Surgical Care

Surgical Care solutions are designed to enhance patient outcomes through actionable intraoperative insights that optimise device placement.

An audiologist conducts a hearing test with a patient

What you will find on this page

  • How Cochlear's intraoperative tools can optimise your surgical outcomes
  • The Nucleus® SmartNav System*

Optimising Surgical Care

We understand the importance of your role in delivering the best possible hearing outcomes to your patients. That’s why we continue to pioneer new technology and develop solutions to improve the surgical experience for you and your patients.

Our Surgical Care solutions are designed to enhance patient outcomes through intraoperative tools and insights. With increased confidence in device placement, surgical outcomes and postoperative clinical performance may also be optimised.

The Nucleus® SmartNav System

The award-winning Nucleus SmartNav System provides wireless, real-time, actionable insights to support navigation during cochlear implant surgery, delivering added assurance that surgery was successful, and the electrode was properly placed.1

This iPad-based solution and surgical processor provide an intuitive workflow to help you in surgery, giving you real-time feedback for in-theatre decision-making around angular depth and the consistency of insertion.2-7

Wireless connectivity, digital implant registration, and intuitive design deliver a more seamless workflow in the operating room.8

Data can then be directly imported into Custom Sound® Pro fitting software to support MAP creation.9

SmartNav image.png

Nucleus SmartNav intraoperative measures:

  • Placement check – provides valuable information on final electrode placement and is designed to reduce the need for intraoperative imaging post electrode insertion.8,10-12
  • Angular insertion depth – provides real-time measurement of angular insertion depth and final electrode position.*,5-6
  • Time of insertion (per electrode) – provides feedback on consistency of the electrode insertion.8
  • Impedance – provides assurance that the device is operating as intended, prior to leaving the operating room.8,13
  • Advanced and AutoNRT® measurements – the option to use Advanced NRT for obtaining neural response telemetry thresholds, providing flexibility in settings for optimal measurement.8,13
  • Electrical Stapedius Reflex Threshold (eSRT) – confirms nerve response to electrical stimulation.8,14

More information

Connecting-people-with-hearing-care.jpg

Care Practice

Optimising outcomes through evidence-based care.

Read more
M image

In-clinic Care

In-clinic Care gives you the tools you need to ensure every clinic appointment delivers the best result for your patient.

Read more
M image

Contact us

Have a question? We're here to help. We look forward to hearing from you!

Contact

Disclaimer

This material is intended for health professionals. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

For a full list of Cochlear’s trademarks, please visit our Terms of Use page.

* The angular insertion depth function is for lateral wall electrodes only.

References
  1. Page JC, Cox MD, Hollowoa B, Bonilla-Velez J, Trinidade A, Dornhoffer JL. Trends in Intraoperative Testing During Cochlear Implantation. Otol Neurotol. 2018;39(3):294–8.
  2. Kontorinis G, Lenarz T, Stöver T, Paasche G. Impact of the insertion speed of cochlear implant electrodes on the insertion forces. Otol Neurotol. 2011;32(4):565–70.
  3. Rajan GP, Kontorinis G, Kuthubutheen J. The effects of insertion speed on inner ear function during cochlear implantation: a comparison study. Audiol Neurootol. 2013;18(1):17–22.
  4. Todt I, Mittmann P, Ernst A. Intracochlear fluid pressure changes related to the insertional speed of a CI electrode. Biomed Res Int. 2014;2014:507241.
  5. Morrel WG, Holder JT, Dawant BM, Noble JH, Labadie RF. Effect of Scala Tympani Height on Insertion Depth of Straight Cochlear Implant Electrodes. Otolaryngol Head Neck Surg. 2020;162(5):718–24.
  6. Skarzynski H, Lorens A, Matusiak M, Porowski M, Skarzynski PH, James CJ. Cochlear implantation with the nucleus slim straight electrode in subjects with residual low-frequency hearing. Ear Hear. 2014;35(2):e33–43.
  7. Cochlear Limited. D1665111 V1 SEP2019. Angular Insertion Monitoring Algorithm TRL6 Validation.
  8. Cochlear Limited. D1946550 Cochlear Nucleus® SmartNav App user guide.
  9. Cochlear Limited. D1840640 Custom Sound Pro User guide.
  10. Cooper J, Stidham KR, Morgan S, Schmelzer M, Albinus R. Utilization of SmartNav technology in cochlear implantation: optimizing efficiency in assessment of electrode placement. Cochlear Implants Int. 2024;25(4):308–15.
  11. Arambula AM, Piper R, Murray G, Mowry SE, Rivas A, Semaan M, et al. Sensitivity and Specificity of Intraoperative TransImpedance Matrix Recordings Compared With X-ray Imaging in Detecting Perimodiolar Cochlear Implant Tip Foldovers: A Multicenter Study. Otol Neurotol. 2025;46(6):627–33.
  12. Tejani V, Piper R, Murray G, Manzoor NF, Mowry S, Semaan M, et al. Sensitivity and Costs of Intraoperative Trans-Impedance Matrix Recordings, Spread of Excitation Functions, and X-ray Imaging in Detecting Cochlear Implant Tip Foldovers. Otol Neurotol. 2024;45(10):e763–e71.
  13. Botros A, van Dijk B, Killian M. AutoNR: an automated system that measures ECAP thresholds with the Nucleus Freedom cochlear implant via machine intelligence. Artif Intell Med. 2007;40(1):15–28.
  14. Pérez-Rodríguez M, Torres-Gómez SF, Conde-Pacheco ME, Romero-Díaz A. Electrically evoked stapedial reflex threshold and behavioral method usefulness in the cochlear implant programming in pediatric population. Int J Pediatr Otorhinolaryngol. 2023;166:111473.