1. Cochlear™ Advanced Hearing Solutions

2. You are not alone… One out of 10 Americans — approximately 30 million — experience some form of hearing loss. While the majority of these people can be helped with hearing aids, for many, even the most advanced and powerful hearing aids cannot provide an adequate solution Over 85,000 people have made the decision to get a CI.

3. This presentation will explain: Different types of hearing loss Innovative technology that may help you when hearing aids are not enough

4. Pediatric Hearing Loss Facts: Everyday in the United States, approximately 1 in 1,000 newborns (or 33 babies every day) is born profoundly deaf with another 2-3 out of 1,000 babies born with partial hearing loss, making hearing loss the number one birth defect in America Of the 12,000 babies in the United States born annually with some form of hearing loss, only half exhibit a risk factor – meaning that if only high-risk infants are screened, half of the infants with some form of hearing loss will not be tested and identified

5. Adult Hearing Loss Facts: One in every ten (28 million) Americans have hearing loss. As baby boomers reach retirement age starting in 2010, this number is expected to rapidly climb and nearly double by the year 2030 The prevalence of hearing loss increases with age, up to 1 in 3 over age 65. Most hearing losses develop over a period of 25 to 30 years Among seniors, hearing loss is the third most prevalent, but treatable disabling condition, behind arthritis and hypertension

6. How Hearing Works 1.Sound waves travel through the ear canal and strike the eardrum 2.Sound waves cause the eardrum to vibrate, sending the bones in the middle ear into motion 3.This motion causes the fluid inside the inner ear (cochlea) to move the hair cells 4.The hair cells change the movement into electric impulses, which are sent to the hearing nerve into the brain; this allows you to hear sound

7. How we hear

8. Hearing Loss Hearing loss can be categorized by where or what part of the auditory system is damaged. There are three basic types of hearing conditions Cochlear’s technology can help: –sensorineural hearing loss –conductive hearing loss –mixed hearing loss

9. Types of Hearing Loss Sensorineural Hearing Loss: Sensorineural hearing loss (often referred to as nerve deafness) occurs when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear to the brain Conductive Hearing Loss: Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones, or ossicles, of the middle ear Mixed Hearing Loss: Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss. In other words, there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve

10. Hearing aid

11. Why aren’t hearing aids enough for some people? Hearing aids amplify sound from the external world that are picked up by the hearing aid microphone. Although some sound processing is applied to the amplified sound, for many people with moderate-to-profound sensorineural hearing loss, even the best, most advanced hearing aids may not work well because the sounds are made louder not clearer In other words, the person may hear sounds with hearing aids, but understanding speech may still be very difficult, particularly in background noise

12. Why aren’t hearing aids enough for some people? Your cochlea, located deep inside your ear, is responsible for sending sound information to your brain Inside your cochlea are very delicate hair cells. These tiny hair cells allow you to hear different pitches and rhythms of sound If the hair cells are damaged enough (as they are in severe-to-profound sensorineural hearing loss), the ability to hear is diminished to the point that no amount of amplification from a hearing aid will adequately improve performance

13. Cochlear Nucleus Freedom System

14. Cochlear’s Nucleus ® Freedom™ cochlear implant system: Designed to provide everyday hearing for those experiencing severe-to- profound sensorineural hearing loss in both ears. Cochlear’s Nucleus Freedom implant acts as a replacement for inner ear hair cells For many recipients, a CI provides the ability to perceive and understand speech that a hearing aid could not The CI does not increase sound volume like a hearing aid. Rather it allows sound to bypass the damaged part of the ear and sends sound directly to the auditory (hearing) nerve to provide a clearer understanding of sound and speech

15. How does the Cochlear Implant work? 1.Sound processor: External sound processor captures sound and converts it into digital signals 2.Digital signals: Processor sends digital signals to internal implant 3.Electrode array: Internal implant converts signals into electrical energy, sending it to an electrode array inside the cochlea 4.Hearing nerve: Electrodes stimulate hearing nerve, bypassing damaged hair cells, and the brain perceives signals as sound

16. Cochlear Implant

17. Freedom BTE Freedom Bodyworn Freedom Mini BTE Freedom Babyworn Nucleus Freedom cochlear implant Nucleus ® Freedom™ Cochlear Implant System

18. Identical Main Modules Different Controllers Freedom Modularity

19. Performance and Reliability Hearing performance: –Studies show that Nucleus Freedom helps recipients hear better and faster than any other system * Reliability: –Comprehensive testing shows that Nucleus Freedom is the most reliable cochlear implant on the market ** * 1 Bassim, M.K., Buss, E., Clark, M.S., Kolin, K.A., Pillsbury, M.S., Pillsbury, H.C., & Buchman, C.A. (2005). MED-EL Combi40+ Cochlear Implantation in Adults. Laryngoscope, 115:1568-1573. 2 Séguin, C., Schramm, D., Fitzpatrick, E., Armstrong, S., & Chénier, J. (2005). Patient Performance With the Advanced Bionics® Res 90K Helix 1 Device with HiFocus Perimodiolar (Helix) Electrode. Advanced Bionics White Paper. 3 Parkinson, A.J., Arcaroli, J., Staller, S., Ardnt, P., Cosgriff, A., & Ebinger, K. (2002). The Nucleus 24 Contour Cochlear Implant System: Adult Clinical Trial Results. 4 System 4 North American Clinical Trial: Data on file. ** Cochlear: Cumulative Failure Percentages & Tally of Failures for Implants, Dec 2006 Report Med-El Technology Update: Newsletter for CI Professionals, January 2006 AB: Auditory Reliability Report, 2006

20. Performance 1 Bassim, M.K., Buss, E., Clark, M.S., Kolin, K.A., Pillsbury, M.S., Pillsbury, H.C., & Buchman, C.A. (2005). MED-EL Combi40+ Cochlear Implantation in Adults. Laryngoscope, 115:1568-1573. 2 Séguin, C., Schramm, D., Fitzpatrick, E., Armstrong, S., & Chénier, J. (2005). Patient Performance With the Advanced Bionics® HiRes 90K Helix 1 Device with HiFocus Perimodiolar (Helix) Electrode. Advanced Bionics White Paper. 3 Parkinson, A.J., Arcaroli, J., Staller, S., Ardnt, P., Cosgriff, A., & Ebinger, K. (2002). The Nucleus 24 Contour Cochlear Implant System: Adult Clinical Trial Results. 4 System 4 North American Clinical Trial: Data on file.

21. Nucleus® Cochlear implants have the best reliability Converting CSRs into implant numbers after 2 years ( Combined data: adults and children) Ref.: Cochlear: Cumulative Failure Percentages & Tally of Failures for Implants, Dec 2006 Report Med-El Technology Update: Newsletter for CI Professionals, January 2006 AB: Auditory Reliability Report, 2006 Internal Processor Reliability

22. When using hearing aids …(Cont’d) While dining in restaurants, do you or your child have difficulty following the conversation? Do you avoid social activities because you do not know what is being said and are afraid you may respond incorrectly? Are you or your child exhausted at the end of the day because communication requires such a high degree of concentration? If you answered “yes” to two or more of these questions, you or your child may be a good candidate for a cochlear implant Answer the following questions to see if Cochlear’s Nucleus Freedom may help you or your child* *Questions pertain to those people with a sufficient degree of hearing loss to be CI candidates.

23. Want to learn more? The process is actually pretty simple Step 1: Be evaluated by a cochlear implant audiologist To find a clinic go to www.cochlear.comwww.cochlear.com If you need help with Insurance (pre-verification, verification, appeals,etc.) contact OMS Insurance support at www.omsinsurancesupport.org Step 2: Complete a medical evaluation by an otologist (ear specialist) Step 3: Schedule surgery date Step 4: Activate your implant and have it programmed by an audiologist (typically 2-4 weeks following surgery) Step 5: Rehabilitation and practice.

24. Don’t let hearing loss effect your life or freedom. Do something today! Cochlear implants are approved by the FDA for use by people who are experiencing severe-to-profound sensorineural hearing loss in both ears Cochlear Nucleus implant users report that they now connect with friends, family and co-workers in more situations than ever before, even in challenging noisy environments If you or a loved one has a hearing loss and find that hearing aids just don’t work, now is the time to explore a Nucleus cochlear implant

25. Don’t let hearing loss effect your life or freedom. Do something today! To find out if Cochlear’s Nucleus Freedom cochlear implant system can help you or a loved one, contact your hearing health professional or Cochlear Americas Visit us online at www.cochlear.com or call us at 800.523.5798 for help finding a Nucleus cochlear implant or Baha center near you