First Experiences with the Cochlear Nucleus SmartNav System

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Introduction As part of a controlled market introduction (CMR), a new measuring system (Cochlear SmartNav) was tested for intraoperative implant testing in CI surgeries. Methods From February to November 2022, SmartNav was used in 13 unilaterally implanted patients (7 x right, 6 x left). The patients (7 female, 6 male) were 46 to 86 years old (mean age 67.7 years). The electrodes used were 7x Slim Modiolar (632), 5x Slim Straight (622) and 1x Contour Advance (612). Results The SmartNav system was able to measure properly in all implantations. The insertion speed varied between 0.23 and 0.66 mm/s (mean 0.39 mm/s) with insertion duration from 52s to 126s (mean 78.6s). For technical reasons, a live measurement of the insertion angle was only carried out with straight electrodes (5). The placement check was carried out in 11/13 and showed a correct placement in each case. The impedance measurement was successfully obtained for all 22 electrodes at 12 implants; in one case only 18/22 impedances could be measured correctly. The AutoNRT could not be fully determined in 3 cases, in the remaining cases thresholds could be determined for all 22 contacts. Discussion SmartNav is significantly faster than previous intraoperative measurement methods. Additional measurements provide useful information about the insertion depth and the electrode position, so that a possible electrode displacement or a tip-fold-over can still be detected intraoperatively without radiation exposure from x-rays. The measurement of the insertion speed leads to a deliberately slower insertion. Publication History Article published online: 12 May 2023 Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany

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