CI24REH Nucleus device and an Off-The-Ear (OTE - Kanso) and Behind-The-Ear (BTE – N6 or N7) processor.
◦ Surgeries took place between May 2016 to September 2017 for patients seen at RMEC.
Demographics Groups Subjects Age(years)
AtsurgeryInternalDevice
Received
Adult N=106 Range:18-96yrs 66CI53232CI5223CI512
5HYBRIDL24
Pediatric N=27
Range:9moto17yrs 22CI5322CI5223CI512
Total N=133 Range:9moto96yrs 88CI53234CI5226CI512
5HYBRIDL24
User Preference
Preferred Processor
PER
CE
NTA
GE
TOTAL ADULTS PEDIATRIC 0
10
20
30
40
50
60
39
51
10
37
51
12
48 52
OTE
BTE
BOTH
Survey Results - Comfort
Which Processor Is More
Comfortable?
Which Processor Is Easier To Seat?
Which Processor Has Better
Retention?
Which Processor Is More Discreet?
Survey Results – Battery Use, Connectivity &
Performance
Which Processor Is Easier To
Change Batteries?
Is Direct iPhone Connectivity with
a Processor Important?
Which Processor Has Best
Performance?
Hearing Performance Is There A Difference?
Hearing Performance In Noise
BTE OTE
SCO
RE
%
0
10
20
30
40
50
60
70
80
90
100
75 74
Survey Results – Which Factors Are Most Important?
Factor1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0
Avg.Response
-60.0% -40.0% -20.0% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
GanttPercent
Batterylife
Comfort
Discretion
Ease-batteries
Easeofplacement
Familiarity
FMease
Hearspeech
IPhone
Predictabilitybattery
Rechargeablebattery
Retention
4.23
4.47
2.83
3.70
3.80
3.07
3.17
4.87
3.80
4.03
3.80
4.27
FactorImportance
Answer
Null
NotImportant
SomewhatImportant
Neutral
ModeratelyImportant
VeryImportant
Hearing Preservation and Processor Preference
PER
CE
NTA
GE
OF
SUJB
EC
TS
OTE BTE 0
10
20
30
40
50
60
70
80
40
60
Conclusion
◦ Slightly more than 50% preferred BTE over OTE. For pediatrics
the preference was almost equal.
◦ In the categories of comfort, retention, and discretion, OTE was preferred. Changing the batteries was found to be easier and slightly more subjects reported better performance for BTE.
◦ On average, no performance differences in noise between BTE and OTE.
◦ 40% of subjects with hearing preservation preferred OTE.
Which Processor Is More Discreet?
