Deafness, Hearing Loss, Cochlear, Hearing Loss, Sensorineural
Conditions
Keywords
Hearing Loss, Cochlear Implant surgery, Otorhinolaryngology, Oticon Medical, Neuro Cochlear Implant System
Brief summary
The purpose of the study is to assess the efficacy and the safety profile of the Neuro Cochlear Implant System (CIS) in adults with severe-to-profound hearing loss.
Detailed description
Appropriate adult cochlear implant candidates with sensorineural hearing loss, from English French Canadian centres and Danish centre, received Neuro Zti cochlear implant and fit with Neuro One sound processor. Speech perception testing, using HINT (Hearing In Noise Test) sentences in quiet (65 dB SPL) (decibel, Sound Pressure Level) and in noise (+10 dB SNR) (decibel, Signal-to-Noise-Ratio), will be administrated pre-operatively in the best listening conditions and 3, 6, and 12 months post-activation in the implanted ear. Adverse events will be collected during the surgery and over the post-surgical period from activation to12 months post-activation. Safety will be assessed on the overall English, French and Danish participants. Efficacy will be assessed on English speaking participants.
Interventions
Cochlear implant
Sound processor
Sponsors
Study design
Eligibility
Inclusion criteria
* Adults, eighteen (18) years of age or older. * Bilateral severe-to-profound sensorineural hearing loss, defined by pure-tone average (PTA) ≥70 dB HL (Hearing Level) at 500, 1000 and 2000 Hz on both ears. * HINT sentences recognition scores in quiet ≤ 50% correct, in the best-aided listening condition. * Post-lingual onset of deafness. * Primary implantation (no re-implantation). * Up-to-date pneumococcal vaccine.
Exclusion criteria
* Medical conditions that contraindicate undergoing cochlear implant surgery (middle ear diseases i.e. AOM/CSOM (Acute Otitis Media/Chronic Suppurative Otitis Media) , lesions of auditory nerve, pathologies of central auditory pathway, otosclerosis; cochlear malformation i.e. Mondini malformation, cochlear ossification, large vestibular aqueduct). * Unrealistic expectations regarding the possible benefits, risks, and limitations that are inherent to the surgical procedure and medical device. * Unwillingness or inability of the candidate to comply with all investigational requirements.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Hearing In Noise Test Score in Quiet (HINT-Q) From Baseline to 6 Months in English-speaking Participants. | pre-operative, 6 Months | To assess the clinical efficiency, speech perception performance using the HINT sentences was measured in quiet at 6 months pos-activation in English speaking participants. Primary clinical efficiency outcome is defined as the change in HINT scores from baseline to 6 months post-activation. Recorded HINT sentences lists were presented to the participant at 60 dB SPL (sound pressure level) pre-operatively in the best aided hearing conditions and at 6 months in the implanted ear after Neuro Zti implant activation. The post-activation assessment was performed in the implanted ear alone with masked controlateral ear. Resultant score is a percentage of words correctly repeated. Possible scores are range from 0% to 100% words correctly repeated. Change = (6 Months score - Baseline score). A score greater or equal to 10% was considered clinically significant improvement. |
| Major Related Adverse Event (AE) | 12 months | Adverse event (AE) is defined as any undesired change from the participant's baseline condition symptom or clinically relevant symptom or disease, regardless of its cause. AEs include complications that are related to the device or clinical procedure, as well as unrelated AE that are not related to the device or the trial procedure. AEs were classified as Major if they corresponded to any of the following criteria: * life-threatening conditions (e.g. meningitis) * require hospitalization * result in permanent disability or damage (e.g. facial nerve paresis) * require revision surgery with or without explantation or re-implantation (e.g. device failure, flap necrosis) * medical events that could not be alleviated by electrode deactivation (e.g. tinnitus, facial nerve stimulation, pain) The co-primary safety endpoint is the major related adverse events rate during the surgery and over the post-surgical period from activation to 12 months post-activation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Benefit on English-speaking Participants | 3, 6 and 12 months | Clinical benefit is defined as the change of HINT scores post-operatively in the implanted ear only with masked contralateral ear and pre-operatively in the best aided conditions. Clinical benefit is measured in quiet and in noise using the Hearing in Noise Test (HINT). In quiet, HINT sentences lists were presented to the participant at 60 decibel sound pressure level (dB SPL). In noise, the sentences were presented with concurrent background noise at +10 decibel signal-to-noise-ratio (dB SNR), signal level at 65 dB SPL and noise at 55 dB SPL. Resultant score is a percentage of words correctly repeated, possibly ranged from 0% to 100%. Clinical benefit is computed for each participant. A positive difference of post- and pre-operative HINT scores is considered clinically significant if it exceeded 10 percentage points (pp). A decrease that exceeded 10 pp is considered a clinically significant decrement. A difference of less than 10 pp was considered as no change in performance. |
| Hearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | pre-operative, 3, 6 and 12 Months | To assess the clinical efficiency, speech perception performance using the HINT sentences was measured in quiet pre-operatively, 3-, 6- and 12-months pos-activation on English speaking participants. Secondary clinical efficiency outcome is defined as the mean HINT scores from baseline to 12 months post-activation. Recorded HINT sentences lists were presented to the participant at 60 dB SPL pre-operatively in the best aided hearing conditions, at -, 6- and 12- months. The post-activation assessment was performed in the implanted ear alone with masked controlateral ear. Resultant score is a percentage of words correctly repeated. Possible scores are range from 0% to 100% words correctly repeated. A higher score is better. |
| Hearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | pre-operative, 3-, 6- and 12-Months | To assess the clinical efficiency, speech perception performance using the HINT sentences was measured in noise pre-operatively, 3-, 6- and 12-months pos-activation on English speaking participants. Secondary clinical efficiency outcome is defined as the mean HINT scores from baseline to 12 months post-activation. Testing open-set sentence recognition with concurrent background noise present at +10 decibel signal-to-ratio (dB SNR) with signal level presented at 65 dB SPL and noise at 55 dB SPL. Recorded HINT sentences lists were presented to the participant in front pre-operatively in the best aided condition and post-operatively in the implanted ear alone with masked contralateral ear. Speech and noise were colocated (S0N0). Resultant score is a percentage of words correct. Possible scores range from 0% to 100% words correctly repeated. A higher score is better. |
| Minor Adverse Events (AE) | 12 months | Adverse event (AE) is defined as any undesired change from the participant's baseline condition symptom or clinically relevant symptom or disease, regardless of its cause. AEs include complications that are related to the device or clinical procedure, as well as unrelated AE that are not related to the device or the trial procedure. AEs were classified as Minor if they corresponded to any of the following criteria: * adverse event settled spontaneously without surgical procedure (e.g. hematoma) * adverse event settled spontaneously with conservative medical management The secondary safety endpoint is the minor related adverse events rate during the surgery and over the post-surgical period from activation to 12 months post-activation. |
Countries
Canada, Denmark
Participant flow
Recruitment details
Efficacy outcomes will be based on English speaking participants, and safety on overall patients; English, French and Danish speaking participants.
Participants by arm
| Arm | Count |
|---|---|
| Neuro Zti/Neuro One Study Group Neuro Zti: cochlear implant Neuro One: sound processor
All patients will receive a Neuro Zti implant and fit with Neuro One sound processor | 51 |
| Total | 51 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | cholesteatoma prevented implantation | 1 |
| Overall Study | Death | 1 |
| Overall Study | Surgical failure | 1 |
Baseline characteristics
| Characteristic | Neuro Zti/Neuro One Study Group | — |
|---|---|---|
| Age at implantation | 69.5 years STANDARD_DEVIATION 11.4 | — |
| Age, Customized [18;40] years old | 1 Participants | — |
| Age, Customized [40;50] years old | 2 Participants | — |
| Age, Customized [50;60] years old | 7 Participants | — |
| Age, Customized >=60 years old | 41 Participants | — |
| Duration of hearing aid use Contralateral ear | 22.6 years STANDARD_DEVIATION 15.8 | — |
| Duration of hearing aid use Implanted ear | 22.2 years STANDARD_DEVIATION 15.8 | — |
| Duration of hearing loss Contralateral ear | 33.2 years STANDARD_DEVIATION 19.6 | — |
| Duration of hearing loss Implanted ear | 30.7 years STANDARD_DEVIATION 19 | — |
| Implanted ear (side) Left | 22 participants | — |
| Implanted ear (side) Right | 29 participants | — |
| Primary hearing loss etiology Aging | 3 Participants | — |
| Primary hearing loss etiology Genetics | 7 Participants | — |
| Primary hearing loss etiology Menière's disease | 3 Participants | — |
| Primary hearing loss etiology Noise exposure | 7 Participants | — |
| Primary hearing loss etiology Other | 6 Participants | — |
| Primary hearing loss etiology Otosclerosis | 1 Participants | — |
| Primary hearing loss etiology Unknown | 23 Participants | — |
| Primary hearing loss etiology Viral | 1 Participants | — |
| PTA (Pure Tone Average), 500 Hz to 2000 Hz Contralateral ear | 95.8 dB HL STANDARD_DEVIATION 16.3 | — |
| PTA (Pure Tone Average), 500 Hz to 2000 Hz Implanted ear | 101.3 dB HL STANDARD_DEVIATION 13.3 | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Sex: Female, Male Female | 31 Participants | — |
| Sex: Female, Male Male | 20 Participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 1 / 53 |
| other Total, other adverse events | 15 / 51 |
| serious Total, serious adverse events | 3 / 51 |
Outcome results
Change in Hearing In Noise Test Score in Quiet (HINT-Q) From Baseline to 6 Months in English-speaking Participants.
To assess the clinical efficiency, speech perception performance using the HINT sentences was measured in quiet at 6 months pos-activation in English speaking participants. Primary clinical efficiency outcome is defined as the change in HINT scores from baseline to 6 months post-activation. Recorded HINT sentences lists were presented to the participant at 60 dB SPL (sound pressure level) pre-operatively in the best aided hearing conditions and at 6 months in the implanted ear after Neuro Zti implant activation. The post-activation assessment was performed in the implanted ear alone with masked controlateral ear. Resultant score is a percentage of words correctly repeated. Possible scores are range from 0% to 100% words correctly repeated. Change = (6 Months score - Baseline score). A score greater or equal to 10% was considered clinically significant improvement.
Time frame: pre-operative, 6 Months
Population: Clinical efficiency is reported on the thirty-three (33) English-speaking participants.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Change in Hearing In Noise Test Score in Quiet (HINT-Q) From Baseline to 6 Months in English-speaking Participants. | 51.5 percent change words correctly repeated | Standard Deviation 33.1 |
Major Related Adverse Event (AE)
Adverse event (AE) is defined as any undesired change from the participant's baseline condition symptom or clinically relevant symptom or disease, regardless of its cause. AEs include complications that are related to the device or clinical procedure, as well as unrelated AE that are not related to the device or the trial procedure. AEs were classified as Major if they corresponded to any of the following criteria: * life-threatening conditions (e.g. meningitis) * require hospitalization * result in permanent disability or damage (e.g. facial nerve paresis) * require revision surgery with or without explantation or re-implantation (e.g. device failure, flap necrosis) * medical events that could not be alleviated by electrode deactivation (e.g. tinnitus, facial nerve stimulation, pain) The co-primary safety endpoint is the major related adverse events rate during the surgery and over the post-surgical period from activation to 12 months post-activation.
Time frame: 12 months
Population: Safety is reported, on overall participants, in terms of surgical safety (intra-operative major complication rate) and post-surgical safety (major complication rate from the surgery to 12 months post activation to determine the long-term safety profile of the Neuro cochlear implant system).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Major Related Adverse Event (AE) | Major device related AE | 1 number of major adverse events |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Major Related Adverse Event (AE) | Major trial procedure related AE | 1 number of major adverse events |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Major Related Adverse Event (AE) | Major unrelated AE | 2 number of major adverse events |
Clinical Benefit on English-speaking Participants
Clinical benefit is defined as the change of HINT scores post-operatively in the implanted ear only with masked contralateral ear and pre-operatively in the best aided conditions. Clinical benefit is measured in quiet and in noise using the Hearing in Noise Test (HINT). In quiet, HINT sentences lists were presented to the participant at 60 decibel sound pressure level (dB SPL). In noise, the sentences were presented with concurrent background noise at +10 decibel signal-to-noise-ratio (dB SNR), signal level at 65 dB SPL and noise at 55 dB SPL. Resultant score is a percentage of words correctly repeated, possibly ranged from 0% to 100%. Clinical benefit is computed for each participant. A positive difference of post- and pre-operative HINT scores is considered clinically significant if it exceeded 10 percentage points (pp). A decrease that exceeded 10 pp is considered a clinically significant decrement. A difference of less than 10 pp was considered as no change in performance.
Time frame: 3, 6 and 12 months
Population: Clinical benefit is reported on the English-speaking participants.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Similar (-10 to 10 percent points) | 2 Participants |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Better (> 10 percent points) | 26 Participants |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Worse (< -10 percent points) | 5 Participants |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Better (> 10 percent points) | 22 Participants |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Similar (-10 to 10 percent points) | 7 Participants |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Worse (< -10 percent points) | 4 Participants |
| Neuro Zti/Neuro One English-speaking Participants 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Worse (< -10 percent points) | 3 Participants |
| Neuro Zti/Neuro One English-speaking Participants 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Similar (-10 to 10 percent points) | 6 Participants |
| Neuro Zti/Neuro One English-speaking Participants 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Better (> 10 percent points) | 29 Participants |
| Neuro Zti/Neuro One English-speaking Participants 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Better (> 10 percent points) | 24 Participants |
| Neuro Zti/Neuro One English-speaking Participants 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Similar (-10 to 10 percent points) | 3 Participants |
| Neuro Zti/Neuro One English-speaking Participants 6 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Worse (< -10 percent points) | 1 Participants |
| Neuro Zti/Neuro One English-speaking Participants 12 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Similar (-10 to 10 percent points) | 2 Participants |
| Neuro Zti/Neuro One English-speaking Participants 12 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Worse (< -10 percent points) | 1 Participants |
| Neuro Zti/Neuro One English-speaking Participants 12 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Worse (< -10 percent points) | 0 Participants |
| Neuro Zti/Neuro One English-speaking Participants 12 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Better (> 10 percent points) | 27 Participants |
| Neuro Zti/Neuro One English-speaking Participants 12 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Quiet (60dB SPL) | Better (> 10 percent points) | 30 Participants |
| Neuro Zti/Neuro One English-speaking Participants 12 Months | Clinical Benefit on English-speaking Participants | HINT sentences in Noise (+10 dB SNR) | Similar (-10 to 10 percent points) | 6 Participants |
Hearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants
To assess the clinical efficiency, speech perception performance using the HINT sentences was measured in noise pre-operatively, 3-, 6- and 12-months pos-activation on English speaking participants. Secondary clinical efficiency outcome is defined as the mean HINT scores from baseline to 12 months post-activation. Testing open-set sentence recognition with concurrent background noise present at +10 decibel signal-to-ratio (dB SNR) with signal level presented at 65 dB SPL and noise at 55 dB SPL. Recorded HINT sentences lists were presented to the participant in front pre-operatively in the best aided condition and post-operatively in the implanted ear alone with masked contralateral ear. Speech and noise were colocated (S0N0). Resultant score is a percentage of words correct. Possible scores range from 0% to 100% words correctly repeated. A higher score is better.
Time frame: pre-operative, 3-, 6- and 12-Months
Population: Clinical efficiency is reported on the thirty-three (33) English-speaking participants.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-N score at baseline in best aided condition | 13.3 percentage of words correctly repeated | Standard Deviation 17.7 |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-N score at 3 months in implanted ear | 43.8 percentage of words correctly repeated | Standard Deviation 30.6 |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-N score at 6 months in implanted ear | 52.3 percentage of words correctly repeated | Standard Deviation 30 |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-N score at 12 months in implanted ear | 57.6 percentage of words correctly repeated | Standard Deviation 29.9 |
Hearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants
To assess the clinical efficiency, speech perception performance using the HINT sentences was measured in quiet pre-operatively, 3-, 6- and 12-months pos-activation on English speaking participants. Secondary clinical efficiency outcome is defined as the mean HINT scores from baseline to 12 months post-activation. Recorded HINT sentences lists were presented to the participant at 60 dB SPL pre-operatively in the best aided hearing conditions, at -, 6- and 12- months. The post-activation assessment was performed in the implanted ear alone with masked controlateral ear. Resultant score is a percentage of words correctly repeated. Possible scores are range from 0% to 100% words correctly repeated. A higher score is better.
Time frame: pre-operative, 3, 6 and 12 Months
Population: Clinical efficiency is reported on the thirty-three (33) English-speaking participants.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-Q score at baseline in best aided conditions | 13.3 percentage of words correctly repeated | Standard Deviation 16 |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-Q score at 3 months in implanted ear | 55.8 percentage of words correctly repeated | Standard Deviation 31.8 |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-Q score at 6 months in implanted ear | 64.8 percentage of words correctly repeated | Standard Deviation 27.2 |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Hearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking Participants | HINT-Q score at 12 months in implanted ear | 70.1 percentage of words correctly repeated | Standard Deviation 24.5 |
Minor Adverse Events (AE)
Adverse event (AE) is defined as any undesired change from the participant's baseline condition symptom or clinically relevant symptom or disease, regardless of its cause. AEs include complications that are related to the device or clinical procedure, as well as unrelated AE that are not related to the device or the trial procedure. AEs were classified as Minor if they corresponded to any of the following criteria: * adverse event settled spontaneously without surgical procedure (e.g. hematoma) * adverse event settled spontaneously with conservative medical management The secondary safety endpoint is the minor related adverse events rate during the surgery and over the post-surgical period from activation to 12 months post-activation.
Time frame: 12 months
Population: Safety is reported, on overall participants, in terms of surgical safety (intra-operative minor complication rate) and post-surgical safety (minor complication rate from the surgery to 12 months post activation to determine the long-term safety profile of the Neuro cochlear implant system).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Minor Adverse Events (AE) | Device related AE | 16 number of minor adverse events |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Minor Adverse Events (AE) | Trial procedure related AE | 20 number of minor adverse events |
| Neuro Zti/Neuro One English-Speaking Participants - 6 Months | Minor Adverse Events (AE) | Unrelated AE | 31 number of minor adverse events |