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The Neuro Zti Cochlear Implant System Efficacy and Safety in Adults

The Neuro Zti Cochlear Implant System Efficacy and Safety in Adults

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02941627
Enrollment
53
Registered
2016-10-21
Start date
2017-02-02
Completion date
2019-11-22
Last updated
2021-11-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Deafness, Hearing Loss, Cochlear, Hearing Loss, Sensorineural

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

DEVICENeuro Zti

Cochlear implant

DEVICENeuro One

Sound processor

Sponsors

Oticon Medical
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

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

MeasureTime frameDescription
Change in Hearing In Noise Test Score in Quiet (HINT-Q) From Baseline to 6 Months in English-speaking Participants.pre-operative, 6 MonthsTo 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 monthsAdverse 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

MeasureTime frameDescription
Clinical Benefit on English-speaking Participants3, 6 and 12 monthsClinical 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 Participantspre-operative, 3, 6 and 12 MonthsTo 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 Participantspre-operative, 3-, 6- and 12-MonthsTo 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 monthsAdverse 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

ArmCount
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
Total51

Withdrawals & dropouts

PeriodReasonFG000
Overall Studycholesteatoma prevented implantation1
Overall StudyDeath1
Overall StudySurgical failure1

Baseline characteristics

CharacteristicNeuro Zti/Neuro One Study Group
Age at implantation69.5 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 typeEG000
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

Primary

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.

ArmMeasureValue (MEAN)Dispersion
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsChange 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 repeatedStandard Deviation 33.1
Primary

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).

ArmMeasureGroupValue (NUMBER)
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsMajor Related Adverse Event (AE)Major device related AE1 number of major adverse events
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsMajor Related Adverse Event (AE)Major trial procedure related AE1 number of major adverse events
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsMajor Related Adverse Event (AE)Major unrelated AE2 number of major adverse events
Secondary

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.

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Similar (-10 to 10 percent points)2 Participants
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Better (> 10 percent points)26 Participants
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Worse (< -10 percent points)5 Participants
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Better (> 10 percent points)22 Participants
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Similar (-10 to 10 percent points)7 Participants
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Worse (< -10 percent points)4 Participants
Neuro Zti/Neuro One English-speaking Participants 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Worse (< -10 percent points)3 Participants
Neuro Zti/Neuro One English-speaking Participants 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Similar (-10 to 10 percent points)6 Participants
Neuro Zti/Neuro One English-speaking Participants 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Better (> 10 percent points)29 Participants
Neuro Zti/Neuro One English-speaking Participants 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Better (> 10 percent points)24 Participants
Neuro Zti/Neuro One English-speaking Participants 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Similar (-10 to 10 percent points)3 Participants
Neuro Zti/Neuro One English-speaking Participants 6 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Worse (< -10 percent points)1 Participants
Neuro Zti/Neuro One English-speaking Participants 12 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Similar (-10 to 10 percent points)2 Participants
Neuro Zti/Neuro One English-speaking Participants 12 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Worse (< -10 percent points)1 Participants
Neuro Zti/Neuro One English-speaking Participants 12 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Worse (< -10 percent points)0 Participants
Neuro Zti/Neuro One English-speaking Participants 12 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Better (> 10 percent points)27 Participants
Neuro Zti/Neuro One English-speaking Participants 12 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Quiet (60dB SPL)Better (> 10 percent points)30 Participants
Neuro Zti/Neuro One English-speaking Participants 12 MonthsClinical Benefit on English-speaking ParticipantsHINT sentences in Noise (+10 dB SNR)Similar (-10 to 10 percent points)6 Participants
Secondary

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.

ArmMeasureGroupValue (MEAN)Dispersion
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-N score at baseline in best aided condition13.3 percentage of words correctly repeatedStandard Deviation 17.7
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-N score at 3 months in implanted ear43.8 percentage of words correctly repeatedStandard Deviation 30.6
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-N score at 6 months in implanted ear52.3 percentage of words correctly repeatedStandard Deviation 30
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Noise (HINT-N) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-N score at 12 months in implanted ear57.6 percentage of words correctly repeatedStandard Deviation 29.9
Secondary

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.

ArmMeasureGroupValue (MEAN)Dispersion
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-Q score at baseline in best aided conditions13.3 percentage of words correctly repeatedStandard Deviation 16
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-Q score at 3 months in implanted ear55.8 percentage of words correctly repeatedStandard Deviation 31.8
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-Q score at 6 months in implanted ear64.8 percentage of words correctly repeatedStandard Deviation 27.2
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsHearing In Noise Test Score in Quiet (HINT-Q) Pre-operatively, at 3-, 6- and 12-Months on English-speaking ParticipantsHINT-Q score at 12 months in implanted ear70.1 percentage of words correctly repeatedStandard Deviation 24.5
Secondary

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).

ArmMeasureGroupValue (NUMBER)
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsMinor Adverse Events (AE)Device related AE16 number of minor adverse events
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsMinor Adverse Events (AE)Trial procedure related AE20 number of minor adverse events
Neuro Zti/Neuro One English-Speaking Participants - 6 MonthsMinor Adverse Events (AE)Unrelated AE31 number of minor adverse events

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026