Advanced Cochlear Implant Technology: AI, Safety & Better Hearing

Hundreds [music] of engineers across the

world answer to him every day. April

14th, [music] 2026,

he also opened a new chapter.

Your team has [music] come up with the

first of its kind dedicated AI chip in

the hearing industry.

>> This program [music] does nearly 8

billion operations per second.

>> Can the cochlear implant be hacked?

>> I will say that

>> A cochlear implant is a very powerful

and successful neuro prosthetic device

in the field of medicine. My guest today

has spent 23 years in a single company

with a single mission.

Providing the best possible hearing

technology and building the strong

research behind this cochlear implant.

Hundreds of engineers across the world

answer to him every day.

His team built the first dedicated AI

chip in the hearing industry. And on

April 14th, 2026,

he also opened a new chapter, a research

collaboration with spiral therapeutics

where a medicine is being precisely

delivered into the cochlea at the moment

of surgery itself. He's none other than

the senior vice president of global

research and development Advanced

Bionics, Mr. Fernando Chapa. Welcome

you, sir.

>> Thank you very much for having me here,

and it's

it's the first time that I've been in

your hospital, in your clinic.

Extraordinarily impressive.

Extraordinarily impressive. I'm very

impressed with everything that I've

seen.

>> Thank you so much, sir. That means a

lot.

And joining him today, the engineer who

transforms the entire research into a

device itself. He has his own patent

where he designed a self-coiling

electrode which when placed into the

cochlea takes the shape of the cochlear.

is none other than director of global

research and technology, Advanced

Bionics, Mr. Anil Patnala.

Welcome to India.

>> Thank you, Dr. Shree. It's a pleasure.

It's actually an honor for me to be

here.

It's an extraordinary journey for us to

be part of such a mission that you

champion and you take it forward. And we

at the at the core of this feel

extremely privileged to be able to work

on solving such problems that make

meaningful difference that you bring it

to these recipients that we met today.

Thank you.

>> Thank you so much. Thank you so much

both of you for being on this Hearing

Circle podcast. Thank you for accepting

the invitation. Now, without any further

delay, I have a question for you, Mr.

Fernando. 23 years in a single company.

It's incredible. But when you look at

the cochlear implant,

how do you feel?

What do you look at that a surgeon like

us doesn't see?

>> I've seen quite a lot over the decades

that I've been with Advanced Bionics.

And one of the things that maybe

is not appreciated as much is that

the industry as a whole

>> Mhm.

>> um still actually has a long way to go

when it comes to how do we test whether

the hearing performance and how do we

test whether the listening effort, the

comfort, the ability to hear in

different situations, how do we test

those so that we can really

uh understand

where the improvements need to be made.

And so, one of the things that I've seen

is that when we went from our Harmony

sound processors quite a long time ago

to the Naída Q sound processors,

we turned off some of the advanced

features. We went to the newer

technology.

And the recipients that we bring in for

internal patients at Advanced Bionics

would put those on and say, "Wow, this

is a amazing. This is a night and day

difference. When I go from my Harmony to

my Naída CIU, it's amazing." And when we

turn off some of the advanced features,

what we would see is a little bump in

speech scores.

The

But we wouldn't see what matches their

reaction.

And so there's something there that

wasn't being captured.

When we go from Naída CIU to Naída M, we

saw the same thing. Patients would come

in that went from Harmony to Naída CIU

to Naída M. And when they would wear the

the Marvel devices, they would say,

"Wow, this is amazing. It's a such a

night and day difference."

And yet you don't see that in the

measurements that the industry is

capturing.

>> True. So I would

>> say that in the signal processing,

in the measurements that we take, the

thing that we still have uh that we

still have to focus on as an industry,

not just Advanced Bionics, is how do we

measure those changes? How do we measure

that every time we come out with a new

sound processor or new technology, we

hear, "This is amazing. It's so much

different than the previous version."

and to be able to objectively see those

scores out in the industry.

>> Perfect. Perfect. Now, with that being

said,

this is for you.

You and your team helped in building the

internal component of a cochlear

implant, the one that stays inside the

child's life throughout. You also have a

patent where

there is you have designed a

self-coiling electrode, the one which

goes when placed inside the cochlea, it

takes the shape of the cochlea. Now,

when you look at the finished product

holding in your hand, How do you feel

about it?

>> Extremely humbled actually. What we see

in other technologies, other things in

everyday today life is something that

you can bring it to hearing. It's

something

an extremely important initiative from

our team's perspective. So, we don't

just stay at what matters for the

hearing, what is required. We try to

look outside the box.

And that's what led us to look at these

new materials.

If you're building traditional cochlear

implant, which everybody has been

building,

they're looking at solving a problem.

We're not just looking at solving a

problem.

We're looking at solving a few different

problems at the same time.

So,

the genesis or the starting point of

this so-called self-coiling electrode is

to solve more than one problem.

What it can do is something I think

patients can tell the difference. As you

can tell,

the natural shape is super important and

the placement is extremely important to

ensure the patient gets the best in

ensuring they can do their best,

we are doing our job to give the best

instrument.

>> Wonderful. Very well said. Now, to Mr.

Fernando,

the question that millions of parents

they search this question every month.

How does a cochlear implant work?

Now, give your point of view

like a researcher.

>> Well, I would probably start

um backwards

at the cochlea itself.

The cochlea

is this spiral

uh organ within the within the human

body.

And it just happens to have been created

in such a way

that you can think of it as the keys of

a piano. All of the frequencies are

spread out and they're at particular

locations in the cochlea. And when we do

the a surgery to insert what you could,

you know, think of as a thread

that goes into the cochlea, it curls

around and positions itself along all of

those piano keys. Along that, there are

spaced apart little metal contacts.

And those metal contacts are the ones

that we can use to create some

electrical stimulation to activate that

part of the cochlea. And ultimately,

what we're doing here is trying to

figure out what the right pattern is to

stimulate, what the right level is to

stimulate at all of those levels in the

cochlea.

And you might imagine that as sound

comes in and gets processed, that it's

it's a very simple mapping of the sound

that comes in to the sound to what gets

stimulated on each electrode in the

cochlea. It turns out that it's not that

simple. We don't do that in a very

sequential way. There's a particular

pattern that you have to do, taking into

consideration the prior electrode that's

stimulated, the next one, how far apart

they are, where it is with respect to

everything else, how far away it is from

the area of the cochlea that it needs to

stimulate. All of these things get taken

into account.

If we now approach it from the other

end, you can think of a hearing aid.

People understand uh the hearing aids,

they take some sound that comes in

through some microphone. It then goes

through a process of cleaning that

sound. It reduces the sounds that you

don't want. It understands your

environment um to to understand what

you're listening to, so that it can know

what sound to focus on, what sound not

to focus on.

So, the front end is very much like what

a hearing aid does.

And then it goes through the cochlear

implant specific processing. Now, let's

do further cleaning that's specific for

cochlear implants.

And then finally, turning that into that

complex stimulation pattern in order to

take all of that processed sound and

finally stimulate the right parts of the

cochlea at exactly the right time.

>> All this happens in few milliseconds, is

it?

>> In a few milliseconds, yes.

>> Wow. Fantastic. That's That's the amount

of research that went in. Fantastic.

Now, to Mr. Anil, Mr. Fernando was

mentioning about how the hearing aid

works and how the cochlear implant is

much superior, completely different.

Hearing aid versus cochlear implant.

When do you think that this hearing aid

is enough, it's not working anymore, you

need to upgrade to the cochlear implant.

When should people go ahead with that?

If you could just let us know.

>> That's a billion-dollar question.

And that's it, there's a billion-dollar

answer to it, too.

But I'll I'll attempt to give a simple,

short

answer from a purely from a a scientific

perspective. One of the main things, I

guess, is it's an acoustic amplification

of the sound. Meaning, the sound is

amplified, so you can hear louder.

Louder doesn't mean better. So, in those

instances,

you need to bypass the acoustic path

to go directly

to the electrical stimulation. Now, they

are a candidate for cochlear implants.

To put it simply, well, there is

arguments on audiograms, severe to

profound, profound, or medium hearing

loss.

It's a little bit gray zone, too.

This is where I think

sometimes, if you prolong this aspect

about hearing aid, continue, or should I

start with my cochlear implants?

Now, that's the journey which allows you

to take advantage of that distinction

between hearing aids and cochlear

implants actually. To put it even more

briefly, I think

it's something that you cannot explain.

As Fernando said,

one of the key aspects is we here at AB

are trying to objectively define what is

the threshold that allows

a recipient or a candidate

to start their cochlear implant journey.

Having the advantage of

this parent company of Sonova and the

Phonak that allows us

to understand where we can make that

journey or transition from hearing aid

to a cochlear implant.

>> Very well said. In fact, because you

work with both hearing aids and cochlear

implants, you're the only company who

does who does that. There's something

called 60/60 rule where the

if your

hearing gets less than 60 decibels and

less than 60% of the speech

discrimination score, your hearing aids

are no longer useful. That is what we

surgeons had, but I didn't know that

there is so much of research in-depth

research which went into it, but thank

you for letting us know about it.

Your entire research, if we see,

it's simply based on

the deadline that exists, a window into

a child's brain that never stays open.

Now, as a researcher, what's exactly

happening in the child's brain? Why are

we worried about that window getting

closed? What is it that getting closing

in the child's brain? Can you just

explain it to common people out there?

>> It really is that time is of the essence

with children. When

a child is born, there are neural

pathways that are being developed. There

are connections that are being made.

And there are many ways to think about

this, but you know, if you were to to

take this idea of a bridge that there

are bridges that are being built from

one part of the nervous system, one part

of the brain to another part.

And what causes those bridges to be

built? What causes those connections to

be built? Is that they are stimulated.

They have some active sound coming in.

The same thing happens for visual. You

know, the you need to have some

stimulation. That stimulation gives the

instructions to build the connections,

to build the bridges.

But

if that stimulation doesn't come in in

the early years,

it then the bridges are never built.

And if the bridges are never built, if

the connections are never made, then

much later in life, if you were then try

to go and now produce that stimulation,

um the bridge is not there. The bridge

was never built. The connections were

never made.

And so some people will wonder

maybe I should wait for the new

technology.

Um let's not uh maybe get a cochlear

implant now, get a cochlear implant

later.

While you might be able to make those

arguments for, you know, your next phone

or your next computer and everything,

for cochlear implants it's a very

different story. Time is of the essence.

You will perform better the earlier

you get that uh cochlear implant. And

not only the earlier that you get the

cochlear implant, but then super

critical is that you actually give

enough of that stimulation throughout

the day. You know, if someone gets the

cochlear implant and they only have it

turned on 4 hours a day, they are not

going to do as well as someone that has

it turned on 16 hours a day.

Time is of the essence, and then the

amount of wearing time and the time that

you have it on is of the essence. And if

you do both of those right, then you're

in a perfect situation to have the full

advantage of the cochlear implant.

>> We always tell all the parents about

neural plasticity

uh in the surgeon's terms. But now, do

not wait for the technology.

Time is brain.

Early intervention is mandatory. It's a

crucial part for success. And point

number four, it's not just the time,

it's a duration of time that your child

gets exposed for the sound, the better

the outcomes are there.

That's a perfect thing what you

consolidated about it. Thank you for

that. Now, let us talk about the one

that is quite fascinating nowadays, AI,

artificial intelligence. Your team has

come up with a first-of-its-kind

dedicated AI chip, Deep Sonic, in the

hearing industry.

Now, how is this AI chip or Deep Sonic

helping you or helping people who have

hearing loss? Actually, what's happening

inside?

>> Well, let me take a a step back

and say first that we have had AI in the

sound processors in the hearing aids for

quite a long time.

Um one of the first companies to have

AI.

But the way we're applying AI now is

different than the way we were applying

AI 5 years ago.

One of the things from from many years

ago that's still available in all of the

sound processors and hearing aids is

that AI would

uh understand the scene

that the recipient was in.

If they were in a restaurant, in a noisy

restaurant, the AI would understand that

they're in a noisy restaurant. If they

were listening to music, it would

understand that they were listening to

music. We try to make things very, very

simple

from the controls perspective, like a

remote control, and from the automation

perspective. But, under the hood,

underneath,

it understands quite a lot. The The AI

that we've had in there for a very long

time understands the difference between

classical music and jazz music and rock

music. And, that's not really exposed to

the outer world, but it's trained AI is

trained on all of that.

It would use this information to

understand what environment you're in,

and then understand what sounds need to

be focused on,

and switch to the right set of

parameters, the right set of programs.

Within the Within the the sound

processor, there are several programs.

There's a music program and a speech and

noise program and various

And, this AI that we've had in there for

a very long time

is using all of that information to

figure out how to get the right mixture,

not just switch from one program to

another. How to get the exact right

mixture of these programs for the exact

environment that you're in.

And, there's hundreds of possibilities

there.

With Deep Sonic,

you we take that to a different level.

Deep Sonic is not about understanding

the environment you're in, it's about

taking all of that information for the

environment you're in,

taking the sound that's coming in,

combining those together

to clean the sound based on what the

patient or recipient wants to focus on.

So, here it has to take into

consideration

what is the most important sound, the

the sound to focus on. If I'm having a

conversation with someone, then it knows

that

that sound that's part of that

conversation is what they need to focus

on. And then, it can reduce all of the

unwanted sounds. That's what Deep Sonic

is doing. We needed a lot of computing

power to be able to do this. What we

would a lot of manufacturers in the

industry do

is they try to reduce costs by taking an

off-the-shelf chip, an AI chip off the

shelf.

And so, they'll take an AI I chip off

the shelf and just incorporate it into

their device.

All of the AI chips out there did not

have the computing power that we needed.

So, we had to build one from scratch.

One that could do in this version of

DeepSonic, and we're already working on

the next version, but in this version

does nearly 8 billion operations per

second.

8 billion per second in the processing

and calculations that it does in order

to clean the sound, to remove the

unwanted sounds, to increase the sound

that you want to be focused on.

Um it was very costly.

Um I don't uh I I could probably speak

in terms of US dollars in this in this

case, but when you look at effort that

it took, the research, the effort to

build that chip from the very beginning

to the very end,

um we invested nearly $150 million

to develop that chip. And it could have

been the cheap just get the chip off the

shelf like everybody else was doing,

but that doesn't give you the 8 billion

operations per second that you need in

order to do the calculations that you

need in order to really have true AI.

>> Um discovering and learning as we are

learning more and more on the power that

we start to unlock

and yet to unlock as the computing gets

even more.

And I think it's an evolution of the

system. So, now we have a a strong

platform. And now that is evolving, and

I think

we just need to unlock it and give it to

the that benefit to the patients.

>> Patients. But but if we look at it, most

of our recipients, most of the families,

they are already exposed to this AI as

you were mentioning the previous

versions of AI. AutoSense OS

>> Mhm.

>> Marvel software already provides us and

kids are

definitely loving it.

>> Right.

>> Now, how does this AutoSense OS and

DeepSonic

how are these two different? You could

just

>> AutoSense OS is what I was describing as

the one that classifies and understands

what your environment is.

>> Okay.

>> And the purpose of that AI is to

understand your environment

>> Mhm.

>> and then to get the appropriate mixture

of programs to tune things across the

different programs

based on the environment that you're in.

>> For example, if a child is sitting in a

classroom

>> Mhm.

>> that that environment. So suddenly if

they go from the classroom to home the

sound gets lower. So that's what

AutoSense OS is going to do?

>> AutoSense is going to know that they're

in a classroom

>> Okay.

>> or it's going to know that they're in a

noisy restaurant or it's going to know

that they're in a quiet environment at

home.

And then based on knowing the

environment, then it's making micro

adjustments to the programs

to tune them so that it's based on the

location that they are, based on the

environment that they're in.

And that's AutoSense OS. That's the AI

that's in AutoSense OS.

>> Mhm.

>> But now within that environment, let's

say you're let's say it's detected that

you're in a restaurant and it's noisy.

>> Mhm.

>> And it's now adjusted the parameters for

the program. It's mixed the programs for

that

>> Mhm.

>> uh restaurant environment.

The AI on top of that, the DeepSonic AI

on top of that

>> Mhm.

>> can now pick out the sound for the

person that you're having the

conversation with and take all of the

noise that's in the rest of the

restaurants, all of the unwanted noise,

and substantially reduce it.

And to really understand this,

probably the best thing that I can

suggest is if people go to the Phonak

website,

on the Phonak website, there is a there

is a page that you can get to quite

easily

that lets you hear the difference.

And so you go to that website and you

hear an example where you're in a

construction zone or you're in a

restaurant, and then you can turn on the

DeepSonic capability or turn it off,

and you can hear the difference, and

that's what really brings it to life for

people so that they can understand what

the AI is doing.

>> Oh, so it's a much upgraded version of

AutoSense, so that is what you mean to

say. And is this going to be available

for our recipients, too?

Soon?

>> Uh

we're DeepSonic.

Yeah, so we're working we have been

working on it, and

here's something else that's interesting

that not a lot of people outside of

Sonova know.

It used to be the case that my Advanced

Bionics engineers would collaborate with

the Sonova engineers, and they would

share some information and all of that

whatever would happen,

but it was still that Advanced Bionics

was doing its it had its own goals, it

had its own thing that it was doing. The

hearing aid part of Sonova had its own

goals and what it was doing. And within

research and development, those two

parts have been merged. The walls have

been torn down between them.

It's not a Advanced Bionics engineers

and hearing aid engineers, it's one

global team of engineers.

>> Wow.

>> Um so, for this

for this global team of engineers, it's

fairly recently now that we've taken the

entire effort under Sonova and really

started paying attention to cochlear

implants. When we did this merging, you

know, I'll be honest, it it wasn't

because we needed to

take Advanced Bionics engineers to boost

what's happening in hearing aid

research.

>> It was that we wanted to take the

advantage of all of that hearing aid

research and integrate it from the from

the very beginning into the Advanced

Bionics products. So, now we have this

global team working on it and it it's

not going to be in a product that we

release this year or necessarily next

year, but the teams are very actively

working on it, so that will speed the

time to market. And from this point on,

when you see something that gets

developed for hearing aid,

>> Mhm.

>> um

almost purely for regulatory reasons,

it'll be a little bit delayed on the CI

side. It'll be very much closer

together. You'll see Phonak releasing a

hearing aid and then on the same

platform, cochlear implants following

shortly behind.

>> Wow.

That's fantastic. It's something which

is so extraordinary even for our

recipients, right? Now, this is for you,

uh Mr. Anil.

If you see the sound processors, you've

designed two separate sound processor,

one different for kids and one for

adults. But, the internal component

remains the same. As an engineer, why

did you and your team decide to do so?

>> It's a great question, actually,

>> [clears throat]

>> in a way, because um

the child becomes the adult very soon.

When we design these instruments, I

think they are supposed to last for a

lifetime. The performance,

the capability that we need to ensure is

something that they can take advantage

of as they are developing.

Now, as a child

you needed a specific things from the

external side of things. Now, here's the

the best part with AB system. We have

ensured the programmability, all the

advantages that Fernando mentioned about

the technology that we're bringing AI

advancements.

We ensure that we can customize it. We

can individualize it. This one you

cannot go and operate every time and you

wanted to.

Now, that's where I think we have made

specific device for pediatric, specific

for adults. Now, what that gives us it

speaks to comfort because, you know, the

anatomy is different, especially the

exterior, but the cochlea is made the

same. I think that's the one of the most

important things because the cochlea is

fully formed

>> It stays the same.

>> and stays the same. Now, what happens is

the pinna or the ear canal and the

anatomy and the size of the those shoes.

What it means is

it means the comfort. It means they can

do their path of hearing without need to

worry about adult size. So, think of it

like, you know, if you're wearing an

adult shoe trying to walk versus you

wear the same shoes that are meant for

the pediatrics.

After some time the adults have same

size shoes, right? Now, we maintain

that.

Think of that.

In that sense, I think we feel

when it comes to the externals, you want

to make sure that

there is an opportunity to customize. In

terms of the implant

because it stays for the life, we want

to ensure

we provide all the capabilities inside

the implant

and ensure that

they go into their adult life you can

still, you know, performance

and capability to

upgrade and capability to bring in

latest of the technology as they are

developing.

>> There's something that's

funny story

related to this. When you go back to the

Marvel device

and looking at the training of of

AutoSense OS to detect what environment

you're in.

This is goes all the way back, I think,

if I remember correctly, to 2017, the

year 2017-2018. We had to in the Sky OS,

which is the pediatric version of the AI

that was being trained there. It was

trained very much with a lot of in a lot

of environments where children are in a

kindergarten class, in schools, in

a school bus, those types of things.

And it's a good thing that we focused on

that child-specific training of the AI

because what we found is that in some

cases in the early version, it wasn't

classifying the scene correctly. You

would get into a classroom with small

children

and it would classify that environment

as heavy metal music.

And so we had to say we had to train the

AI, "No, when you hear a whole bunch of

kids yelling, this is not heavy metal

music. This are you're in a classroom."

so we've taken advantage in in the Sky

products and across our products, a lot

of this AI and machine learning training

that was done

with pediatric specifically in mind. And

and it made it into those pediatric

products.

>> I think that is excellent the right

approach to the product. I spoke about

the comfort and also the device that is

made for all.

And

but I think

the the engine that will ensure that we

can adapt

to a kid's environment, to an adult

environment

is the other one.

Thank you for that. Thanks.

>> Mr. Fernando, now every parent is

worried about the smart devices.

The smartphones, they are getting

hacked.

Apple, in fact, it advertises more about

privacy

when compared to its other features.

That's how important right now is the

privacy. Now, I'm literally as a surgeon

I'm placing electronics inside the head

of a child, which is going to stay

throughout the life. Now, this question

that parents ask me at the end of my

consultation.

Can a cochlear implant be hacked?

>> I will say that for the answer for

Advanced Bionics, which takes

cybersecurity, not just testing that

happens at the very end, but

fundamentally from the very beginning of

the design,

cybersecurity is built in.

So, the short answer for Advanced

Bionics devices is no.

The The reasoning behind it is

severalfold. First of all, these devices

that we have

are not connected to the internet. They

don't have the ability to communicate

with the internet. It's not even

possible within those devices.

You can have a Bluetooth connection to

your phone,

but you don't have any type of direct

connection to the internet. The other

piece of information is that everything

is encrypted. It's encrypted on the

device. It's encrypted in all the

communication that it's doing with with

your phone.

It's encrypted in the communication

that's happening in all of the ways that

it's communicating.

And because it's not going out to the

internet, there someone might ask,

"Well, even if it's encrypted, if you

have some communication out to the

internet, is there a possibility that it

gets hacked?"

Well, here this is not even a question

because it doesn't go out to the

internet. In order to hack something,

you would have to bypass the encryption

that's the same type of encryption

that's used for bank accounts and things

like that. You'd have to to bypass that

encryption and you'd have to do it

millimeters away. What you're trying to

figure out how to to get past if you're

a if you're a hacker

is something that's happening between

the headpiece and the sound processor

and the implant. Even if the hacker

comes up and is right there next to your

head saying, "Hey, stand still so that I

can hack your device."

Even then they're going to not going to

run into too much luck. They're going to

find this difficulty because everything

is simple but it starts or I'm sorry

everything is encrypted. But it starts

with this is not some general system

that's out on the internet. This is To

even begin to answer that question you

would have to have a hacker that comes

right up next to your head and says,

"Stand still while I hack your device."

And even that is not possible.

>> So, answer is absolutely no.

The scheme where the communication

happens

I think

it's a what we call a tightly coupled

link that we have.

So, knowing that there is a tightly

coupled link

is an important aspect.

And without the tightly coupling you

cannot

do this

wirelessly or something. And it That

tightly coupled link is guided by a

specific

frequency specific what we call a

telemetry scheme that needs to be

used

that can only

be part of this. And they have to go

through multiple folds of that scheme to

get into the system.

So, it's not an easy path to come.

Proximity

and the way the both devices communicate

is proprietary to the device.

Proprietary to the system.

>> So, it's impossible.

>> It is.

And

one of the other things that we do is

we're very confident in our

cybersecurity approach and our process

and and building it into the device.

But, we also want independent

verification. So, with our sound

processors, with our software,

we send it out to an external

independent cybersecurity lab, and they

do what is called penetration testing.

And there, they take their hacking

abilities, the experts that they have at

hacking, and they try to hack the

device, and they try to do this. And

every time we release a device,

every device that we release has gone

through that independent penetration

testing. Then we take the results from

that lab, from that cybersecurity lab,

where they've tried to hack the device,

and we take those results, and we

provide them not only to our own

engineers, but to the FDA, to the other

regulatory agencies across the world, so

that they can see that

you don't just take our word for it.

There's independent labs that are

showing that these devices are secure.

>> Don't just believe in the technology,

test it, validate it, verify it,

and then you have the proof.

>> Now, I've seen in many movies where

hearing aid can record conversation.

Now, a cochlear implant also can record

the conversations that are happening?

>> That is not something that the cochlear

implant can do. The cochlear implant

itself is not going to do anything

without the sound processor.

The sound processors don't have the

capability to record any conversation.

Um they are taking the sound that's

coming in,

and they have enough processing memory

to at any moment in time hold a few

milliseconds of information in their

memory in order to clean the sound, in

order to apply all of the processing

that's happening.

Um there's simply no capability to do

any type of recording. And like I said

before, the

these devices are not connected to the

internet.

And so,

not only can they not record the

information,

but there's also no connection to send

them out to the cloud or anything like

that as well.

>> So, we cannot record.

But But Mr. Fernando, when a child comes

to our clinic, we connect it to the

system, and then we check the data,

clinical data. How long are they using

the

the processor in a

So, what are we actually checking there?

The duration of hours or

about the conversations also? Can we

check? Is there any possibility or it's

Even that's impossible.

>> It's not possible to check the

conversations. So, it's simply not

possible. And here's something where

clinicians, hearing care professionals,

have asked us for that capability.

It would be very nice

if when a patient came into the clinic

and they told us that they were having

in a particular situation, a particular

environment, they were having some

trouble, "Hey, can you just

audiologist or clinician, can you Is

there a way for you to see what

conversation was happening there, to

hear it, to be able to diagnose it?"

And the answer is is simply no. It's

It's impossible for that to happen.

When

the device gets connected to the

audiologist's computer

or hearing care professional's computer,

the only thing that they're able to see

is what's recorded on the device, which

are statistics.

How long has the device been turned on?

How long did it spend in the music

program? How long did it spend in the

speech and noise program? How long did

it spend in this other program?

Uh what parameters were used for a

certain amount of time. But even then,

it's very statistical,

which means that if you wanted to say to

to ask a question like

Um, well, were they in this program

yesterday

uh, 11:00.

Um,

it's the system is not capable of

providing that information.

Um, it only has uh,

s- sums aggregate statistical

information. It says in general, how

long have has it been turned on? How

long has it spent in this program? How

long has it spent in another program?

>> So, if you see the head of the research

himself is mentioning that a cochlear

implant cannot record conversations.

Extreme privacy is being maintained for

all the kids as well as adults.

Now, Mr. Fernando, this is

something which even I as a surgeon am I

I'm worried about.

Now, there are two different

philosophies in the industry which is

happening.

One company, they are placing a

chip, an updatable computer in the

internal component itself.

Whereas your company,

you are making the internal component

extremely robust. I can say nearly

indestructible one, very strong.

And you're maintaining all the AI, the

updates, everything on the external

process, the external component.

As a researcher,

why did you and your team decide to do

this?

>> There are several reasons. It was a very

intentional design decision.

Um,

when we designed the cochlear implants,

what we decided is that we need to have

a high-speed communication to each of

the electrodes.

Earlier I talked about how ultimately it

was about figuring out the right pattern

to stimulate those electrodes.

So, if we created a channel

to the outside

for each of those electrodes, and the

outside sound processor could say turn

on one electrode or 16 electrodes

um to independently control them at a at

a fine level of granularity to be able

to send information and read information

from them,

then you really have no advantage for

putting smarts in the cochlear implant

itself.

Everything that you could possibly want

to do, you can control from outside.

And that's where you want to control it

because when you have that controlled

from the outside, when the new AI

technology comes up, you can upgrade it.

No surgery needed. You don't have to

switch your implant.

When new sound processing comes up, you

can

you can take advantage of that by

upgrading the outside.

You don't lose anything cuz of that

high-speed connection to every

individual electrode that you have.

And there's another reason though that

we didn't go in that direction.

And that is

that if you have this very robust device

with

a lot of flexibility, the flexibility to

control every electrode from the

outside,

if and I'm going to give this just as an

example, if the fundamental of that

design is maybe five components,

and you then take something that's very,

very complex. When you look at that

sound processor on the outside,

it doesn't have

just twice as many components. It

doesn't have 10 times as many

components. It has thousands of more

components. In other words,

it's much, much more complex than all

the processing that it can do that the

sound processors turn on the outside.

If you put that on the inside,

you go from a device where you have to

make sure that five components are solid

and that they don't break. And if they

don't break over time, if they don't

break when they get hit by a soccer ball

or football, and that, you know, in all

of these conditions. And now instead of

designing a device that can withstand

that has that's made up of five

components, now you're talking about a

device that has hundreds upon hundreds

upon hundreds of components, any one of

those can break.

From a pure reliability perspective,

the design that we chose to go with and

that we persist with

takes advantage of

you you don't want to put so much

complexity

inside where every one of those points

along the path has an opportunity to

break.

We can design that extremely robustly if

we have to to do that between five

components. If you have to do it with

500 components,

that's a much more difficult thing to

do.

>> The brilliance of the internal

component, to add to what Fernando

mentioned, is

is um

if you look at the overall cochlear

implants

for the past four decades or so,

if you were to think about how it

happens,

takes the sound,

processes the sound,

and then unpacks that sound into

electrical current.

That's this one. This did not change.

The fundamental aspects, coming back to

those five components, the critical

components

that has to power the

and ensure that the stimulation is

delivered should not be disturbed. We

cannot compromise that.

The beauty of all the advantage of we

can take on sound cleaning, noise

canceling, the power of AI and digital

connectivity and everything,

we solve this one

with an external.

We don't need to go to touch the

internal.

So, we not only made the device

reliable, but we made it flexible by

design by taking all those components

outside.

Which gives the user

to keep up with the upgrades

while also ensuring the reliability is

always maintained. So, I think the

cochlear implant, unless some new ways

of communi- new ways of stimulation

happens, something like a science

fiction,

I think for the fundamental physics, we

want to make sure that the stimulation

is delivered reliably.

>> The technology changes over time. The

technology for AI changes over time. The

technology for sound processing changes

over time.

And no matter how good of a job we want

to do, um if we try to to put inside,

surgically implanted into the device,

some amount of processing power, some

amount of intelligence, even if you

could upgrade it with firmware,

the CPU, as for example,

that's done. That's the hardware. It

doesn't change.

Um one of the examples that I've had

discussions with my own engineers about

is you take the example of this flip

phone.

It's the old phones.

And this was there was a real case with

Motorola where they wanted to design

their flip phone for upgradeability. And

they gave it more RAM than it needed.

They gave it more processing power than

it needed.

And sure enough, they could upgrade that

phone

one time, maybe two times. And then at

that point it's just that the CPU

was outdated.

It It became outdated much more quickly

than they thought. And we see this

example after example happening across

various industries where if you try to

say, "No, we're going to We're going to

choose a certain amount of memory,

certain amount of processing power, a

certain CPU, certain hardware, and we're

just going to stick with that. And

that's what's going to serve you for 20

years or for 30 years."

That is that's that's something that has

been shown to

to not work. It will become outdated.

That flip phone was great with the extra

processing

until the smartphones came along, and

then all of that old technology was

really old technology.

So, here the flexibility of the design

to say, "We want to give you a hardware

connection to each individual electrode

and to allow you to control that finely

and then to put that intelligent

intelligence on the outside,

it puts you in a position to not only

have the higher reliability on the

inside and the fewer components and the

full flexibility, but also that you

never run into that upgrade issue. You

can always upgrade the external part.

>> If I can just add one last thing on this

one.

I was thinking about the design. One of

the early times when I was looking at

the inside of this implant,

I was kind of also thinking about what

else can we do to make space, you know?

You're thinking about a child, how small

you can make it.

You wanted to maintain those critical

components.

And this is a fact that I had a natural

question, why 16 different capacitors?

16. They take a lot of space.

When we talk about reliability, it's not

the mechanical reliability.

Electrically, when I saw that this is 16

different independent current sources,

which actually takes up So, for the

stimulation to ensure it's delivered, we

had the independent current sources by

design also available.

I understand that I think that is not a

mandatory, you can still do it. But I

think by design we ensure that. Now,

what that gave us is a flexibility to

have that 16 independent current

sources. It was in the previous

generation, in the current generation,

and it will continue to have it in the

future generation.

Now, that became a now a industry

standard. Independent current sources is

now an industry standard. So, we

set the foundation on independent

current sources.

>> Perfect.

>> And the final thing here is that um

we are always working on many different

products. Some that will come out next

year, some that come out the year after,

some that come out many years down the

road.

And one of the things that we're working

on are the next generation of implants,

with the next generation of implant

designs.

And fundamentally,

we have an opportunity to, for example,

embed

chips and AI processing everything in

the implant design itself.

And we are not

we're not doing it very purposefully.

So, the next generation of implants that

come out, and the implant generation

that comes out after that,

is staying true

for very good reasons to the same

fundamental design choices that we have

for the current generation of implants.

To summarize,

we made some very intentional design

choices

that give you ultimate control of every

independent electrode that's in the

cochlea.

And because you have that independent

control and you can control it from the

outside

there's no advantage to putting more

smarts in the implant itself.

What would you do with that extra

intelligence in the implant when the

external part can control all of the

exact same thing?

One of the things that I ask

people that are asking me about, you

know, can you put more intelligence in

the implant? It's like what would you

do? And they might give me one example.

Well, maybe you could do this.

We could already do that.

From external.

Well, maybe you could do option number

two or maybe you can implement idea

number three. It's like we can already

do that.

We can do everything that we need to do

with that high-speed communication that

controls every electrode.

The other aspect that we talked about is

the reliability.

It's something that we can control

uh very well in the design to say if you

have five components of the implant that

we can make those very reliable. We can

make them reliable against impacts. We

do impact testing. We do it in

real-world situations, you know, to see

what happens when you get hit by a

football in the head.

and you can create very robust devices

when you're dealing with five

five components.

If you're dealing with something that

you put

a computer in the implant in the implant

itself

you go from five components to 500

components. Now, the reliability is a

very

much more complicated thing to manage

because you're not just taking the

connections between five components,

you're taking connections between 500

components, every one of those

has to turn into something that's robust

and reliable.

And and ultimately, like I said, there

isn't any processing advantage for

putting that technology on the inside.

There's a lot of advantage for

controlling it from the outside and

always having that upgrade ability.

>> Now, talking about MRI,

if we want to operate on a 1-year-old

child, we have to get an MRI done for

sure, before surgery also.

And after surgery, until their lifetime,

they require definitely a couple of MRIs

to be done. Now, how did you design that

internal component, specially the magnet

part, in such a way that it's completely

MRI safe?

>> I'm very proud of the team that designed

that. That It was quite an ingenious

design.

Because

inside the magnet, you know, normally

you have a disc magnet. And when you're

inside of the MRI,

in that machine, it's trying to take

that magnet that looks like a coin,

and it's trying to align it with the

magnet that's being the magnetic field

that's being generated by the MRI.

And so, that coin that's implanted in

somebody's head is now trying to flip.

Um and that's not something you want.

You don't want the parts that are inside

moving at all.

So, with the MRI safe magnet,

it's

it it's made up of magnetic cylinders.

And because they're cylinders, each

cylinder can spin.

And as that external magnetic field in

the MRI is putting force on that, or

trying to to adjust that, the internal

cylinders can spin freely.

And then, within those, not only can

they spin in that direction,

but

the the

coin that they sit within, that can

rotate as well. So, you get all of the

axis of freedom,

and as the magnetic field is spinning

around you and trying to get those to

move,

the internal magnet is moving around and

adjusting so that it doesn't put any

pressure.

Like I said, a design that I'm very

proud that the team was able to come up

with

because

when we measure the amount of torque,

this is the force

that is the amount of pressure that's

put on

have having the magnet trying to flip.

Our MRI safe magnet has the least amount

of torque.

It It's the most comfortable, especially

for children, because you go into those

MRI machines, and it's not putting a lot

of pressure, you know, they're not

feeling like it's trying to move of

something that's inside their head.

Um some of the other MRI safe magnets

that we've seen, and MRI safe designs

that we've seen,

they're safe,

but they're not as comfortable because

they produce more torque

than what our magnets have.

>> Yeah.

I think you so- you said it actually. I

think one of the

by design, there are

two or maybe multiple ways of looking at

solving the problem MRI.

One is to restrict the motion,

which I think you in the past you have

to be managed. That is to restrict the

motion.

let the magnets reorient. Now, that's

the more complex approach, required a

lot and it's an ingenious way.

Because if they're orienting in the

right direction,

then you don't need to worry about

restricting the motion.

Now, that makes it more natural because

the especially the pediatrics,

the skin thickness is so thin, the a

thickness.

So, any kind of restriction

that you do

may or may not You may still need to

Yes, you will restrict so that it does

not

it does not you know, kind of flip or

anything.

But, what if you allow it to freely move

in its natural

dipoles?

So, that's where the team did a

fantastic To me, I think the advent of

MRI-safe magnets itself is an important

topic. The solution that came out of

Advanced Bionics team is an ingenious

one. It's a brilliant one.

I think it speaks to especially to a

pediatric not to restrict, but to let

the magnet do its work while they don't

feel a thing.

>> But, Mr. Anil, most of the parents, they

ask me,

"Doctor, my

child underwent a cochlear implant

surgery.

Now, will my child's brain develop in

the same way that a normal child at

typical child without cochlear implant

develops? Is there any answer for this?

They also ask this, "How do we know that

my child is hearing?" They say that the

the implant processor, if the light is

blinking, child is hearing.

But,

I don't understand. Is there any

objective proof that my child is

hearing?

Can you answer these two questions, Mr.

Anil?

>> That's an uh

a question that every audiologist, every

clinician, every manufacturer, every

parent

want to know.

Are we delivering the right stimulus

that will ensure

the child is on the right track towards

the development?

Now,

when you talk about an infant or a

child,

they cannot tell what they're hearing.

But, they are hearing. So, their hearing

can tell something or their brain can

tell.

For a normal atypical normal hearing

and when you have somebody with a

cochlear implant,

there are some charts that allows them

what a normal hearing should be.

When you think about from a pediatrician

or a regular visits, they have a way to

check every developmental ability, limb

movements, growth charts, head,

other things.

Hearing su- Hearing charts are always

subjective.

I think we are embarking on

defining an objective way

to allow the clinician

and give the parents

the right

confidence that their child is on the

right track track for the development.

So, we worked on a system called BEEP.

BEEP stands for bionic ear evoked

potential.

What we are doing with this system is we

take our existing implant and complement

complement with a simple

setup

that will allow the clinician

to stimulate

and ensure that they can also pick up

the signal they have stimulated. What

this gives you the clinician is an

opportunity to understand

if the signal that is delivered is

optimal or not.

This gives the parents, especially, a

piece of mind.

Now, traditionally, to do these such

measurements because it involves picking

signals from brain,

it requires time, patience,

and a complex setup.

We already

ensured that we can do this with our

cochlear implant system with a simple

setup.

The second most important is

you can do this in their own natural

environment. No more complex

setups on their head.

The child is comfortably sitting in a

parent's lap

or doing an activity

while these measurements are done.

And these are done in a

rather

fast, quick way. So, they don't need to

take time to get these measurements.

>> Mr. Anil, how long does this BEEP take?

Does it take some hours or how long does

this take?

>> With our current setup, we have made it

exceedingly simple, so we don't take

away the precious time

for the kids or the parents. It takes

anywhere between 3 to 5 minutes to

complete the full measurements.

>> Wow. Wow. Just 3 to 5 minutes.

>> This is actually something that's very

important to not overlook.

That because you can do this measurement

in 3 to 5 minutes with the child sitting

on the parent's lap and doing playing or

doing whatever it is they're going to

do,

it's a measurement that you can do.

And the difference is that the

traditional way of doing these

measurements, cuz you could do these

measurements with very complex setups

where you have to get a child to sit

still and to be very quiet and all of

these

one of the consequences of that is that

sometimes the measurements won't be

done.

They won't be done either because you

can't get the child to sit still long

enough, you can't get an accurate

reading. In some cases, even the

clinicians will say, "Oh, well, for this

child that's so wiggly, we're not even

going to attempt it."

And so, a lot of parents

won't even be able to get the answer

that they're looking for.

With this BEEP Bionic Ear Evoked

Potential system,

that you don't have to be so still that

you can be at the child can be in the

parent's lap that you can do it in just

a few minutes.

This is a game changer. This is

something where in some cases you

wouldn't even get the answer because of

all of these challenges.

And now you can get the answer.

>> It's worthwhile.

>> It is very instantaneous. I think

I think one of the advantages is

more like a diagnostic

that I think you feel

confident walking as a parent walking

out of the clinic that

my time and my child's time

is first of all spent to understand that

he or she is on the right track to the

development on the development.

And two is

in objective way to say that here's a

chart

that tells me that he's actually slowly

or she's actually slowly working

their way to normal child.

Now this is a confirmation as a mission

that you can give it to the parent and

as a parent you walk out of the clinic

knowing that I don't need to worry about

my child's development abilities while I

can focus on other things that are

important.

>> I just wanted to ask one more thing.

Once you were mentioning that we are

recording this brain waves

uh through the implant. Because as a

surgeon as a doctor myself when you tell

anything about brain, it could be better

brain stem evoked response audiometry or

it could be EEG electroencephalogram.

Child should be sedated.

Child should be given anesthesia. Does

this require any anesthesia? Any

sedation required for BEEP?

>> Absolutely not.

The child can be very active

and one of the most complex things is do

an activity

that actually allows them to be in their

natural way natural environment.

We have seen where the child is sitting

comfortably in a parent's lap playing

or doing a drawing or playing with the

toys while this measurement is done.

All the heavy lifting that is done is

left to the device, not the taxing to

the parent or the child.

>> I have a interesting story what has

happened. In a single day we had three

switch ons.

Three switch on of the implant.

Three kids were of the almost same age,

1 year 1 and 1/2 year.

Um and one more around 11 months old.

Both are bilateral recipients. Now

we have done an intraoperative NRI

and the same thing was matched and the

response was given to the first kid.

Child didn't respond well.

Child only blinking of eyes. They were

just turning this side and that side.

Only that was the response.

And our audiologist, our implant

audiologist, he was like, "I think the

stimulus is not enough for this baby.

So, let me just increase that volume a

bit.

Let me increase the current levels."

Now, for the second baby, once again,

when we switched on

he's around 1 and 1/2 year old.

For that

the intraoperative measurements once

again were correlated and we turned on

we switched on. The minute we switched

on, the child started crying, "Bah!"

this way, that way, throwing tantrums.

He was just putting his head on way all

this. And this was observed by first and

third patients.

They started asking, "The first baby

didn't respond well.

And now the second baby is crying too

much. I think the stimulus is not enough

for my baby."

The first parent started. And now for

the second baby, because they were

shouting so much, they were crying so

much, they had our implant audiologist

had to reduce the volume

because it was a guesswork.

There's no objective response how much

should the threshold the minimum comfort

levels of the threshold values were kept

the biomarkers was not there and the

third one

he was

they didn't know even that child she

didn't show any responses just like

Parkinson's face

mask face. She was not even blinking.

She was not even crying.

Now their parents they were catching our

neck. This implant is not working.

Because there are no responses in the

child's face.

So I would like to really know that is

there any objective biomarker that you

could help us from the implant companies

where you can take a surgeons like us

from the risk where you can also help

the implant audiologist. See this is the

biomarker. This is the P1 latency at its

peak. I can put the T and C levels at

this level and the child will be

comfortable and show that wave to the

parents. Is there any way that you could

help us?

>> [snorts]

>> And this is exactly what

what the deep the bionic ear potential

system is doing. It's a research system

and we hope to turn it from a research

system into something more than a

research system.

But it exactly answers that question. It

is measuring the response from the brain

in an objective way

and further

if the parent were to say I don't think

that implant is working. This is the

objective measurement where the

clinician

can comfortably tell the the the parent

it's like oh no they are hearing.

I have proof

in the response that I got from the

brain that they are receiving it. They

are getting that not just at the cochlea

but deeper in the brain

that they are receiving that um

and it takes us from that subjectivity,

the uncertainty, into the realm of an

objective measurement.

>> Yeah, that's that's exactly the

endeavor. We wanted to ensure that

the

all the measures

along the auditory path

are uncovered.

You want a progress report.

You want a report of not one measure.

As we are unlocking every

measure

it is not just a progress report for the

journey. You see how the numbers are

changing.

It also gives

the full spectrum of all the

measurements. So, when you go through,

um, a normal normal testing, right?

The confidence that you can go with is

you're looking at from different

dimensions, different angles.

Now, when you're looking at one measure,

NRI or ECAPs, is not sufficient.

You wanted to go into deeper.

You want to go into EABR, auditory brain

response.

And then you want to go even more

higher.

So,

our endeavor

with this one

with this particular BEEP system is to

unlock all these measures and provide

the clinician

a sense of confidence and also a sense

of peace for the patients and the

parents.

>> Thank you for designing such a wonderful

device for us. Where are these BEEP

researches happening across the world?

>> This is a very

well-curated study. It's a challenging

and it has

the genesis of this study

started in early work of

somewhere where the university looked

into these

EEG measurements.

So, we started looking into different

ways of how we can

bring that

theory into practice.

So, we started partnering with

several key clinics across the globe. We

started with a clinic in Colorado

where the early early work of

using these measures to quantify how the

child development especially their

hearing journey is or hearing

development pathway is.

And then we partnered with another

clinic in USA.

And this third clinic

we started partnering with Dr. Sri Rao's

clinic in Hyderabad. This is the first

clinic

not just in India

the first clinic in

complete entire Asia Pacific.

And we are exceedingly proud that we got

exciting but valuable data

that

will get you to the pathway you can

provide your recipients a progress

report. A sense of confidence, a sense

of peace that they are on the right path

towards the hearing journey.

>> We are mutually excited and very

thankful for making us as our as your

global research partner

for this BEEP study to advance Bionics

in fact at the Asia Pacific level. Thank

you so much for including us, Dr. Rao's

ENT center.

>> Uh if I may add one of the important

dimensions to this study is

looking at unlocking the child's

potential.

And um

I think it is equally important for us

have the right partners, clinical

partners to enable us as as a researcher

to understand the potential of this

research.

And

the respect and more importantly the

excitement is mutual.

And we are truly excited to have the

opportunity to work with

your

team of exciting team of researchers

and your patients and recipients

and um giving us the opportunity to

work closely

every journey every step along this

development of Bip system. Thank you,

Dr. She.

>> Thank you.

I want to also say thank you.

Uh you have a world-class facility, a

world-class team

and um

you have become a world-class research

partner.

And our collaborative research that

we're doing together is allowing us to

really progress this part of the

science.

>> On April 14, 2026, you opened a new

chapter. You and your team you opened a

new chapter. A research collaboration

with Spiral Therapeutics where a

medicine is precisely delivered into the

cochlea

at the moment of surgery itself. Now,

why does an implant company require a

medicine?

They're completely different. Can you

explain us why?

>> Yeah,

this is something that's not specific to

Advanced Bionics. The industry has been

looking at for quite a long time

applying certain medicines where they

coat the electrodes.

>> Mhm.

>> And this is because when you do the

cochlear implant surgery

you're putting something into the

cochlea that causes the body to respond

with some inflammation.

>> Mhm.

>> And that inflammation can cause uh if

you have residual hearing, if you still

have some residual hearing

it can cause some additional damage to

that.

>> So, what we do here and what the

industry has been doing is let's put

some anti-inflammatory

some anti-inflammatory medication

onto the devices coded on the devices so

that over time they uh

they release this medication

and it keeps the inflammation low.

The

the challenge that the industry has

is that coding the electrodes that way

can only release that with a certain

amount of potency

over a relatively short period of time.

Sometimes it's weeks, sometimes it's a

couple of months. But what you really

need here is something that can last

longer than that and also something

where you can adjust the potency

depending on the specifics of the of the

patient

and the specifics of the surgical

situation.

So, our partnership with Spiral is a

rather unique approach. It's actually

taking a different approach than just

coding the electrodes

which has uh

quite a few shortcomings and instead

giving us the opportunity

to use different formulations that can

be applied during surgery and that can

release over a long period of time into

the cochlea

and something rather unique that can be

reapplied if necessary to even extend

that

much further.

It's a unique approach that addresses

some of the shortcomings of

electrode coatings.

>> I think to add to this, one of the

unique advantages

of this particular collaboration brings

the advantages to address some of the

other underlying things that happen in

the middle ear space.

So, this drug

and the collaboration started with the

drug developed for Meniere's disease.

So, what we are actually looking into is

extending the access

to also

into the cochlea, intracochlea.

Now,

to do that, I think, which we can do

postoperatively,

there is a unique mechanism or a

patented system that was developed by

Spiral.

Now, with this collaboration, we get

this access to this what we call MIX

system, MIC's system. It's a minimally

invasive system that you can go

transtympanic

and then deliver at the entry of the

round window.

What this gives you is

it does not

limit your ability to what you can coat

on the electrode, but gives you an

opportunity to reapply

as needed. So, now,

instead of a topical steroid, you can

deliver the medicine right at the site.

So, it's a combination of how it is

delivered, and it is also the drug

itself.

>> Actually,

the fibrosis, post operative fibrosis or

scarring, is a kind of enemy for the

electrode. For our surgeons as well as

audiologists, surgery goes on well,

implant audiologist programs well,

everything will be fine. Over a couple

of years, slowly the impedances started

start falling down as well as the

hearing capacity,

they tends to go down. It's because of

the fibrosis around the implant

electrode. After all, this is a foreign

body. And that's the reason we tend to

give intraoperative anti-inflammatory,

dexamethasone. But, as you said, it's

going to act for a very limited period

of time.

And this is very useful not just for the

patients, it's useful for us surgeons,

for audiologists,

mainly for the patient throughout their

life.

>> Mhm.

>> Something which is quite important. And

the one what you mentioned mix, MICS,

minimally invasive cochlear system. I've

seen the CEO Hugo Peris talking about

this.

But I had a question then.

Now think about the electrode design

that you have given.

Now we are giving a drug, a medicine

through the

round window. Trans-tympanic through the

round window, we are giving the drug.

Is there any way that the electrode

design tends to change, anything happens

to the electrode, or any change in the

direction of the angle that we need to

go ahead?

Have you any any time thought about it?

Because it's a drug, definitely.

>> Mhm.

>> The drug is designed as a specific and a

special formulation. It's a actually a

proprietary formulation that is

designed.

It starts as a liquid format and slowly

becomes a gel.

It actually aids, if anything, with the

surgical procedure of inserting the

electrode. It helps retain the electrode

while slowly diffusing the drug through

the round window. So it has a two-fold

advantage to it.

Once it solidifies into a gel,

it actually aids with the packing, so

you don't need to do to ensure the

electrode is back out. That's number

one. The second aspect is it is a time

release, which means it gently diffuses

through the round window over a period

of time. And integrates and

disintegrates. Now this allows for a

slow healing at the entry of round

window when you insert the electrode,

while also provide the access to the

drug.

>> Mhm.

>> And when we say period time, we're

talking about months.

>> In a traditional drug release that is

coated with the electrode

what we call is that happens as a burst

release. So, in the initial burst

release of the drug happens, then you

have a sustained release. It slowly

tapers down.

Now, after some time

whatever the drug that's released gets

absorbed and it's over. You cannot apply

any other drugs to it because it will be

exhausted and absorbed into the body.

With this minimally invasive cochlear

system it allows

the clinician

to go for periodic

>> Mhm.

>> steroidal treatments.

>> Anti-inflammatory treatment.

>> Anti-inflammatory treatments, yes.

One of the other advantages of the

system, I think will allow you is you

don't need to come back on a

regular OR procedure. It can be done as

a out of the office clinical

presentation.

>> Oh, seriously?

>> Yes.

>> Just OPD procedure.

>> Yes.

>> Oh, so if a patient, example, we are

implanting a child 1 year old

the child will definitely develop some

amount of fibrosis somewhere around

15-16 years.

>> Exactly.

>> So, they can just come into the OPD

>> OPD.

>> and get this done

and boom, they'll be able to hear like

normal. Can we just state it or not?

>> This is This is one of the advantages.

It it I don't know about hearing normal,

but it aids with

any kind of

anti-inflammatory

treatments

and for which a normal topical or a any

other treatment will not otherwise be

effective, you can deliver the treatment

right at the site and you can do this

not

requiring any anesthesia, not requiring

any

OR.

>> Just as an OPD procedure. Now, before we

get into the last but one question, let

me ask you something.

What are you excited at the moment? And

what can we expect from Advanced Bionics

in the upcoming 5 or 10 years?

>> It's too much for me to talk about

with respect to this, but I will tell

you more fundamentally that

the Sonova hearing aid part of the

business and the Advanced Bionics

cochlear implant side of the business

have come together with a focus to

benefit cochlear implant patients. That

was the main driver, the main reason for

tearing down those walls and merging

into a global R&D team.

And with that focus on helping cochlear

implant patients,

what you can expect to see is we've

already talked about a lot of the

research that's happening in parallel on

many things. First of all,

that to be expanded. So, there are even

more things that we will work on in

parallel.

And then, addition In addition to that,

it's uh to take

all of those people, the researchers,

the the the money that's going into the

research,

and accelerate

the time to market.

Um there are things that take a very

long time. It might take from beginning

to end in some cases 5 years or 6 years

or 7 years

to go from concept to market. And we

intend to

um half the time that it used to take

us. So,

big picture, I think we'll expect to see

much more frequent releases and

accelerated time to market. That's what

I'm most excited about.

>> As Commandor already mentioned about

this excellent collaboration, which is

phenomenal because it gives us access to

extend our research in different

things, different

um questions that we wanted to answer,

right? And it gives us the access to the

resources.

And also the access to the collaborative

technology that we can bring in to

answer these questions. So, as a

researching and researching team,

everybody is excited about this. As a a

bit of a personal sense of

accomplishment as we are embarking on

these new programs like this bionic ear

about potential program.

It is truly unlocking some of the

mysteries

of the CI.

That's exciting.

We are unlocking

mysteries of

what goes inside the cochlear,

what how does the electrode behave,

what is its behaving. It's always been a

guesswork.

We are slowly starting to unlock

and take the guesswork out of the

equation

and provide you with clear answers.

This includes

innovation in electrode and device

technology,

imaging side of things, imaging

technology.

We already spoke about the collaboration

in the drugs and therapeutics.

And there are other collaborations.

The advent of all the objective measures

that we are unlocking

give you this progress report, a sense

absolute peace of mind knowing that

we have done it right.

And the child is on the right track

or the

child is developing on the right path.

And overall,

we could do this

in a much more exciting way. We extended

this research thanks to the

collaboration, as Fernando mentioned, we

have extended this beyond the borders,

across the continents, across the

Atlantics, and across the oceans. To

make it a truly a global product, we

need collaborations, we need insights,

we need data, we need answers,

everything from across the globe. So, we

are powering a global product with a

global perspective. So, as a research

team, we are excited about bringing that

perspective in all these different

technologies that we are going to

unlock. So, for me, yeah, I can go on

and on.

>> That's nice. So, Mr. Fernando, we have

come to the end of the podcast. So, this

is my last question. Now, somewhere in

the middle of the night, a parent would

have been seeing this podcast.

Their kid would have not passed a

newborn hearing screening test. They'll

be much worried. They'll be scrolling

through multiple

multiple mobiles about collecting all

the data. If you could tell them

assuringly something about the cochlear

implant, are there any words that you

could convey them? Could you just tell

them at this point?

>> I have had family members,

people very close to me, that have gone

through this. And so, I know that when

the test comes back, the test result

comes back,

it does create anxiety. It does create

worry. What does this mean for my child?

Are they Are they going to be limited?

Um do I have to send them to a special

school?

And what I would like to convey the most

is that

at Advanced Bionics,

There are people that work

within Advanced Bionics that are

cochlear implant recipients.

There are neighbors that I have that are

teachers that are cochlear implant

recipients.

There are firefighters in my family that

have Advanced Bionics cochlear implants.

I will go and say that

someone that held the position that I

have today before I did

was a senior vice president of global

research and development and was a

Advanced Bionics cochlear implant

recipient.

And what we see here is that

what will be available to your child is

not something that you should worry

about. What will be available to your

child is

they can become CEOs. They can become

teachers. They can become athletes. They

can become

uh they can enjoy music. They can truly

live a life without limitations.

And

if you take parents

that had these worries that are very

natural to have

and you were to ask them 5 years after

the implantation

what they would also tell you is

it's going to be fine.

Your children will be able to grow up

without limitations.

>> I think one of the most compelling

things

I will tell a small

personal story why I chose AB.

And this is a story of me

looking at one of the recipient.

And um

a curiosity that led me

to join the AB.

And I would look back since then.

Because that same curiosity is what

drove me.

And as I am

looking for new answers on

how important this hearing is, I start

to appreciate the pain,

the confusion, the anxiety,

all the emotional things a parent will

go through.

That led me to further

push myself

and looking into ways how we can

make this better every single day.

I can only say two things.

Rest assured.

There are three ways that we look at it

here at AB from a research perspective.

Starting one,

you want to provide the best starting

point. You have the best equipment that

you can be rest assured that performs

and outperforms

every time and

allows the child

to be on the right track for

development.

We work so closely with excellent

collaborators, researchers, clinicians,

surgeons, audiologists.

Everything is

validated, verified. No more guesswork.

This is not a science that is built on

guesswork. It is objective. It is

measurable. You can see it. You can see

what the patient or your child is going

to be like.

This is a sense of assurance that I

believe it cannot top.

I am extremely proud that we have this

opportunity to share our passion

on why and how we can share this

confidence with you in the form of a

device, in the form of a promise that we

wanted to keep

and

keep making things better. Thank you.

>> Thank you so much for coming all the way

from United States

to flying to our country

and accepting for being here on this

Hearing Circle podcast. Thank you so

much. Thank you.

>> Thank you. Hours

hours and 55 minutes.

View full transcript

00:00:00 Hundreds [music] of engineers across the

00:00:02 world answer to him every day. April

00:00:05 14th, [music] 2026,

00:00:07 he also opened a new chapter.

00:00:10 Your team has [music] come up with the

00:00:11 first of its kind dedicated AI chip in

00:00:14 the hearing industry.

00:00:16 >> This program [music] does nearly 8

00:00:19 billion operations per second.

00:00:23 >> Can the cochlear implant be hacked?

00:00:26 >> I will say that

00:00:30 >> A cochlear implant is a very powerful

00:00:32 and successful neuro prosthetic device

00:00:34 in the field of medicine. My guest today

00:00:37 has spent 23 years in a single company

00:00:40 with a single mission.

00:00:42 Providing the best possible hearing

00:00:44 technology and building the strong

00:00:46 research behind this cochlear implant.

00:00:49 Hundreds of engineers across the world

00:00:52 answer to him every day.

00:00:54 His team built the first dedicated AI

00:00:57 chip in the hearing industry. And on

00:01:00 April 14th, 2026,

00:01:02 he also opened a new chapter, a research

00:01:05 collaboration with spiral therapeutics

00:01:07 where a medicine is being precisely

00:01:10 delivered into the cochlea at the moment

00:01:12 of surgery itself. He's none other than

00:01:16 the senior vice president of global

00:01:19 research and development Advanced

00:01:21 Bionics, Mr. Fernando Chapa. Welcome

00:01:24 you, sir.

00:01:25 >> Thank you very much for having me here,

00:01:26 and it's

00:01:28 it's the first time that I've been in

00:01:30 your hospital, in your clinic.

00:01:33 Extraordinarily impressive.

00:01:35 Extraordinarily impressive. I'm very

00:01:37 impressed with everything that I've

00:01:38 seen.

00:01:39 >> Thank you so much, sir. That means a

00:01:40 lot.

00:01:41 And joining him today, the engineer who

00:01:45 transforms the entire research into a

00:01:48 device itself. He has his own patent

00:01:51 where he designed a self-coiling

00:01:53 electrode which when placed into the

00:01:55 cochlea takes the shape of the cochlear.

00:01:58 is none other than director of global

00:02:01 research and technology, Advanced

00:02:03 Bionics, Mr. Anil Patnala.

00:02:06 Welcome to India.

00:02:07 >> Thank you, Dr. Shree. It's a pleasure.

00:02:10 It's actually an honor for me to be

00:02:12 here.

00:02:13 It's an extraordinary journey for us to

00:02:15 be part of such a mission that you

00:02:17 champion and you take it forward. And we

00:02:21 at the at the core of this feel

00:02:24 extremely privileged to be able to work

00:02:26 on solving such problems that make

00:02:29 meaningful difference that you bring it

00:02:32 to these recipients that we met today.

00:02:35 Thank you.

00:02:36 >> Thank you so much. Thank you so much

00:02:37 both of you for being on this Hearing

00:02:39 Circle podcast. Thank you for accepting

00:02:42 the invitation. Now, without any further

00:02:44 delay, I have a question for you, Mr.

00:02:46 Fernando. 23 years in a single company.

00:02:51 It's incredible. But when you look at

00:02:53 the cochlear implant,

00:02:55 how do you feel?

00:02:57 What do you look at that a surgeon like

00:02:59 us doesn't see?

00:03:00 >> I've seen quite a lot over the decades

00:03:03 that I've been with Advanced Bionics.

00:03:06 And one of the things that maybe

00:03:10 is not appreciated as much is that

00:03:13 the industry as a whole

00:03:15 >> Mhm.

00:03:16 >> um still actually has a long way to go

00:03:19 when it comes to how do we test whether

00:03:22 the hearing performance and how do we

00:03:24 test whether the listening effort, the

00:03:27 comfort, the ability to hear in

00:03:30 different situations, how do we test

00:03:32 those so that we can really

00:03:36 uh understand

00:03:39 where the improvements need to be made.

00:03:42 And so, one of the things that I've seen

00:03:44 is that when we went from our Harmony

00:03:47 sound processors quite a long time ago

00:03:49 to the Naída Q sound processors,

00:03:52 we turned off some of the advanced

00:03:53 features. We went to the newer

00:03:55 technology.

00:03:56 And the recipients that we bring in for

00:03:59 internal patients at Advanced Bionics

00:04:02 would put those on and say, "Wow, this

00:04:04 is a amazing. This is a night and day

00:04:06 difference. When I go from my Harmony to

00:04:08 my Naída CIU, it's amazing." And when we

00:04:11 turn off some of the advanced features,

00:04:13 what we would see is a little bump in

00:04:16 speech scores.

00:04:18 The

00:04:20 But we wouldn't see what matches their

00:04:23 reaction.

00:04:25 And so there's something there that

00:04:26 wasn't being captured.

00:04:28 When we go from Naída CIU to Naída M, we

00:04:30 saw the same thing. Patients would come

00:04:32 in that went from Harmony to Naída CIU

00:04:34 to Naída M. And when they would wear the

00:04:37 the Marvel devices, they would say,

00:04:38 "Wow, this is amazing. It's a such a

00:04:41 night and day difference."

00:04:43 And yet you don't see that in the

00:04:46 measurements that the industry is

00:04:48 capturing.

00:04:49 >> True. So I would

00:04:49 >> say that in the signal processing,

00:04:52 in the measurements that we take, the

00:04:55 thing that we still have uh that we

00:04:59 still have to focus on as an industry,

00:05:01 not just Advanced Bionics, is how do we

00:05:04 measure those changes? How do we measure

00:05:07 that every time we come out with a new

00:05:09 sound processor or new technology, we

00:05:11 hear, "This is amazing. It's so much

00:05:13 different than the previous version."

00:05:16 Um

00:05:17 and to be able to objectively see those

00:05:19 scores out in the industry.

00:05:21 >> Perfect. Perfect. Now, with that being

00:05:23 said,

00:05:24 this is for you.

00:05:26 You and your team helped in building the

00:05:28 internal component of a cochlear

00:05:31 implant, the one that stays inside the

00:05:33 child's life throughout. You also have a

00:05:35 patent where

00:05:37 there is you have designed a

00:05:38 self-coiling electrode, the one which

00:05:40 goes when placed inside the cochlea, it

00:05:42 takes the shape of the cochlea. Now,

00:05:44 when you look at the finished product

00:05:46 holding in your hand, How do you feel

00:05:48 about it?

00:05:49 >> Extremely humbled actually. What we see

00:05:51 in other technologies, other things in

00:05:54 everyday today life is something that

00:05:56 you can bring it to hearing. It's

00:05:59 something

00:06:01 an extremely important initiative from

00:06:04 our team's perspective. So, we don't

00:06:06 just stay at what matters for the

00:06:09 hearing, what is required. We try to

00:06:11 look outside the box.

00:06:13 And that's what led us to look at these

00:06:15 new materials.

00:06:17 If you're building traditional cochlear

00:06:19 implant, which everybody has been

00:06:21 building,

00:06:22 they're looking at solving a problem.

00:06:24 We're not just looking at solving a

00:06:26 problem.

00:06:28 We're looking at solving a few different

00:06:30 problems at the same time.

00:06:33 So,

00:06:34 the genesis or the starting point of

00:06:37 this so-called self-coiling electrode is

00:06:40 to solve more than one problem.

00:06:43 What it can do is something I think

00:06:46 patients can tell the difference. As you

00:06:48 can tell,

00:06:49 the natural shape is super important and

00:06:52 the placement is extremely important to

00:06:56 ensure the patient gets the best in

00:06:59 ensuring they can do their best,

00:07:01 we are doing our job to give the best

00:07:05 instrument.

00:07:06 >> Wonderful. Very well said. Now, to Mr.

00:07:09 Fernando,

00:07:10 the question that millions of parents

00:07:13 they search this question every month.

00:07:17 How does a cochlear implant work?

00:07:21 Now, give your point of view

00:07:23 like a researcher.

00:07:24 >> Well, I would probably start

00:07:27 um backwards

00:07:29 at the cochlea itself.

00:07:32 The cochlea

00:07:33 is this spiral

00:07:36 uh organ within the within the human

00:07:38 body.

00:07:39 And it just happens to have been created

00:07:41 in such a way

00:07:43 that you can think of it as the keys of

00:07:45 a piano. All of the frequencies are

00:07:48 spread out and they're at particular

00:07:51 locations in the cochlea. And when we do

00:07:54 the a surgery to insert what you could,

00:07:57 you know, think of as a thread

00:08:00 that goes into the cochlea, it curls

00:08:01 around and positions itself along all of

00:08:04 those piano keys. Along that, there are

00:08:07 spaced apart little metal contacts.

00:08:10 And those metal contacts are the ones

00:08:12 that we can use to create some

00:08:14 electrical stimulation to activate that

00:08:16 part of the cochlea. And ultimately,

00:08:18 what we're doing here is trying to

00:08:19 figure out what the right pattern is to

00:08:22 stimulate, what the right level is to

00:08:25 stimulate at all of those levels in the

00:08:27 cochlea.

00:08:28 And you might imagine that as sound

00:08:31 comes in and gets processed, that it's

00:08:35 it's a very simple mapping of the sound

00:08:37 that comes in to the sound to what gets

00:08:40 stimulated on each electrode in the

00:08:41 cochlea. It turns out that it's not that

00:08:44 simple. We don't do that in a very

00:08:46 sequential way. There's a particular

00:08:48 pattern that you have to do, taking into

00:08:51 consideration the prior electrode that's

00:08:53 stimulated, the next one, how far apart

00:08:55 they are, where it is with respect to

00:08:57 everything else, how far away it is from

00:08:59 the area of the cochlea that it needs to

00:09:01 stimulate. All of these things get taken

00:09:04 into account.

00:09:05 If we now approach it from the other

00:09:07 end, you can think of a hearing aid.

00:09:10 People understand uh the hearing aids,

00:09:12 they take some sound that comes in

00:09:14 through some microphone. It then goes

00:09:16 through a process of cleaning that

00:09:17 sound. It reduces the sounds that you

00:09:20 don't want. It understands your

00:09:22 environment um to to understand what

00:09:24 you're listening to, so that it can know

00:09:26 what sound to focus on, what sound not

00:09:28 to focus on.

00:09:29 So, the front end is very much like what

00:09:31 a hearing aid does.

00:09:33 And then it goes through the cochlear

00:09:35 implant specific processing. Now, let's

00:09:37 do further cleaning that's specific for

00:09:40 cochlear implants.

00:09:42 And then finally, turning that into that

00:09:45 complex stimulation pattern in order to

00:09:47 take all of that processed sound and

00:09:49 finally stimulate the right parts of the

00:09:51 cochlea at exactly the right time.

00:09:53 >> All this happens in few milliseconds, is

00:09:55 it?

00:09:55 >> In a few milliseconds, yes.

00:09:57 >> Wow. Fantastic. That's That's the amount

00:10:00 of research that went in. Fantastic.

00:10:03 Now, to Mr. Anil, Mr. Fernando was

00:10:07 mentioning about how the hearing aid

00:10:09 works and how the cochlear implant is

00:10:10 much superior, completely different.

00:10:13 Hearing aid versus cochlear implant.

00:10:15 When do you think that this hearing aid

00:10:17 is enough, it's not working anymore, you

00:10:20 need to upgrade to the cochlear implant.

00:10:22 When should people go ahead with that?

00:10:24 If you could just let us know.

00:10:26 >> That's a billion-dollar question.

00:10:28 And that's it, there's a billion-dollar

00:10:30 answer to it, too.

00:10:31 But I'll I'll attempt to give a simple,

00:10:34 short

00:10:35 answer from a purely from a a scientific

00:10:38 perspective. One of the main things, I

00:10:40 guess, is it's an acoustic amplification

00:10:44 of the sound. Meaning, the sound is

00:10:46 amplified, so you can hear louder.

00:10:49 Louder doesn't mean better. So, in those

00:10:52 instances,

00:10:54 you need to bypass the acoustic path

00:10:57 to go directly

00:10:59 to the electrical stimulation. Now, they

00:11:01 are a candidate for cochlear implants.

00:11:04 To put it simply, well, there is

00:11:06 arguments on audiograms, severe to

00:11:09 profound, profound, or medium hearing

00:11:13 loss.

00:11:14 It's a little bit gray zone, too.

00:11:16 This is where I think

00:11:18 sometimes, if you prolong this aspect

00:11:21 about hearing aid, continue, or should I

00:11:25 start with my cochlear implants?

00:11:27 Now, that's the journey which allows you

00:11:30 to take advantage of that distinction

00:11:32 between hearing aids and cochlear

00:11:34 implants actually. To put it even more

00:11:36 briefly, I think

00:11:39 it's something that you cannot explain.

00:11:40 As Fernando said,

00:11:42 one of the key aspects is we here at AB

00:11:46 are trying to objectively define what is

00:11:49 the threshold that allows

00:11:52 a recipient or a candidate

00:11:56 to start their cochlear implant journey.

00:11:58 Having the advantage of

00:12:00 this parent company of Sonova and the

00:12:03 Phonak that allows us

00:12:06 to understand where we can make that

00:12:09 journey or transition from hearing aid

00:12:12 to a cochlear implant.

00:12:13 >> Very well said. In fact, because you

00:12:16 work with both hearing aids and cochlear

00:12:18 implants, you're the only company who

00:12:20 does who does that. There's something

00:12:22 called 60/60 rule where the

00:12:25 if your

00:12:26 hearing gets less than 60 decibels and

00:12:29 less than 60% of the speech

00:12:31 discrimination score, your hearing aids

00:12:33 are no longer useful. That is what we

00:12:35 surgeons had, but I didn't know that

00:12:38 there is so much of research in-depth

00:12:40 research which went into it, but thank

00:12:42 you for letting us know about it.

00:12:45 Your entire research, if we see,

00:12:48 it's simply based on

00:12:51 the deadline that exists, a window into

00:12:54 a child's brain that never stays open.

00:12:58 Now, as a researcher, what's exactly

00:13:00 happening in the child's brain? Why are

00:13:02 we worried about that window getting

00:13:04 closed? What is it that getting closing

00:13:07 in the child's brain? Can you just

00:13:09 explain it to common people out there?

00:13:12 >> It really is that time is of the essence

00:13:16 with children. When

00:13:19 a child is born, there are neural

00:13:21 pathways that are being developed. There

00:13:24 are connections that are being made.

00:13:27 And there are many ways to think about

00:13:29 this, but you know, if you were to to

00:13:32 take this idea of a bridge that there

00:13:34 are bridges that are being built from

00:13:36 one part of the nervous system, one part

00:13:38 of the brain to another part.

00:13:41 And what causes those bridges to be

00:13:43 built? What causes those connections to

00:13:45 be built? Is that they are stimulated.

00:13:48 They have some active sound coming in.

00:13:51 The same thing happens for visual. You

00:13:52 know, the you need to have some

00:13:54 stimulation. That stimulation gives the

00:13:57 instructions to build the connections,

00:13:59 to build the bridges.

00:14:01 But

00:14:02 if that stimulation doesn't come in in

00:14:05 the early years,

00:14:07 it then the bridges are never built.

00:14:10 And if the bridges are never built, if

00:14:12 the connections are never made, then

00:14:14 much later in life, if you were then try

00:14:16 to go and now produce that stimulation,

00:14:19 um the bridge is not there. The bridge

00:14:21 was never built. The connections were

00:14:23 never made.

00:14:25 And so some people will wonder

00:14:28 um

00:14:29 maybe I should wait for the new

00:14:32 technology.

00:14:33 Um let's not uh maybe get a cochlear

00:14:35 implant now, get a cochlear implant

00:14:37 later.

00:14:38 While you might be able to make those

00:14:39 arguments for, you know, your next phone

00:14:42 or your next computer and everything,

00:14:44 for cochlear implants it's a very

00:14:46 different story. Time is of the essence.

00:14:49 You will perform better the earlier

00:14:54 you get that uh cochlear implant. And

00:14:57 not only the earlier that you get the

00:15:00 cochlear implant, but then super

00:15:03 critical is that you actually give

00:15:06 enough of that stimulation throughout

00:15:08 the day. You know, if someone gets the

00:15:10 cochlear implant and they only have it

00:15:12 turned on 4 hours a day, they are not

00:15:15 going to do as well as someone that has

00:15:18 it turned on 16 hours a day.

00:15:20 Time is of the essence, and then the

00:15:22 amount of wearing time and the time that

00:15:24 you have it on is of the essence. And if

00:15:25 you do both of those right, then you're

00:15:28 in a perfect situation to have the full

00:15:30 advantage of the cochlear implant.

00:15:32 >> We always tell all the parents about

00:15:34 neural plasticity

00:15:36 uh in the surgeon's terms. But now, do

00:15:39 not wait for the technology.

00:15:42 Time is brain.

00:15:43 Early intervention is mandatory. It's a

00:15:46 crucial part for success. And point

00:15:49 number four, it's not just the time,

00:15:51 it's a duration of time that your child

00:15:54 gets exposed for the sound, the better

00:15:56 the outcomes are there.

00:15:58 That's a perfect thing what you

00:16:00 consolidated about it. Thank you for

00:16:02 that. Now, let us talk about the one

00:16:04 that is quite fascinating nowadays, AI,

00:16:07 artificial intelligence. Your team has

00:16:10 come up with a first-of-its-kind

00:16:12 dedicated AI chip, Deep Sonic, in the

00:16:15 hearing industry.

00:16:16 Now, how is this AI chip or Deep Sonic

00:16:20 helping you or helping people who have

00:16:23 hearing loss? Actually, what's happening

00:16:25 inside?

00:16:26 >> Well, let me take a a step back

00:16:29 and say first that we have had AI in the

00:16:34 sound processors in the hearing aids for

00:16:36 quite a long time.

00:16:38 Um one of the first companies to have

00:16:40 AI.

00:16:41 But the way we're applying AI now is

00:16:44 different than the way we were applying

00:16:46 AI 5 years ago.

00:16:48 One of the things from from many years

00:16:51 ago that's still available in all of the

00:16:53 sound processors and hearing aids is

00:16:55 that AI would

00:16:58 uh understand the scene

00:17:00 that the recipient was in.

00:17:02 If they were in a restaurant, in a noisy

00:17:05 restaurant, the AI would understand that

00:17:07 they're in a noisy restaurant. If they

00:17:09 were listening to music, it would

00:17:10 understand that they were listening to

00:17:11 music. We try to make things very, very

00:17:15 simple

00:17:16 from the controls perspective, like a

00:17:18 remote control, and from the automation

00:17:21 perspective. But, under the hood,

00:17:24 underneath,

00:17:26 it understands quite a lot. The The AI

00:17:29 that we've had in there for a very long

00:17:31 time understands the difference between

00:17:33 classical music and jazz music and rock

00:17:36 music. And, that's not really exposed to

00:17:38 the outer world, but it's trained AI is

00:17:41 trained on all of that.

00:17:43 It would use this information to

00:17:45 understand what environment you're in,

00:17:47 and then understand what sounds need to

00:17:50 be focused on,

00:17:51 and switch to the right set of

00:17:55 parameters, the right set of programs.

00:17:58 Within the Within the the sound

00:18:00 processor, there are several programs.

00:18:02 There's a music program and a speech and

00:18:04 noise program and various

00:18:06 And, this AI that we've had in there for

00:18:09 a very long time

00:18:10 is

00:18:12 is using all of that information to

00:18:14 figure out how to get the right mixture,

00:18:16 not just switch from one program to

00:18:17 another. How to get the exact right

00:18:19 mixture of these programs for the exact

00:18:22 environment that you're in.

00:18:23 And, there's hundreds of possibilities

00:18:25 there.

00:18:26 With Deep Sonic,

00:18:28 you we take that to a different level.

00:18:31 Deep Sonic is not about understanding

00:18:33 the environment you're in, it's about

00:18:34 taking all of that information for the

00:18:36 environment you're in,

00:18:37 taking the sound that's coming in,

00:18:40 combining those together

00:18:41 to clean the sound based on what the

00:18:46 patient or recipient wants to focus on.

00:18:49 So, here it has to take into

00:18:50 consideration

00:18:52 what is the most important sound, the

00:18:55 the sound to focus on. If I'm having a

00:18:57 conversation with someone, then it knows

00:18:59 that

00:19:00 that sound that's part of that

00:19:02 conversation is what they need to focus

00:19:04 on. And then, it can reduce all of the

00:19:07 unwanted sounds. That's what Deep Sonic

00:19:09 is doing. We needed a lot of computing

00:19:11 power to be able to do this. What we

00:19:14 would a lot of manufacturers in the

00:19:15 industry do

00:19:17 is they try to reduce costs by taking an

00:19:21 off-the-shelf chip, an AI chip off the

00:19:24 shelf.

00:19:25 And so, they'll take an AI I chip off

00:19:28 the shelf and just incorporate it into

00:19:30 their device.

00:19:32 All of the AI chips out there did not

00:19:35 have the computing power that we needed.

00:19:37 So, we had to build one from scratch.

00:19:40 One that could do in this version of

00:19:43 DeepSonic, and we're already working on

00:19:46 the next version, but in this version

00:19:48 does nearly 8 billion operations per

00:19:52 second.

00:19:54 8 billion per second in the processing

00:19:58 and calculations that it does in order

00:19:59 to clean the sound, to remove the

00:20:02 unwanted sounds, to increase the sound

00:20:04 that you want to be focused on.

00:20:07 Um it was very costly.

00:20:11 Um I don't uh I I could probably speak

00:20:15 in terms of US dollars in this in this

00:20:18 case, but when you look at effort that

00:20:21 it took, the research, the effort to

00:20:23 build that chip from the very beginning

00:20:25 to the very end,

00:20:26 um we invested nearly $150 million

00:20:31 to develop that chip. And it could have

00:20:33 been the cheap just get the chip off the

00:20:35 shelf like everybody else was doing,

00:20:37 but that doesn't give you the 8 billion

00:20:40 operations per second that you need in

00:20:41 order to do the calculations that you

00:20:43 need in order to really have true AI.

00:20:46 >> Um discovering and learning as we are

00:20:49 learning more and more on the power that

00:20:52 we start to unlock

00:20:55 and yet to unlock as the computing gets

00:20:58 even more.

00:21:00 And I think it's an evolution of the

00:21:02 system. So, now we have a a strong

00:21:04 platform. And now that is evolving, and

00:21:08 I think

00:21:09 we just need to unlock it and give it to

00:21:11 the that benefit to the patients.

00:21:13 >> Patients. But but if we look at it, most

00:21:16 of our recipients, most of the families,

00:21:18 they are already exposed to this AI as

00:21:20 you were mentioning the previous

00:21:21 versions of AI. AutoSense OS

00:21:24 >> Mhm.

00:21:24 >> Marvel software already provides us and

00:21:26 kids are

00:21:27 definitely loving it.

00:21:29 >> Right.

00:21:29 >> Now, how does this AutoSense OS and

00:21:32 DeepSonic

00:21:34 how are these two different? You could

00:21:36 just

00:21:36 >> AutoSense OS is what I was describing as

00:21:39 the one that classifies and understands

00:21:42 what your environment is.

00:21:44 >> Okay.

00:21:45 >> And the purpose of that AI is to

00:21:48 understand your environment

00:21:50 >> Mhm.

00:21:50 >> and then to get the appropriate mixture

00:21:53 of programs to tune things across the

00:21:56 different programs

00:21:58 based on the environment that you're in.

00:21:59 >> For example, if a child is sitting in a

00:22:01 classroom

00:22:02 >> Mhm.

00:22:02 >> that that environment. So suddenly if

00:22:05 they go from the classroom to home the

00:22:07 sound gets lower. So that's what

00:22:09 AutoSense OS is going to do?

00:22:12 >> AutoSense is going to know that they're

00:22:13 in a classroom

00:22:14 >> Okay.

00:22:14 >> or it's going to know that they're in a

00:22:16 noisy restaurant or it's going to know

00:22:18 that they're in a quiet environment at

00:22:19 home.

00:22:21 And then based on knowing the

00:22:22 environment, then it's making micro

00:22:25 adjustments to the programs

00:22:27 to tune them so that it's based on the

00:22:30 location that they are, based on the

00:22:32 environment that they're in.

00:22:34 And that's AutoSense OS. That's the AI

00:22:36 that's in AutoSense OS.

00:22:38 >> Mhm.

00:22:39 >> But now within that environment, let's

00:22:41 say you're let's say it's detected that

00:22:43 you're in a restaurant and it's noisy.

00:22:46 >> Mhm.

00:22:46 >> And it's now adjusted the parameters for

00:22:49 the program. It's mixed the programs for

00:22:51 that

00:22:52 >> Mhm.

00:22:53 >> uh restaurant environment.

00:22:55 The AI on top of that, the DeepSonic AI

00:22:59 on top of that

00:23:00 >> Mhm.

00:23:00 >> can now pick out the sound for the

00:23:04 person that you're having the

00:23:05 conversation with and take all of the

00:23:07 noise that's in the rest of the

00:23:09 restaurants, all of the unwanted noise,

00:23:12 and substantially reduce it.

00:23:16 And to really understand this,

00:23:18 probably the best thing that I can

00:23:20 suggest is if people go to the Phonak

00:23:23 website,

00:23:24 on the Phonak website, there is a there

00:23:28 is a page that you can get to quite

00:23:30 easily

00:23:32 that lets you hear the difference.

00:23:35 And so you go to that website and you

00:23:37 hear an example where you're in a

00:23:40 construction zone or you're in a

00:23:41 restaurant, and then you can turn on the

00:23:44 DeepSonic capability or turn it off,

00:23:47 and you can hear the difference, and

00:23:50 that's what really brings it to life for

00:23:53 people so that they can understand what

00:23:54 the AI is doing.

00:23:56 >> Oh, so it's a much upgraded version of

00:23:59 AutoSense, so that is what you mean to

00:24:01 say. And is this going to be available

00:24:04 for our recipients, too?

00:24:06 Soon?

00:24:07 >> Uh

00:24:07 we're DeepSonic.

00:24:09 Yeah, so we're working we have been

00:24:11 working on it, and

00:24:13 here's something else that's interesting

00:24:15 that not a lot of people outside of

00:24:17 Sonova know.

00:24:18 It used to be the case that my Advanced

00:24:22 Bionics engineers would collaborate with

00:24:25 the Sonova engineers, and they would

00:24:27 share some information and all of that

00:24:30 whatever would happen,

00:24:32 but it was still that Advanced Bionics

00:24:34 was doing its it had its own goals, it

00:24:36 had its own thing that it was doing. The

00:24:38 hearing aid part of Sonova had its own

00:24:40 goals and what it was doing. And within

00:24:42 research and development, those two

00:24:44 parts have been merged. The walls have

00:24:47 been torn down between them.

00:24:50 It's not a Advanced Bionics engineers

00:24:52 and hearing aid engineers, it's one

00:24:55 global team of engineers.

00:24:57 >> Wow.

00:24:58 >> Um so, for this

00:25:01 for this global team of engineers, it's

00:25:04 fairly recently now that we've taken the

00:25:07 entire effort under Sonova and really

00:25:11 started paying attention to cochlear

00:25:14 implants. When we did this merging, you

00:25:16 know, I'll be honest, it it wasn't

00:25:18 because we needed to

00:25:20 take Advanced Bionics engineers to boost

00:25:23 what's happening in hearing aid

00:25:24 research.

00:25:26 >> It was that we wanted to take the

00:25:27 advantage of all of that hearing aid

00:25:29 research and integrate it from the from

00:25:34 the very beginning into the Advanced

00:25:35 Bionics products. So, now we have this

00:25:37 global team working on it and it it's

00:25:40 not going to be in a product that we

00:25:42 release this year or necessarily next

00:25:44 year, but the teams are very actively

00:25:46 working on it, so that will speed the

00:25:48 time to market. And from this point on,

00:25:51 when you see something that gets

00:25:52 developed for hearing aid,

00:25:54 >> Mhm.

00:25:54 >> um

00:25:55 almost purely for regulatory reasons,

00:25:58 it'll be a little bit delayed on the CI

00:26:00 side. It'll be very much closer

00:26:02 together. You'll see Phonak releasing a

00:26:04 hearing aid and then on the same

00:26:07 platform, cochlear implants following

00:26:09 shortly behind.

00:26:10 >> Wow.

00:26:12 That's fantastic. It's something which

00:26:15 is so extraordinary even for our

00:26:17 recipients, right? Now, this is for you,

00:26:20 uh Mr. Anil.

00:26:21 If you see the sound processors, you've

00:26:24 designed two separate sound processor,

00:26:26 one different for kids and one for

00:26:29 adults. But, the internal component

00:26:30 remains the same. As an engineer, why

00:26:32 did you and your team decide to do so?

00:26:35 >> It's a great question, actually,

00:26:36 >> [clears throat]

00:26:37 >> in a way, because um

00:26:39 the child becomes the adult very soon.

00:26:41 When we design these instruments, I

00:26:44 think they are supposed to last for a

00:26:45 lifetime. The performance,

00:26:47 the capability that we need to ensure is

00:26:51 something that they can take advantage

00:26:53 of as they are developing.

00:26:56 Now, as a child

00:26:57 you needed a specific things from the

00:27:00 external side of things. Now, here's the

00:27:02 the best part with AB system. We have

00:27:04 ensured the programmability, all the

00:27:07 advantages that Fernando mentioned about

00:27:09 the technology that we're bringing AI

00:27:11 advancements.

00:27:13 We ensure that we can customize it. We

00:27:15 can individualize it. This one you

00:27:18 cannot go and operate every time and you

00:27:20 wanted to.

00:27:21 Now, that's where I think we have made

00:27:22 specific device for pediatric, specific

00:27:25 for adults. Now, what that gives us it

00:27:27 speaks to comfort because, you know, the

00:27:30 anatomy is different, especially the

00:27:32 exterior, but the cochlea is made the

00:27:34 same. I think that's the one of the most

00:27:36 important things because the cochlea is

00:27:38 fully formed

00:27:39 >> It stays the same.

00:27:40 >> and stays the same. Now, what happens is

00:27:42 the pinna or the ear canal and the

00:27:46 anatomy and the size of the those shoes.

00:27:49 What it means is

00:27:50 it means the comfort. It means they can

00:27:53 do their path of hearing without need to

00:27:57 worry about adult size. So, think of it

00:28:00 like, you know, if you're wearing an

00:28:01 adult shoe trying to walk versus you

00:28:03 wear the same shoes that are meant for

00:28:05 the pediatrics.

00:28:07 After some time the adults have same

00:28:09 size shoes, right? Now, we maintain

00:28:11 that.

00:28:12 Think of that.

00:28:13 In that sense, I think we feel

00:28:16 when it comes to the externals, you want

00:28:18 to make sure that

00:28:20 there is an opportunity to customize. In

00:28:22 terms of the implant

00:28:24 because it stays for the life, we want

00:28:25 to ensure

00:28:26 we provide all the capabilities inside

00:28:28 the implant

00:28:30 and ensure that

00:28:31 they go into their adult life you can

00:28:34 still, you know, performance

00:28:36 and capability to

00:28:38 upgrade and capability to bring in

00:28:41 latest of the technology as they are

00:28:42 developing.

00:28:43 >> There's something that's

00:28:45 funny story

00:28:46 related to this. When you go back to the

00:28:49 Marvel device

00:28:51 and looking at the training of of

00:28:54 AutoSense OS to detect what environment

00:28:57 you're in.

00:28:58 This is goes all the way back, I think,

00:28:59 if I remember correctly, to 2017, the

00:29:02 year 2017-2018. We had to in the Sky OS,

00:29:07 which is the pediatric version of the AI

00:29:10 that was being trained there. It was

00:29:12 trained very much with a lot of in a lot

00:29:15 of environments where children are in a

00:29:17 kindergarten class, in schools, in

00:29:20 a school bus, those types of things.

00:29:23 And it's a good thing that we focused on

00:29:27 that child-specific training of the AI

00:29:30 because what we found is that in some

00:29:33 cases in the early version, it wasn't

00:29:35 classifying the scene correctly. You

00:29:37 would get into a classroom with small

00:29:41 children

00:29:42 and it would classify that environment

00:29:45 as heavy metal music.

00:29:48 And so we had to say we had to train the

00:29:50 AI, "No, when you hear a whole bunch of

00:29:53 kids yelling, this is not heavy metal

00:29:55 music. This are you're in a classroom."

00:29:58 Um

00:29:58 so we've taken advantage in in the Sky

00:30:02 products and across our products, a lot

00:30:05 of this AI and machine learning training

00:30:07 that was done

00:30:09 with pediatric specifically in mind. And

00:30:12 and it made it into those pediatric

00:30:15 products.

00:30:16 >> I think that is excellent the right

00:30:19 approach to the product. I spoke about

00:30:21 the comfort and also the device that is

00:30:23 made for all.

00:30:25 And

00:30:26 but I think

00:30:27 the the engine that will ensure that we

00:30:30 can adapt

00:30:32 to a kid's environment, to an adult

00:30:34 environment

00:30:35 is the other one.

00:30:36 Thank you for that. Thanks.

00:30:37 >> Mr. Fernando, now every parent is

00:30:41 worried about the smart devices.

00:30:43 The smartphones, they are getting

00:30:45 hacked.

00:30:46 Apple, in fact, it advertises more about

00:30:49 privacy

00:30:51 when compared to its other features.

00:30:53 That's how important right now is the

00:30:56 privacy. Now, I'm literally as a surgeon

00:30:59 I'm placing electronics inside the head

00:31:01 of a child, which is going to stay

00:31:03 throughout the life. Now, this question

00:31:05 that parents ask me at the end of my

00:31:07 consultation.

00:31:09 Can a cochlear implant be hacked?

00:31:12 >> I will say that for the answer for

00:31:15 Advanced Bionics, which takes

00:31:16 cybersecurity, not just testing that

00:31:19 happens at the very end, but

00:31:21 fundamentally from the very beginning of

00:31:23 the design,

00:31:25 cybersecurity is built in.

00:31:27 So, the short answer for Advanced

00:31:29 Bionics devices is no.

00:31:32 The The reasoning behind it is

00:31:35 severalfold. First of all, these devices

00:31:38 that we have

00:31:39 are not connected to the internet. They

00:31:41 don't have the ability to communicate

00:31:43 with the internet. It's not even

00:31:45 possible within those devices.

00:31:47 You can have a Bluetooth connection to

00:31:48 your phone,

00:31:50 but you don't have any type of direct

00:31:51 connection to the internet. The other

00:31:53 piece of information is that everything

00:31:56 is encrypted. It's encrypted on the

00:31:58 device. It's encrypted in all the

00:32:00 communication that it's doing with with

00:32:02 your phone.

00:32:03 It's encrypted in the communication

00:32:05 that's happening in all of the ways that

00:32:07 it's communicating.

00:32:09 And because it's not going out to the

00:32:12 internet, there someone might ask,

00:32:14 "Well, even if it's encrypted, if you

00:32:16 have some communication out to the

00:32:18 internet, is there a possibility that it

00:32:20 gets hacked?"

00:32:22 Well, here this is not even a question

00:32:24 because it doesn't go out to the

00:32:25 internet. In order to hack something,

00:32:29 you would have to bypass the encryption

00:32:33 that's the same type of encryption

00:32:35 that's used for bank accounts and things

00:32:36 like that. You'd have to to bypass that

00:32:39 encryption and you'd have to do it

00:32:41 millimeters away. What you're trying to

00:32:43 figure out how to to get past if you're

00:32:45 a if you're a hacker

00:32:47 is something that's happening between

00:32:49 the headpiece and the sound processor

00:32:50 and the implant. Even if the hacker

00:32:52 comes up and is right there next to your

00:32:55 head saying, "Hey, stand still so that I

00:32:57 can hack your device."

00:32:59 Even then they're going to not going to

00:33:01 run into too much luck. They're going to

00:33:02 find this difficulty because everything

00:33:04 is simple but it starts or I'm sorry

00:33:06 everything is encrypted. But it starts

00:33:09 with this is not some general system

00:33:11 that's out on the internet. This is To

00:33:13 even begin to answer that question you

00:33:16 would have to have a hacker that comes

00:33:17 right up next to your head and says,

00:33:19 "Stand still while I hack your device."

00:33:21 And even that is not possible.

00:33:24 >> So, answer is absolutely no.

00:33:27 The scheme where the communication

00:33:28 happens

00:33:30 I think

00:33:31 it's a what we call a tightly coupled

00:33:33 link that we have.

00:33:35 So, knowing that there is a tightly

00:33:37 coupled link

00:33:39 is an important aspect.

00:33:42 And without the tightly coupling you

00:33:44 cannot

00:33:45 do this

00:33:46 wirelessly or something. And it That

00:33:49 tightly coupled link is guided by a

00:33:52 specific

00:33:54 frequency specific what we call a

00:33:56 telemetry scheme that needs to be

00:34:00 used

00:34:01 that can only

00:34:03 be part of this. And they have to go

00:34:04 through multiple folds of that scheme to

00:34:08 get into the system.

00:34:09 So, it's not an easy path to come.

00:34:12 Proximity

00:34:14 and the way the both devices communicate

00:34:16 is proprietary to the device.

00:34:19 Proprietary to the system.

00:34:21 >> So, it's impossible.

00:34:22 >> It is.

00:34:23 And

00:34:24 one of the other things that we do is

00:34:27 we're very confident in our

00:34:29 cybersecurity approach and our process

00:34:31 and and building it into the device.

00:34:34 But, we also want independent

00:34:38 verification. So, with our sound

00:34:41 processors, with our software,

00:34:44 we send it out to an external

00:34:46 independent cybersecurity lab, and they

00:34:49 do what is called penetration testing.

00:34:52 And there, they take their hacking

00:34:54 abilities, the experts that they have at

00:34:57 hacking, and they try to hack the

00:34:59 device, and they try to do this. And

00:35:01 every time we release a device,

00:35:03 every device that we release has gone

00:35:05 through that independent penetration

00:35:07 testing. Then we take the results from

00:35:10 that lab, from that cybersecurity lab,

00:35:13 where they've tried to hack the device,

00:35:15 and we take those results, and we

00:35:17 provide them not only to our own

00:35:19 engineers, but to the FDA, to the other

00:35:22 regulatory agencies across the world, so

00:35:25 that they can see that

00:35:27 you don't just take our word for it.

00:35:29 There's independent labs that are

00:35:31 showing that these devices are secure.

00:35:33 >> Don't just believe in the technology,

00:35:35 test it, validate it, verify it,

00:35:38 and then you have the proof.

00:35:41 >> Now, I've seen in many movies where

00:35:44 hearing aid can record conversation.

00:35:47 Now, a cochlear implant also can record

00:35:49 the conversations that are happening?

00:35:51 >> That is not something that the cochlear

00:35:53 implant can do. The cochlear implant

00:35:55 itself is not going to do anything

00:35:56 without the sound processor.

00:35:58 The sound processors don't have the

00:36:00 capability to record any conversation.

00:36:04 Um they are taking the sound that's

00:36:06 coming in,

00:36:08 and they have enough processing memory

00:36:11 to at any moment in time hold a few

00:36:14 milliseconds of information in their

00:36:16 memory in order to clean the sound, in

00:36:19 order to apply all of the processing

00:36:22 that's happening.

00:36:23 Um there's simply no capability to do

00:36:26 any type of recording. And like I said

00:36:28 before, the

00:36:30 these devices are not connected to the

00:36:33 internet.

00:36:34 And so,

00:36:36 not only can they not record the

00:36:37 information,

00:36:39 but there's also no connection to send

00:36:42 them out to the cloud or anything like

00:36:44 that as well.

00:36:46 >> So, we cannot record.

00:36:48 But But Mr. Fernando, when a child comes

00:36:50 to our clinic, we connect it to the

00:36:54 system, and then we check the data,

00:36:57 clinical data. How long are they using

00:36:59 the

00:37:01 the processor in a

00:37:03 So, what are we actually checking there?

00:37:04 The duration of hours or

00:37:06 about the conversations also? Can we

00:37:09 check? Is there any possibility or it's

00:37:11 Even that's impossible.

00:37:13 >> It's not possible to check the

00:37:14 conversations. So, it's simply not

00:37:16 possible. And here's something where

00:37:20 clinicians, hearing care professionals,

00:37:22 have asked us for that capability.

00:37:25 It would be very nice

00:37:27 if when a patient came into the clinic

00:37:31 and they told us that they were having

00:37:33 in a particular situation, a particular

00:37:36 environment, they were having some

00:37:37 trouble, "Hey, can you just

00:37:40 audiologist or clinician, can you Is

00:37:43 there a way for you to see what

00:37:44 conversation was happening there, to

00:37:46 hear it, to be able to diagnose it?"

00:37:49 And the answer is is simply no. It's

00:37:51 It's impossible for that to happen.

00:37:53 When

00:37:55 the device gets connected to the

00:37:57 audiologist's computer

00:37:59 or hearing care professional's computer,

00:38:02 the only thing that they're able to see

00:38:04 is what's recorded on the device, which

00:38:06 are statistics.

00:38:08 How long has the device been turned on?

00:38:11 How long did it spend in the music

00:38:13 program? How long did it spend in the

00:38:15 speech and noise program? How long did

00:38:17 it spend in this other program?

00:38:20 Uh what parameters were used for a

00:38:24 certain amount of time. But even then,

00:38:27 it's very statistical,

00:38:29 which means that if you wanted to say to

00:38:32 to ask a question like

00:38:34 Um, well, were they in this program

00:38:38 yesterday

00:38:39 at

00:38:40 uh, 11:00.

00:38:44 Um,

00:38:45 it's the system is not capable of

00:38:47 providing that information.

00:38:49 Um, it only has uh,

00:38:51 s- sums aggregate statistical

00:38:54 information. It says in general, how

00:38:56 long have has it been turned on? How

00:38:58 long has it spent in this program? How

00:38:59 long has it spent in another program?

00:39:03 >> So, if you see the head of the research

00:39:06 himself is mentioning that a cochlear

00:39:08 implant cannot record conversations.

00:39:11 Extreme privacy is being maintained for

00:39:14 all the kids as well as adults.

00:39:17 Now, Mr. Fernando, this is

00:39:20 something which even I as a surgeon am I

00:39:23 I'm worried about.

00:39:24 Now, there are two different

00:39:26 philosophies in the industry which is

00:39:27 happening.

00:39:30 One company, they are placing a

00:39:33 chip, an updatable computer in the

00:39:35 internal component itself.

00:39:38 Whereas your company,

00:39:41 you are making the internal component

00:39:43 extremely robust. I can say nearly

00:39:46 indestructible one, very strong.

00:39:49 And you're maintaining all the AI, the

00:39:52 updates, everything on the external

00:39:54 process, the external component.

00:39:57 As a researcher,

00:39:59 why did you and your team decide to do

00:40:01 this?

00:40:03 >> There are several reasons. It was a very

00:40:06 intentional design decision.

00:40:10 Um,

00:40:11 when we designed the cochlear implants,

00:40:14 what we decided is that we need to have

00:40:17 a high-speed communication to each of

00:40:20 the electrodes.

00:40:22 Earlier I talked about how ultimately it

00:40:24 was about figuring out the right pattern

00:40:27 to stimulate those electrodes.

00:40:30 So, if we created a channel

00:40:32 to the outside

00:40:34 for each of those electrodes, and the

00:40:36 outside sound processor could say turn

00:40:39 on one electrode or 16 electrodes

00:40:42 um to independently control them at a at

00:40:45 a fine level of granularity to be able

00:40:48 to send information and read information

00:40:50 from them,

00:40:51 then you really have no advantage for

00:40:54 putting smarts in the cochlear implant

00:40:56 itself.

00:40:57 Everything that you could possibly want

00:40:59 to do, you can control from outside.

00:41:02 And that's where you want to control it

00:41:04 because when you have that controlled

00:41:06 from the outside, when the new AI

00:41:08 technology comes up, you can upgrade it.

00:41:11 No surgery needed. You don't have to

00:41:12 switch your implant.

00:41:14 When new sound processing comes up, you

00:41:17 can

00:41:18 you can take advantage of that by

00:41:20 upgrading the outside.

00:41:21 You don't lose anything cuz of that

00:41:23 high-speed connection to every

00:41:25 individual electrode that you have.

00:41:28 And there's another reason though that

00:41:29 we didn't go in that direction.

00:41:31 And that is

00:41:34 that if you have this very robust device

00:41:38 with

00:41:39 a lot of flexibility, the flexibility to

00:41:42 control every electrode from the

00:41:44 outside,

00:41:46 if and I'm going to give this just as an

00:41:48 example, if the fundamental of that

00:41:49 design is maybe five components,

00:41:53 um

00:41:54 and you then take something that's very,

00:41:57 very complex. When you look at that

00:41:59 sound processor on the outside,

00:42:01 it doesn't have

00:42:02 just twice as many components. It

00:42:05 doesn't have 10 times as many

00:42:07 components. It has thousands of more

00:42:09 components. In other words,

00:42:11 it's much, much more complex than all

00:42:14 the processing that it can do that the

00:42:16 sound processors turn on the outside.

00:42:18 If you put that on the inside,

00:42:21 you go from a device where you have to

00:42:23 make sure that five components are solid

00:42:25 and that they don't break. And if they

00:42:27 don't break over time, if they don't

00:42:29 break when they get hit by a soccer ball

00:42:32 or football, and that, you know, in all

00:42:34 of these conditions. And now instead of

00:42:37 designing a device that can withstand

00:42:40 that has that's made up of five

00:42:41 components, now you're talking about a

00:42:43 device that has hundreds upon hundreds

00:42:46 upon hundreds of components, any one of

00:42:47 those can break.

00:42:49 From a pure reliability perspective,

00:42:52 the design that we chose to go with and

00:42:55 that we persist with

00:42:56 takes advantage of

00:42:59 you you don't want to put so much

00:43:01 complexity

00:43:03 inside where every one of those points

00:43:06 along the path has an opportunity to

00:43:09 break.

00:43:10 We can design that extremely robustly if

00:43:13 we have to to do that between five

00:43:14 components. If you have to do it with

00:43:16 500 components,

00:43:18 that's a much more difficult thing to

00:43:20 do.

00:43:21 >> The brilliance of the internal

00:43:23 component, to add to what Fernando

00:43:26 mentioned, is

00:43:28 is um

00:43:30 if you look at the overall cochlear

00:43:32 implants

00:43:34 for the past four decades or so,

00:43:38 if you were to think about how it

00:43:39 happens,

00:43:40 takes the sound,

00:43:42 processes the sound,

00:43:43 and then unpacks that sound into

00:43:46 electrical current.

00:43:48 That's this one. This did not change.

00:43:51 The fundamental aspects, coming back to

00:43:54 those five components, the critical

00:43:56 components

00:43:57 that has to power the

00:43:59 and ensure that the stimulation is

00:44:01 delivered should not be disturbed. We

00:44:05 cannot compromise that.

00:44:07 The beauty of all the advantage of we

00:44:10 can take on sound cleaning, noise

00:44:13 canceling, the power of AI and digital

00:44:16 connectivity and everything,

00:44:18 we solve this one

00:44:20 with an external.

00:44:22 We don't need to go to touch the

00:44:24 internal.

00:44:25 So, we not only made the device

00:44:28 reliable, but we made it flexible by

00:44:31 design by taking all those components

00:44:35 outside.

00:44:36 Which gives the user

00:44:39 to keep up with the upgrades

00:44:41 while also ensuring the reliability is

00:44:43 always maintained. So, I think the

00:44:46 cochlear implant, unless some new ways

00:44:49 of communi- new ways of stimulation

00:44:51 happens, something like a science

00:44:53 fiction,

00:44:54 I think for the fundamental physics, we

00:44:58 want to make sure that the stimulation

00:44:59 is delivered reliably.

00:45:01 >> The technology changes over time. The

00:45:04 technology for AI changes over time. The

00:45:07 technology for sound processing changes

00:45:09 over time.

00:45:11 And no matter how good of a job we want

00:45:16 to do, um if we try to to put inside,

00:45:21 surgically implanted into the device,

00:45:24 some amount of processing power, some

00:45:26 amount of intelligence, even if you

00:45:28 could upgrade it with firmware,

00:45:30 the CPU, as for example,

00:45:33 that's done. That's the hardware. It

00:45:35 doesn't change.

00:45:37 Um one of the examples that I've had

00:45:39 discussions with my own engineers about

00:45:42 is you take the example of this flip

00:45:43 phone.

00:45:44 It's the old phones.

00:45:47 And this was there was a real case with

00:45:49 Motorola where they wanted to design

00:45:52 their flip phone for upgradeability. And

00:45:55 they gave it more RAM than it needed.

00:45:57 They gave it more processing power than

00:45:58 it needed.

00:45:59 And sure enough, they could upgrade that

00:46:02 phone

00:46:03 uh

00:46:04 one time, maybe two times. And then at

00:46:06 that point it's just that the CPU

00:46:10 was outdated.

00:46:12 It It became outdated much more quickly

00:46:15 than they thought. And we see this

00:46:17 example after example happening across

00:46:19 various industries where if you try to

00:46:23 say, "No, we're going to We're going to

00:46:25 choose a certain amount of memory,

00:46:28 certain amount of processing power, a

00:46:29 certain CPU, certain hardware, and we're

00:46:32 just going to stick with that. And

00:46:34 that's what's going to serve you for 20

00:46:36 years or for 30 years."

00:46:38 That is that's that's something that has

00:46:41 been shown to

00:46:43 to not work. It will become outdated.

00:46:45 That flip phone was great with the extra

00:46:47 processing

00:46:48 until the smartphones came along, and

00:46:51 then all of that old technology was

00:46:53 really old technology.

00:46:55 So, here the flexibility of the design

00:46:59 to say, "We want to give you a hardware

00:47:01 connection to each individual electrode

00:47:04 and to allow you to control that finely

00:47:07 and then to put that intelligent

00:47:09 intelligence on the outside,

00:47:11 it puts you in a position to not only

00:47:13 have the higher reliability on the

00:47:14 inside and the fewer components and the

00:47:17 full flexibility, but also that you

00:47:19 never run into that upgrade issue. You

00:47:22 can always upgrade the external part.

00:47:24 >> If I can just add one last thing on this

00:47:26 one.

00:47:27 I

00:47:28 I was thinking about the design. One of

00:47:31 the early times when I was looking at

00:47:32 the inside of this implant,

00:47:35 I was kind of also thinking about what

00:47:37 else can we do to make space, you know?

00:47:40 You're thinking about a child, how small

00:47:42 you can make it.

00:47:44 You wanted to maintain those critical

00:47:45 components.

00:47:47 And this is a fact that I had a natural

00:47:50 question, why 16 different capacitors?

00:47:54 16. They take a lot of space.

00:47:58 When we talk about reliability, it's not

00:47:59 the mechanical reliability.

00:48:02 Electrically, when I saw that this is 16

00:48:04 different independent current sources,

00:48:06 which actually takes up So, for the

00:48:09 stimulation to ensure it's delivered, we

00:48:13 had the independent current sources by

00:48:15 design also available.

00:48:17 I understand that I think that is not a

00:48:20 mandatory, you can still do it. But I

00:48:23 think by design we ensure that. Now,

00:48:26 what that gave us is a flexibility to

00:48:28 have that 16 independent current

00:48:30 sources. It was in the previous

00:48:31 generation, in the current generation,

00:48:34 and it will continue to have it in the

00:48:35 future generation.

00:48:37 Now, that became a now a industry

00:48:40 standard. Independent current sources is

00:48:43 now an industry standard. So, we

00:48:46 set the foundation on independent

00:48:49 current sources.

00:48:51 >> Perfect.

00:48:52 >> And the final thing here is that um

00:48:57 we are always working on many different

00:49:00 products. Some that will come out next

00:49:02 year, some that come out the year after,

00:49:04 some that come out many years down the

00:49:05 road.

00:49:07 And one of the things that we're working

00:49:08 on are the next generation of implants,

00:49:12 with the next generation of implant

00:49:14 designs.

00:49:16 And fundamentally,

00:49:18 we have an opportunity to, for example,

00:49:21 embed

00:49:23 chips and AI processing everything in

00:49:25 the implant design itself.

00:49:27 And we are not

00:49:29 we're not doing it very purposefully.

00:49:31 So, the next generation of implants that

00:49:33 come out, and the implant generation

00:49:35 that comes out after that,

00:49:37 is staying true

00:49:39 for very good reasons to the same

00:49:42 fundamental design choices that we have

00:49:44 for the current generation of implants.

00:49:47 To summarize,

00:49:49 we made some very intentional design

00:49:52 choices

00:49:53 that give you ultimate control of every

00:49:57 independent electrode that's in the

00:49:59 cochlea.

00:50:01 And because you have that independent

00:50:03 control and you can control it from the

00:50:05 outside

00:50:07 there's no advantage to putting more

00:50:08 smarts in the implant itself.

00:50:11 What would you do with that extra

00:50:12 intelligence in the implant when the

00:50:15 external part can control all of the

00:50:17 exact same thing?

00:50:19 One of the things that I ask

00:50:21 people that are asking me about, you

00:50:24 know, can you put more intelligence in

00:50:26 the implant? It's like what would you

00:50:28 do? And they might give me one example.

00:50:30 Well, maybe you could do this.

00:50:32 We could already do that.

00:50:34 From external.

00:50:35 Well, maybe you could do option number

00:50:37 two or maybe you can implement idea

00:50:39 number three. It's like we can already

00:50:40 do that.

00:50:41 We can do everything that we need to do

00:50:43 with that high-speed communication that

00:50:45 controls every electrode.

00:50:49 The other aspect that we talked about is

00:50:51 the reliability.

00:50:53 It's something that we can control

00:50:57 uh very well in the design to say if you

00:51:00 have five components of the implant that

00:51:02 we can make those very reliable. We can

00:51:05 make them reliable against impacts. We

00:51:07 do impact testing. We do it in

00:51:10 real-world situations, you know, to see

00:51:12 what happens when you get hit by a

00:51:14 football in the head.

00:51:16 Um

00:51:17 and you can create very robust devices

00:51:20 when you're dealing with five

00:51:22 five components.

00:51:24 If you're dealing with something that

00:51:26 you put

00:51:28 a computer in the implant in the implant

00:51:31 itself

00:51:32 you go from five components to 500

00:51:34 components. Now, the reliability is a

00:51:39 very

00:51:40 much more complicated thing to manage

00:51:42 because you're not just taking the

00:51:45 connections between five components,

00:51:46 you're taking connections between 500

00:51:48 components, every one of those

00:51:51 has to turn into something that's robust

00:51:53 and reliable.

00:51:55 And and ultimately, like I said, there

00:51:57 isn't any processing advantage for

00:52:01 putting that technology on the inside.

00:52:03 There's a lot of advantage for

00:52:04 controlling it from the outside and

00:52:06 always having that upgrade ability.

00:52:08 >> Now, talking about MRI,

00:52:10 if we want to operate on a 1-year-old

00:52:14 child, we have to get an MRI done for

00:52:17 sure, before surgery also.

00:52:20 And after surgery, until their lifetime,

00:52:22 they require definitely a couple of MRIs

00:52:25 to be done. Now, how did you design that

00:52:28 internal component, specially the magnet

00:52:31 part, in such a way that it's completely

00:52:33 MRI safe?

00:52:34 >> I'm very proud of the team that designed

00:52:37 that. That It was quite an ingenious

00:52:40 design.

00:52:41 Because

00:52:42 inside the magnet, you know, normally

00:52:44 you have a disc magnet. And when you're

00:52:46 inside of the MRI,

00:52:49 in that machine, it's trying to take

00:52:51 that magnet that looks like a coin,

00:52:54 and it's trying to align it with the

00:52:57 magnet that's being the magnetic field

00:52:59 that's being generated by the MRI.

00:53:01 And so, that coin that's implanted in

00:53:04 somebody's head is now trying to flip.

00:53:07 Um and that's not something you want.

00:53:09 You don't want the parts that are inside

00:53:11 moving at all.

00:53:13 So, with the MRI safe magnet,

00:53:16 it's

00:53:17 it it's made up of magnetic cylinders.

00:53:21 And because they're cylinders, each

00:53:23 cylinder can spin.

00:53:25 And as that external magnetic field in

00:53:28 the MRI is putting force on that, or

00:53:31 trying to to adjust that, the internal

00:53:34 cylinders can spin freely.

00:53:37 And then, within those, not only can

00:53:39 they spin in that direction,

00:53:41 but

00:53:42 the the

00:53:44 coin that they sit within, that can

00:53:47 rotate as well. So, you get all of the

00:53:50 axis of freedom,

00:53:52 and as the magnetic field is spinning

00:53:55 around you and trying to get those to

00:53:56 move,

00:53:57 the internal magnet is moving around and

00:54:00 adjusting so that it doesn't put any

00:54:02 pressure.

00:54:03 Like I said, a design that I'm very

00:54:05 proud that the team was able to come up

00:54:07 with

00:54:08 because

00:54:09 when we measure the amount of torque,

00:54:12 this is the force

00:54:14 that is the amount of pressure that's

00:54:17 put on

00:54:18 have having the magnet trying to flip.

00:54:21 Our MRI safe magnet has the least amount

00:54:25 of torque.

00:54:27 It It's the most comfortable, especially

00:54:29 for children, because you go into those

00:54:31 MRI machines, and it's not putting a lot

00:54:34 of pressure, you know, they're not

00:54:35 feeling like it's trying to move of

00:54:37 something that's inside their head.

00:54:39 Um some of the other MRI safe magnets

00:54:43 that we've seen, and MRI safe designs

00:54:45 that we've seen,

00:54:46 they're safe,

00:54:48 but they're not as comfortable because

00:54:50 they produce more torque

00:54:52 than what our magnets have.

00:54:54 >> Yeah.

00:54:55 I think you so- you said it actually. I

00:54:57 think one of the

00:54:58 by design, there are

00:55:00 two or maybe multiple ways of looking at

00:55:03 solving the problem MRI.

00:55:06 One is to restrict the motion,

00:55:08 which I think you in the past you have

00:55:10 to be managed. That is to restrict the

00:55:11 motion.

00:55:13 Or

00:55:14 let the magnets reorient. Now, that's

00:55:16 the more complex approach, required a

00:55:19 lot and it's an ingenious way.

00:55:21 Because if they're orienting in the

00:55:23 right direction,

00:55:24 then you don't need to worry about

00:55:26 restricting the motion.

00:55:28 Now, that makes it more natural because

00:55:30 the especially the pediatrics,

00:55:33 the skin thickness is so thin, the a

00:55:36 thickness.

00:55:37 So, any kind of restriction

00:55:40 that you do

00:55:41 may or may not You may still need to

00:55:43 Yes, you will restrict so that it does

00:55:45 not

00:55:46 it does not you know, kind of flip or

00:55:49 anything.

00:55:50 But, what if you allow it to freely move

00:55:53 in its natural

00:55:54 dipoles?

00:55:56 So, that's where the team did a

00:55:58 fantastic To me, I think the advent of

00:56:01 MRI-safe magnets itself is an important

00:56:04 topic. The solution that came out of

00:56:07 Advanced Bionics team is an ingenious

00:56:10 one. It's a brilliant one.

00:56:12 I think it speaks to especially to a

00:56:14 pediatric not to restrict, but to let

00:56:17 the magnet do its work while they don't

00:56:19 feel a thing.

00:56:20 >> But, Mr. Anil, most of the parents, they

00:56:23 ask me,

00:56:24 "Doctor, my

00:56:26 child underwent a cochlear implant

00:56:28 surgery.

00:56:29 Now, will my child's brain develop in

00:56:32 the same way that a normal child at

00:56:35 typical child without cochlear implant

00:56:36 develops? Is there any answer for this?

00:56:39 They also ask this, "How do we know that

00:56:42 my child is hearing?" They say that the

00:56:45 the implant processor, if the light is

00:56:47 blinking, child is hearing.

00:56:49 But,

00:56:50 I don't understand. Is there any

00:56:51 objective proof that my child is

00:56:53 hearing?

00:56:54 Can you answer these two questions, Mr.

00:56:56 Anil?

00:56:57 >> That's an uh

00:56:58 a question that every audiologist, every

00:57:01 clinician, every manufacturer, every

00:57:03 parent

00:57:04 want to know.

00:57:06 Are we delivering the right stimulus

00:57:10 that will ensure

00:57:11 the child is on the right track towards

00:57:14 the development?

00:57:16 Now,

00:57:17 when you talk about an infant or a

00:57:19 child,

00:57:21 they cannot tell what they're hearing.

00:57:23 But, they are hearing. So, their hearing

00:57:25 can tell something or their brain can

00:57:27 tell.

00:57:30 For a normal atypical normal hearing

00:57:33 and when you have somebody with a

00:57:35 cochlear implant,

00:57:37 there are some charts that allows them

00:57:39 what a normal hearing should be.

00:57:42 When you think about from a pediatrician

00:57:45 or a regular visits, they have a way to

00:57:48 check every developmental ability, limb

00:57:51 movements, growth charts, head,

00:57:54 other things.

00:57:57 Hearing su- Hearing charts are always

00:58:01 subjective.

00:58:03 I think we are embarking on

00:58:07 defining an objective way

00:58:10 to allow the clinician

00:58:12 and give the parents

00:58:15 the right

00:58:16 confidence that their child is on the

00:58:19 right track track for the development.

00:58:22 So, we worked on a system called BEEP.

00:58:25 BEEP stands for bionic ear evoked

00:58:29 potential.

00:58:30 What we are doing with this system is we

00:58:33 take our existing implant and complement

00:58:36 complement with a simple

00:58:39 setup

00:58:40 that will allow the clinician

00:58:43 to stimulate

00:58:45 and ensure that they can also pick up

00:58:48 the signal they have stimulated. What

00:58:50 this gives you the clinician is an

00:58:53 opportunity to understand

00:58:56 if the signal that is delivered is

00:58:59 optimal or not.

00:59:01 This gives the parents, especially, a

00:59:05 piece of mind.

00:59:08 Now, traditionally, to do these such

00:59:10 measurements because it involves picking

00:59:12 signals from brain,

00:59:15 it requires time, patience,

00:59:18 and a complex setup.

00:59:20 We already

00:59:21 ensured that we can do this with our

00:59:23 cochlear implant system with a simple

00:59:25 setup.

00:59:26 The second most important is

00:59:29 you can do this in their own natural

00:59:31 environment. No more complex

00:59:34 setups on their head.

00:59:36 The child is comfortably sitting in a

00:59:40 parent's lap

00:59:41 or doing an activity

00:59:43 while these measurements are done.

00:59:45 And these are done in a

00:59:47 rather

00:59:48 fast, quick way. So, they don't need to

00:59:52 take time to get these measurements.

00:59:55 >> Mr. Anil, how long does this BEEP take?

00:59:57 Does it take some hours or how long does

01:00:00 this take?

01:00:01 >> With our current setup, we have made it

01:00:03 exceedingly simple, so we don't take

01:00:07 away the precious time

01:00:09 for the kids or the parents. It takes

01:00:12 anywhere between 3 to 5 minutes to

01:00:14 complete the full measurements.

01:00:16 >> Wow. Wow. Just 3 to 5 minutes.

01:00:19 >> This is actually something that's very

01:00:21 important to not overlook.

01:00:24 That because you can do this measurement

01:00:27 in 3 to 5 minutes with the child sitting

01:00:30 on the parent's lap and doing playing or

01:00:33 doing whatever it is they're going to

01:00:34 do,

01:00:36 it's a measurement that you can do.

01:00:39 And the difference is that the

01:00:41 traditional way of doing these

01:00:43 measurements, cuz you could do these

01:00:44 measurements with very complex setups

01:00:46 where you have to get a child to sit

01:00:48 still and to be very quiet and all of

01:00:52 these

01:00:52 one of the consequences of that is that

01:00:55 sometimes the measurements won't be

01:00:58 done.

01:00:58 They won't be done either because you

01:01:00 can't get the child to sit still long

01:01:02 enough, you can't get an accurate

01:01:03 reading. In some cases, even the

01:01:06 clinicians will say, "Oh, well, for this

01:01:08 child that's so wiggly, we're not even

01:01:11 going to attempt it."

01:01:12 And so, a lot of parents

01:01:15 won't even be able to get the answer

01:01:17 that they're looking for.

01:01:19 With this BEEP Bionic Ear Evoked

01:01:22 Potential system,

01:01:24 that you don't have to be so still that

01:01:26 you can be at the child can be in the

01:01:28 parent's lap that you can do it in just

01:01:30 a few minutes.

01:01:31 This is a game changer. This is

01:01:33 something where in some cases you

01:01:35 wouldn't even get the answer because of

01:01:37 all of these challenges.

01:01:39 And now you can get the answer.

01:01:42 >> It's worthwhile.

01:01:43 >> It is very instantaneous. I think

01:01:45 I think one of the advantages is

01:01:48 more like a diagnostic

01:01:50 that I think you feel

01:01:52 confident walking as a parent walking

01:01:55 out of the clinic that

01:01:57 my time and my child's time

01:01:59 is first of all spent to understand that

01:02:03 he or she is on the right track to the

01:02:04 development on the development.

01:02:06 And two is

01:02:08 in objective way to say that here's a

01:02:10 chart

01:02:11 that tells me that he's actually slowly

01:02:13 or she's actually slowly working

01:02:15 their way to normal child.

01:02:18 Now this is a confirmation as a mission

01:02:20 that you can give it to the parent and

01:02:22 as a parent you walk out of the clinic

01:02:25 knowing that I don't need to worry about

01:02:27 my child's development abilities while I

01:02:30 can focus on other things that are

01:02:32 important.

01:02:33 >> I just wanted to ask one more thing.

01:02:34 Once you were mentioning that we are

01:02:36 recording this brain waves

01:02:39 uh through the implant. Because as a

01:02:40 surgeon as a doctor myself when you tell

01:02:43 anything about brain, it could be better

01:02:45 brain stem evoked response audiometry or

01:02:48 it could be EEG electroencephalogram.

01:02:50 Child should be sedated.

01:02:52 Child should be given anesthesia. Does

01:02:54 this require any anesthesia? Any

01:02:56 sedation required for BEEP?

01:02:58 >> Absolutely not.

01:03:00 The child can be very active

01:03:03 and one of the most complex things is do

01:03:06 an activity

01:03:07 that actually allows them to be in their

01:03:10 natural way natural environment.

01:03:13 We have seen where the child is sitting

01:03:15 comfortably in a parent's lap playing

01:03:18 or doing a drawing or playing with the

01:03:22 toys while this measurement is done.

01:03:25 All the heavy lifting that is done is

01:03:28 left to the device, not the taxing to

01:03:30 the parent or the child.

01:03:32 >> I have a interesting story what has

01:03:35 happened. In a single day we had three

01:03:37 switch ons.

01:03:38 Three switch on of the implant.

01:03:42 Three kids were of the almost same age,

01:03:44 1 year 1 and 1/2 year.

01:03:46 Um and one more around 11 months old.

01:03:50 Both are bilateral recipients. Now

01:03:53 we have done an intraoperative NRI

01:03:56 and the same thing was matched and the

01:03:58 response was given to the first kid.

01:04:01 Child didn't respond well.

01:04:04 Child only blinking of eyes. They were

01:04:07 just turning this side and that side.

01:04:09 Only that was the response.

01:04:11 And our audiologist, our implant

01:04:13 audiologist, he was like, "I think the

01:04:15 stimulus is not enough for this baby.

01:04:18 So, let me just increase that volume a

01:04:20 bit.

01:04:21 Let me increase the current levels."

01:04:24 Now, for the second baby, once again,

01:04:27 when we switched on

01:04:28 he's around 1 and 1/2 year old.

01:04:31 For that

01:04:32 the intraoperative measurements once

01:04:34 again were correlated and we turned on

01:04:37 we switched on. The minute we switched

01:04:39 on, the child started crying, "Bah!"

01:04:41 this way, that way, throwing tantrums.

01:04:43 He was just putting his head on way all

01:04:45 this. And this was observed by first and

01:04:48 third patients.

01:04:49 They started asking, "The first baby

01:04:52 didn't respond well.

01:04:54 And now the second baby is crying too

01:04:56 much. I think the stimulus is not enough

01:04:58 for my baby."

01:05:00 The first parent started. And now for

01:05:02 the second baby, because they were

01:05:03 shouting so much, they were crying so

01:05:05 much, they had our implant audiologist

01:05:07 had to reduce the volume

01:05:09 because it was a guesswork.

01:05:12 There's no objective response how much

01:05:14 should the threshold the minimum comfort

01:05:16 levels of the threshold values were kept

01:05:19 the biomarkers was not there and the

01:05:21 third one

01:05:23 he was

01:05:24 they didn't know even that child she

01:05:26 didn't show any responses just like

01:05:28 Parkinson's face

01:05:30 mask face. She was not even blinking.

01:05:32 She was not even crying.

01:05:34 Now their parents they were catching our

01:05:36 neck. This implant is not working.

01:05:40 Because there are no responses in the

01:05:42 child's face.

01:05:44 So I would like to really know that is

01:05:47 there any objective biomarker that you

01:05:50 could help us from the implant companies

01:05:53 where you can take a surgeons like us

01:05:55 from the risk where you can also help

01:05:58 the implant audiologist. See this is the

01:06:00 biomarker. This is the P1 latency at its

01:06:02 peak. I can put the T and C levels at

01:06:05 this level and the child will be

01:06:07 comfortable and show that wave to the

01:06:10 parents. Is there any way that you could

01:06:12 help us?

01:06:13 >> [snorts]

01:06:13 >> And this is exactly what

01:06:15 what the deep the bionic ear potential

01:06:19 system is doing. It's a research system

01:06:22 and we hope to turn it from a research

01:06:24 system into something more than a

01:06:26 research system.

01:06:28 But it exactly answers that question. It

01:06:31 is measuring the response from the brain

01:06:35 in an objective way

01:06:37 and further

01:06:39 if the parent were to say I don't think

01:06:42 that implant is working. This is the

01:06:44 objective measurement where the

01:06:46 clinician

01:06:48 can comfortably tell the the the parent

01:06:51 it's like oh no they are hearing.

01:06:53 I have proof

01:06:55 in the response that I got from the

01:06:56 brain that they are receiving it. They

01:06:59 are getting that not just at the cochlea

01:07:01 but deeper in the brain

01:07:03 that they are receiving that um

01:07:06 and it takes us from that subjectivity,

01:07:09 the uncertainty, into the realm of an

01:07:12 objective measurement.

01:07:16 >> Yeah, that's that's exactly the

01:07:17 endeavor. We wanted to ensure that

01:07:21 the

01:07:22 all the measures

01:07:25 along the auditory path

01:07:27 are uncovered.

01:07:29 You want a progress report.

01:07:30 You want a report of not one measure.

01:07:34 As we are unlocking every

01:07:36 measure

01:07:38 it is not just a progress report for the

01:07:41 journey. You see how the numbers are

01:07:43 changing.

01:07:45 It also gives

01:07:47 the full spectrum of all the

01:07:49 measurements. So, when you go through,

01:07:52 um, a normal normal testing, right?

01:07:55 The confidence that you can go with is

01:07:57 you're looking at from different

01:07:58 dimensions, different angles.

01:08:01 Now, when you're looking at one measure,

01:08:03 NRI or ECAPs, is not sufficient.

01:08:06 You wanted to go into deeper.

01:08:08 You want to go into EABR, auditory brain

01:08:11 response.

01:08:12 And then you want to go even more

01:08:14 higher.

01:08:15 So,

01:08:16 our endeavor

01:08:18 with this one

01:08:19 with this particular BEEP system is to

01:08:22 unlock all these measures and provide

01:08:26 the clinician

01:08:27 a sense of confidence and also a sense

01:08:31 of peace for the patients and the

01:08:33 parents.

01:08:36 >> Thank you for designing such a wonderful

01:08:38 device for us. Where are these BEEP

01:08:40 researches happening across the world?

01:08:43 >> This is a very

01:08:45 well-curated study. It's a challenging

01:08:49 and it has

01:08:51 the genesis of this study

01:08:54 started in early work of

01:08:57 somewhere where the university looked

01:08:59 into these

01:09:01 EEG measurements.

01:09:03 So, we started looking into different

01:09:06 ways of how we can

01:09:08 bring that

01:09:09 theory into practice.

01:09:12 So, we started partnering with

01:09:15 several key clinics across the globe. We

01:09:17 started with a clinic in Colorado

01:09:21 where the early early work of

01:09:25 using these measures to quantify how the

01:09:28 child development especially their

01:09:31 hearing journey is or hearing

01:09:33 development pathway is.

01:09:35 And then we partnered with another

01:09:37 clinic in USA.

01:09:39 And this third clinic

01:09:42 we started partnering with Dr. Sri Rao's

01:09:44 clinic in Hyderabad. This is the first

01:09:48 clinic

01:09:49 not just in India

01:09:52 the first clinic in

01:09:54 complete entire Asia Pacific.

01:09:57 And we are exceedingly proud that we got

01:10:00 exciting but valuable data

01:10:04 that

01:10:05 will get you to the pathway you can

01:10:09 provide your recipients a progress

01:10:13 report. A sense of confidence, a sense

01:10:16 of peace that they are on the right path

01:10:19 towards the hearing journey.

01:10:22 >> We are mutually excited and very

01:10:23 thankful for making us as our as your

01:10:26 global research partner

01:10:28 for this BEEP study to advance Bionics

01:10:31 in fact at the Asia Pacific level. Thank

01:10:33 you so much for including us, Dr. Rao's

01:10:35 ENT center.

01:10:37 >> Uh if I may add one of the important

01:10:39 dimensions to this study is

01:10:42 looking at unlocking the child's

01:10:44 potential.

01:10:46 And um

01:10:48 I think it is equally important for us

01:10:51 to

01:10:52 have the right partners, clinical

01:10:55 partners to enable us as as a researcher

01:10:58 to understand the potential of this

01:11:01 research.

01:11:02 And

01:11:03 the respect and more importantly the

01:11:05 excitement is mutual.

01:11:07 And we are truly excited to have the

01:11:10 opportunity to work with

01:11:12 your

01:11:14 team of exciting team of researchers

01:11:18 and your patients and recipients

01:11:20 and um giving us the opportunity to

01:11:24 work closely

01:11:26 every journey every step along this

01:11:28 development of Bip system. Thank you,

01:11:31 Dr. She.

01:11:32 >> Thank you.

01:11:33 I want to also say thank you.

01:11:36 Uh you have a world-class facility, a

01:11:38 world-class team

01:11:40 and um

01:11:42 you have become a world-class research

01:11:45 partner.

01:11:46 And our collaborative research that

01:11:48 we're doing together is allowing us to

01:11:50 really progress this part of the

01:11:51 science.

01:11:52 >> On April 14, 2026, you opened a new

01:11:55 chapter. You and your team you opened a

01:11:57 new chapter. A research collaboration

01:11:59 with Spiral Therapeutics where a

01:12:01 medicine is precisely delivered into the

01:12:04 cochlea

01:12:05 at the moment of surgery itself. Now,

01:12:08 why does an implant company require a

01:12:10 medicine?

01:12:12 They're completely different. Can you

01:12:14 explain us why?

01:12:15 >> Yeah,

01:12:16 this is something that's not specific to

01:12:19 Advanced Bionics. The industry has been

01:12:22 looking at for quite a long time

01:12:24 applying certain medicines where they

01:12:27 coat the electrodes.

01:12:28 >> Mhm.

01:12:29 >> And this is because when you do the

01:12:31 cochlear implant surgery

01:12:33 you're putting something into the

01:12:34 cochlea that causes the body to respond

01:12:38 with some inflammation.

01:12:40 >> Mhm.

01:12:41 >> And that inflammation can cause uh if

01:12:45 you have residual hearing, if you still

01:12:47 have some residual hearing

01:12:49 it can cause some additional damage to

01:12:51 that.

01:12:53 >> So, what we do here and what the

01:12:56 industry has been doing is let's put

01:12:58 some anti-inflammatory

01:13:00 some anti-inflammatory medication

01:13:03 onto the devices coded on the devices so

01:13:06 that over time they uh

01:13:09 they release this medication

01:13:12 and it keeps the inflammation low.

01:13:15 The

01:13:17 the challenge that the industry has

01:13:20 is that coding the electrodes that way

01:13:23 can only release that with a certain

01:13:26 amount of potency

01:13:28 over a relatively short period of time.

01:13:31 Sometimes it's weeks, sometimes it's a

01:13:33 couple of months. But what you really

01:13:35 need here is something that can last

01:13:37 longer than that and also something

01:13:40 where you can adjust the potency

01:13:42 depending on the specifics of the of the

01:13:46 patient

01:13:47 and the specifics of the surgical

01:13:49 situation.

01:13:50 So, our partnership with Spiral is a

01:13:53 rather unique approach. It's actually

01:13:55 taking a different approach than just

01:13:57 coding the electrodes

01:13:59 which has uh

01:14:01 quite a few shortcomings and instead

01:14:04 giving us the opportunity

01:14:06 to use different formulations that can

01:14:08 be applied during surgery and that can

01:14:11 release over a long period of time into

01:14:13 the cochlea

01:14:15 and something rather unique that can be

01:14:18 reapplied if necessary to even extend

01:14:21 that

01:14:22 much further.

01:14:23 It's a unique approach that addresses

01:14:27 some of the shortcomings of

01:14:31 electrode coatings.

01:14:34 >> I think to add to this, one of the

01:14:37 unique advantages

01:14:39 of this particular collaboration brings

01:14:41 us

01:14:42 the advantages to address some of the

01:14:45 other underlying things that happen in

01:14:47 the middle ear space.

01:14:49 So, this drug

01:14:51 and the collaboration started with the

01:14:53 drug developed for Meniere's disease.

01:14:56 So, what we are actually looking into is

01:14:58 extending the access

01:15:01 to also

01:15:03 into the cochlea, intracochlea.

01:15:05 Now,

01:15:06 to do that, I think, which we can do

01:15:08 postoperatively,

01:15:10 there is a unique mechanism or a

01:15:12 patented system that was developed by

01:15:15 Spiral.

01:15:16 Now, with this collaboration, we get

01:15:19 this access to this what we call MIX

01:15:22 system, MIC's system. It's a minimally

01:15:25 invasive system that you can go

01:15:27 transtympanic

01:15:29 and then deliver at the entry of the

01:15:31 round window.

01:15:32 What this gives you is

01:15:34 it does not

01:15:37 limit your ability to what you can coat

01:15:39 on the electrode, but gives you an

01:15:42 opportunity to reapply

01:15:45 as needed. So, now,

01:15:47 instead of a topical steroid, you can

01:15:51 deliver the medicine right at the site.

01:15:55 So, it's a combination of how it is

01:15:59 delivered, and it is also the drug

01:16:01 itself.

01:16:04 >> Actually,

01:16:05 the fibrosis, post operative fibrosis or

01:16:08 scarring, is a kind of enemy for the

01:16:10 electrode. For our surgeons as well as

01:16:13 audiologists, surgery goes on well,

01:16:15 implant audiologist programs well,

01:16:17 everything will be fine. Over a couple

01:16:20 of years, slowly the impedances started

01:16:23 start falling down as well as the

01:16:25 hearing capacity,

01:16:27 they tends to go down. It's because of

01:16:28 the fibrosis around the implant

01:16:31 electrode. After all, this is a foreign

01:16:32 body. And that's the reason we tend to

01:16:35 give intraoperative anti-inflammatory,

01:16:37 dexamethasone. But, as you said, it's

01:16:40 going to act for a very limited period

01:16:42 of time.

01:16:43 And this is very useful not just for the

01:16:47 patients, it's useful for us surgeons,

01:16:50 for audiologists,

01:16:52 mainly for the patient throughout their

01:16:54 life.

01:16:54 >> Mhm.

01:16:55 >> Something which is quite important. And

01:16:57 the one what you mentioned mix, MICS,

01:17:01 minimally invasive cochlear system. I've

01:17:04 seen the CEO Hugo Peris talking about

01:17:06 this.

01:17:08 But I had a question then.

01:17:10 Now think about the electrode design

01:17:12 that you have given.

01:17:13 Now we are giving a drug, a medicine

01:17:15 through the

01:17:16 round window. Trans-tympanic through the

01:17:18 round window, we are giving the drug.

01:17:21 Is there any way that the electrode

01:17:24 design tends to change, anything happens

01:17:26 to the electrode, or any change in the

01:17:29 direction of the angle that we need to

01:17:31 go ahead?

01:17:33 Have you any any time thought about it?

01:17:35 Because it's a drug, definitely.

01:17:36 >> Mhm.

01:17:37 >> The drug is designed as a specific and a

01:17:40 special formulation. It's a actually a

01:17:42 proprietary formulation that is

01:17:44 designed.

01:17:46 It starts as a liquid format and slowly

01:17:48 becomes a gel.

01:17:50 It actually aids, if anything, with the

01:17:53 surgical procedure of inserting the

01:17:56 electrode. It helps retain the electrode

01:17:59 while slowly diffusing the drug through

01:18:02 the round window. So it has a two-fold

01:18:04 advantage to it.

01:18:06 Once it solidifies into a gel,

01:18:10 it actually aids with the packing, so

01:18:12 you don't need to do to ensure the

01:18:14 electrode is back out. That's number

01:18:16 one. The second aspect is it is a time

01:18:19 release, which means it gently diffuses

01:18:21 through the round window over a period

01:18:23 of time. And integrates and

01:18:25 disintegrates. Now this allows for a

01:18:28 slow healing at the entry of round

01:18:30 window when you insert the electrode,

01:18:32 while also provide the access to the

01:18:34 drug.

01:18:35 >> Mhm.

01:18:37 >> And when we say period time, we're

01:18:38 talking about months.

01:18:40 >> In a traditional drug release that is

01:18:42 coated with the electrode

01:18:45 what we call is that happens as a burst

01:18:47 release. So, in the initial burst

01:18:49 release of the drug happens, then you

01:18:51 have a sustained release. It slowly

01:18:53 tapers down.

01:18:55 Now, after some time

01:18:58 whatever the drug that's released gets

01:19:00 absorbed and it's over. You cannot apply

01:19:03 any other drugs to it because it will be

01:19:07 exhausted and absorbed into the body.

01:19:09 With this minimally invasive cochlear

01:19:11 system it allows

01:19:14 the clinician

01:19:16 to go for periodic

01:19:18 >> Mhm.

01:19:19 >> steroidal treatments.

01:19:21 >> Anti-inflammatory treatment.

01:19:22 >> Anti-inflammatory treatments, yes.

01:19:25 One of the other advantages of the

01:19:28 system, I think will allow you is you

01:19:30 don't need to come back on a

01:19:32 regular OR procedure. It can be done as

01:19:35 a out of the office clinical

01:19:37 presentation.

01:19:38 >> Oh, seriously?

01:19:39 >> Yes.

01:19:40 >> Just OPD procedure.

01:19:41 >> Yes.

01:19:42 >> Oh, so if a patient, example, we are

01:19:44 implanting a child 1 year old

01:19:47 the child will definitely develop some

01:19:49 amount of fibrosis somewhere around

01:19:50 15-16 years.

01:19:52 >> Exactly.

01:19:52 >> So, they can just come into the OPD

01:19:54 >> OPD.

01:19:55 >> and get this done

01:19:57 and boom, they'll be able to hear like

01:19:59 normal. Can we just state it or not?

01:20:01 >> This is This is one of the advantages.

01:20:03 It it I don't know about hearing normal,

01:20:05 but it aids with

01:20:07 any kind of

01:20:08 anti-inflammatory

01:20:10 treatments

01:20:11 and for which a normal topical or a any

01:20:15 other treatment will not otherwise be

01:20:18 effective, you can deliver the treatment

01:20:20 right at the site and you can do this

01:20:23 not

01:20:24 requiring any anesthesia, not requiring

01:20:27 any

01:20:27 OR.

01:20:29 >> Just as an OPD procedure. Now, before we

01:20:32 get into the last but one question, let

01:20:34 me ask you something.

01:20:36 What are you excited at the moment? And

01:20:39 what can we expect from Advanced Bionics

01:20:41 in the upcoming 5 or 10 years?

01:20:44 >> It's too much for me to talk about

01:20:46 with respect to this, but I will tell

01:20:48 you more fundamentally that

01:20:52 the Sonova hearing aid part of the

01:20:55 business and the Advanced Bionics

01:20:57 cochlear implant side of the business

01:21:00 have come together with a focus to

01:21:02 benefit cochlear implant patients. That

01:21:05 was the main driver, the main reason for

01:21:08 tearing down those walls and merging

01:21:10 into a global R&D team.

01:21:14 And with that focus on helping cochlear

01:21:17 implant patients,

01:21:19 what you can expect to see is we've

01:21:20 already talked about a lot of the

01:21:22 research that's happening in parallel on

01:21:24 many things. First of all,

01:21:26 that to be expanded. So, there are even

01:21:29 more things that we will work on in

01:21:30 parallel.

01:21:31 And then, addition In addition to that,

01:21:35 it's uh to take

01:21:38 all of those people, the researchers,

01:21:40 the the the money that's going into the

01:21:42 research,

01:21:44 and accelerate

01:21:47 the time to market.

01:21:49 Um there are things that take a very

01:21:51 long time. It might take from beginning

01:21:52 to end in some cases 5 years or 6 years

01:21:55 or 7 years

01:21:57 to go from concept to market. And we

01:22:00 intend to

01:22:02 um half the time that it used to take

01:22:05 us. So,

01:22:07 big picture, I think we'll expect to see

01:22:10 much more frequent releases and

01:22:12 accelerated time to market. That's what

01:22:14 I'm most excited about.

01:22:16 >> As Commandor already mentioned about

01:22:18 this excellent collaboration, which is

01:22:21 phenomenal because it gives us access to

01:22:23 extend our research in different

01:22:26 things, different

01:22:28 um questions that we wanted to answer,

01:22:31 right? And it gives us the access to the

01:22:34 resources.

01:22:35 And also the access to the collaborative

01:22:39 technology that we can bring in to

01:22:41 answer these questions. So, as a

01:22:43 researching and researching team,

01:22:46 everybody is excited about this. As a a

01:22:48 bit of a personal sense of

01:22:51 accomplishment as we are embarking on

01:22:54 these new programs like this bionic ear

01:22:58 about potential program.

01:23:00 It is truly unlocking some of the

01:23:03 mysteries

01:23:04 of the CI.

01:23:07 That's exciting.

01:23:09 We are unlocking

01:23:10 mysteries of

01:23:12 what goes inside the cochlear,

01:23:14 what how does the electrode behave,

01:23:17 what is its behaving. It's always been a

01:23:20 guesswork.

01:23:21 We are slowly starting to unlock

01:23:24 and take the guesswork out of the

01:23:26 equation

01:23:28 and provide you with clear answers.

01:23:31 This includes

01:23:33 innovation in electrode and device

01:23:36 technology,

01:23:38 imaging side of things, imaging

01:23:40 technology.

01:23:42 We already spoke about the collaboration

01:23:44 in the drugs and therapeutics.

01:23:47 And there are other collaborations.

01:23:50 The advent of all the objective measures

01:23:52 that we are unlocking

01:23:55 give you this progress report, a sense

01:23:57 of

01:23:58 absolute peace of mind knowing that

01:24:02 we have done it right.

01:24:04 And the child is on the right track

01:24:07 or the

01:24:09 child is developing on the right path.

01:24:12 And overall,

01:24:15 we could do this

01:24:17 in a much more exciting way. We extended

01:24:20 this research thanks to the

01:24:22 collaboration, as Fernando mentioned, we

01:24:25 have extended this beyond the borders,

01:24:28 across the continents, across the

01:24:31 Atlantics, and across the oceans. To

01:24:34 make it a truly a global product, we

01:24:37 need collaborations, we need insights,

01:24:40 we need data, we need answers,

01:24:44 everything from across the globe. So, we

01:24:46 are powering a global product with a

01:24:49 global perspective. So, as a research

01:24:52 team, we are excited about bringing that

01:24:55 perspective in all these different

01:24:57 technologies that we are going to

01:24:59 unlock. So, for me, yeah, I can go on

01:25:02 and on.

01:25:04 >> That's nice. So, Mr. Fernando, we have

01:25:06 come to the end of the podcast. So, this

01:25:08 is my last question. Now, somewhere in

01:25:11 the middle of the night, a parent would

01:25:14 have been seeing this podcast.

01:25:17 Their kid would have not passed a

01:25:19 newborn hearing screening test. They'll

01:25:21 be much worried. They'll be scrolling

01:25:23 through multiple

01:25:25 multiple mobiles about collecting all

01:25:28 the data. If you could tell them

01:25:30 assuringly something about the cochlear

01:25:33 implant, are there any words that you

01:25:35 could convey them? Could you just tell

01:25:37 them at this point?

01:25:43 >> I have had family members,

01:25:48 people very close to me, that have gone

01:25:50 through this. And so, I know that when

01:25:52 the test comes back, the test result

01:25:54 comes back,

01:25:56 it does create anxiety. It does create

01:25:59 worry. What does this mean for my child?

01:26:02 Are they Are they going to be limited?

01:26:06 Um do I have to send them to a special

01:26:08 school?

01:26:09 And what I would like to convey the most

01:26:14 is that

01:26:16 at Advanced Bionics,

01:26:18 There are people that work

01:26:21 within Advanced Bionics that are

01:26:22 cochlear implant recipients.

01:26:25 There are neighbors that I have that are

01:26:28 teachers that are cochlear implant

01:26:30 recipients.

01:26:32 There are firefighters in my family that

01:26:36 have Advanced Bionics cochlear implants.

01:26:40 I will go and say that

01:26:42 someone that held the position that I

01:26:44 have today before I did

01:26:47 was a senior vice president of global

01:26:49 research and development and was a

01:26:52 Advanced Bionics cochlear implant

01:26:54 recipient.

01:26:56 And what we see here is that

01:27:00 what will be available to your child is

01:27:03 not something that you should worry

01:27:05 about. What will be available to your

01:27:06 child is

01:27:08 they can become CEOs. They can become

01:27:11 teachers. They can become athletes. They

01:27:14 can become

01:27:16 uh they can enjoy music. They can truly

01:27:19 live a life without limitations.

01:27:22 And

01:27:24 if you take parents

01:27:27 that had these worries that are very

01:27:29 natural to have

01:27:31 and you were to ask them 5 years after

01:27:34 the implantation

01:27:36 what they would also tell you is

01:27:40 it's going to be fine.

01:27:41 Your children will be able to grow up

01:27:43 without limitations.

01:27:45 >> I think one of the most compelling

01:27:48 things

01:27:50 I will tell a small

01:27:52 personal story why I chose AB.

01:27:55 And this is a story of me

01:27:58 looking at one of the recipient.

01:28:01 And um

01:28:02 a curiosity that led me

01:28:05 to join the AB.

01:28:07 And I would look back since then.

01:28:10 Because that same curiosity is what

01:28:13 drove me.

01:28:15 And as I am

01:28:16 looking for new answers on

01:28:19 how important this hearing is, I start

01:28:22 to appreciate the pain,

01:28:26 the confusion, the anxiety,

01:28:29 all the emotional things a parent will

01:28:32 go through.

01:28:33 That led me to further

01:28:36 push myself

01:28:39 and looking into ways how we can

01:28:42 make this better every single day.

01:28:47 I can only say two things.

01:28:50 Rest assured.

01:28:52 There are three ways that we look at it

01:28:54 here at AB from a research perspective.

01:28:58 Starting one,

01:28:59 you want to provide the best starting

01:29:01 point. You have the best equipment that

01:29:05 you can be rest assured that performs

01:29:08 and outperforms

01:29:10 every time and

01:29:12 allows the child

01:29:15 to be on the right track for

01:29:17 development.

01:29:20 We work so closely with excellent

01:29:23 collaborators, researchers, clinicians,

01:29:27 surgeons, audiologists.

01:29:29 Everything is

01:29:31 validated, verified. No more guesswork.

01:29:35 This is not a science that is built on

01:29:39 guesswork. It is objective. It is

01:29:43 measurable. You can see it. You can see

01:29:47 what the patient or your child is going

01:29:51 to be like.

01:29:53 This is a sense of assurance that I

01:29:56 believe it cannot top.

01:29:59 I am extremely proud that we have this

01:30:03 opportunity to share our passion

01:30:06 on why and how we can share this

01:30:09 confidence with you in the form of a

01:30:12 device, in the form of a promise that we

01:30:15 wanted to keep

01:30:16 and

01:30:17 keep making things better. Thank you.

01:30:20 >> Thank you so much for coming all the way

01:30:22 from United States

01:30:24 to flying to our country

01:30:26 and accepting for being here on this

01:30:29 Hearing Circle podcast. Thank you so

01:30:32 much. Thank you.

01:30:34 >> Thank you. Hours

01:30:35 hours and 55 minutes.

About this Podcast

Dr. Shree Rao is one of India’s leading cochlear implant specialists with over 12 years of experience and 200+ successful cochlear implant surgeries. She completed specialized fellowship training under Padmashri Awardee Dr. Milind V. Kirtane and has trained at Singapore General Hospital for rhinoplasty and facial plastic surgery. As Director of Asia’s largest ENT Super Speciality Hospital, she leads teams across 7 OPDs, 3 operation theaters, and specialized units with a 99.9% success rate. Dr. Shree Rao is passionate about creating a “Deaf-Free India” and partners with NGOs to provide free cochlear implant surgeries to underprivileged children.

Fernando Chapa leads global research and development at Advanced Bionics, focusing on innovations in cochlear implant technology and hearing solutions. In this episode, he explains how advanced sound processing, artificial intelligence, implant design, cybersecurity, and research collaborations are helping shape the future of cochlear implants.

Anil Patnala works on translating engineering research into practical cochlear implant technology. His work includes implant design and electrode innovations, including a self-curling electrode designed to follow the shape of the cochlea. In this episode, he discusses implant reliability, MRI-compatible magnet design, pediatric-specific sound processors, and emerging methods for objectively assessing hearing-related responses in children.

Podcast Summary

Advanced cochlear implant technology is transforming how people with hearing loss experience sound, communicate, and develop speech. In this episode of the Hearing Circle podcast, Dr. Shree Rao speaks with Fernando Chapa and Anil Patnala from Advanced Bionics about the research and engineering behind modern cochlear implants.

The conversation explores how cochlear implants work, how they differ from hearing aids, and why choosing the right treatment at the right time is particularly important for children with hearing loss.

One of the key topics is AI-powered sound processing. Fernando Chapa explains how artificial intelligence can identify different listening environments and help focus on speech while reducing unwanted background noise. The discussion also introduces DeepSonic, a dedicated AI processing technology designed to improve sound clarity through advanced processing capabilities.

The episode examines innovations in electrode design, including a self-curling electrode intended to follow the natural shape of the cochlea. Anil Patnala explains how implant design decisions can influence electrode placement, reliability, and long-term technological flexibility.

Another important topic is cochlear implant safety and privacy. The speakers discuss cybersecurity measures, encrypted communication, the absence of direct internet connectivity in the devices described, and why the implant’s internal components are designed to prioritize reliability while advanced processing remains in the external sound processor.

The discussion also covers MRI-compatible implant magnets, pediatric-specific sound processors, and the importance of early hearing intervention. The speakers explain how the early years of life are important for developing auditory neural pathways and why consistent use of a cochlear implant can help children benefit from sound stimulation.

Finally, the episode introduces the Bionic Ear Evoked Potential (BEEP) system, an approach being developed to help clinicians objectively assess responses to cochlear implant stimulation. The system aims to provide useful information about a child’s hearing-related responses and developmental progress. The speakers also discuss collaborative research into electrode technology, drug delivery during cochlear implant surgery, and future hearing innovations.

What You Will Learn in This Podcast

How advanced cochlear implant technology works
The difference between hearing aids and cochlear implants
How AI can improve speech understanding in noisy environments
What DeepSonic technology does in sound processing
How self-curling electrodes are designed to follow the cochlea
Why early cochlear implantation matters for children’s development
How cochlear implant cybersecurity and privacy are addressed
Why internal implant reliability and external upgrades matter
How MRI-compatible magnets are designed
How the Bionic Ear Evoked Potential (BEEP) system aims to assess auditory responses in children with cochlear implants
How research collaborations may shape future cochlear implant technology

Why Is Early Cochlear Implantation Important for Children?

Early hearing intervention is an important part of supporting a child’s auditory and speech development. During the early years, the brain develops connections in response to sensory experiences, including sound.

In the podcast, Fernando Chapa explains that providing appropriate auditory stimulation early can help support the development of neural pathways. He also emphasizes that consistent daily use of the sound processor matters, alongside early intervention.

Parents should consult an experienced pediatric ENT specialist and audiologist to understand their child’s hearing assessment, treatment options, and rehabilitation plan. The appropriate timing and approach depend on each child’s individual needs.

How Does AI Improve Cochlear Implant Hearing?

Artificial intelligence can help a cochlear implant sound processor recognize different listening environments, such as classrooms, restaurants, and quiet rooms.

The episode distinguishes between two approaches:

AutoSense OS: Identifies the listening environment and adjusts sound-processing settings to suit it.
DeepSonic: Uses additional processing to help emphasize the sounds a listener wants to focus on, such as a person’s voice, while reducing unwanted background noise.

The goal is to make listening more comfortable and support speech understanding in challenging environments. Actual results can vary between individuals and listening situations.

Are Cochlear Implants Safe and Secure?

The speakers discuss several design considerations intended to support cochlear implant reliability, cybersecurity, and privacy.

These include encrypted device communication, limited connectivity, independent cybersecurity testing, and an implant design that keeps much of the advanced processing in the external sound processor.

The episode also explains how MRI-compatible magnet designs aim to accommodate magnetic forces during MRI examinations. However, MRI eligibility and scanning requirements depend on the specific implant model and its instructions. Patients should always inform their radiology team about their implant and follow the manufacturer’s and treating clinician’s guidance.

What is the Bionic Ear Evoked Potential (BEEP) system?

The Bionic Ear Evoked Potential (BEEP) system aims to help clinicians objectively measure brain responses to stimulation from a cochlear implant. It may provide additional information about a child’s auditory responses and help clinicians monitor hearing-related development. As discussed in the podcast, the system is designed to make these measurements simpler and more comfortable for children.

Need Expert Care?

If your child has failed a newborn hearing screening or has hearing loss, consult a pediatric ENT specialist for early evaluation and personalized treatment guidance.

Podcast Highlights

What is advanced cochlear implant technology?

Advanced cochlear implant technology combines an implanted electrode system with an external sound processor. The processor analyzes incoming sound and converts it into electrical stimulation patterns that activate the auditory pathway.

How does AI improve cochlear implant performance?

AI can help recognize listening environments and adjust sound processing. More advanced processing can also help emphasize speech and reduce unwanted background noise, potentially making conversations easier to follow.

What is the difference between a hearing aid and a cochlear implant?

A hearing aid amplifies sound acoustically, while a cochlear implant converts sound into electrical signals that stimulate the auditory nerve. A cochlear implant may be considered when hearing aids do not provide sufficient benefit, depending on clinical assessment.

Why is early cochlear implantation important for children?

Early intervention can provide auditory stimulation during important stages of brain development. The timing of treatment, consistent device use, and appropriate rehabilitation can influence a child’s listening and communication development.

Can a cochlear implant be hacked?

In the episode, Advanced Bionics representatives describe security measures including encrypted communication, restricted connectivity, and independent cybersecurity testing. Security considerations can vary by device, so patients should refer to the information for their specific system.

Can children with cochlear implants undergo MRI scans?

Some cochlear implant systems are designed to be compatible with MRI under specified conditions. MRI requirements vary by model, so the implant details must be checked before scanning, and the radiology team must be informed.

What is the BEEP system in cochlear implant technology?

BEEP stands for Bionic Ear Evoked Potential. The system discussed in the podcast aims to help clinicians measure brain responses to stimulation delivered through a cochlear implant, providing additional objective information about auditory responses. The speakers describe a measurement process designed to take approximately three to five minutes without requiring sedation.

Can cochlear implant technology be upgraded over time?

Many improvements can be introduced through compatible external sound processors and software updates, depending on the implant system. The internal implant itself cannot necessarily be upgraded in the same way, which is why device compatibility and long-term treatment planning are important.

Advanced Cochlear Implant Technology: AI, Safety & Better Hearing

Advanced Cochlear Implant Technology: AI, Safety & Better Hearing

About this Podcast

Dr. Shree Rao

Fernando Chapa

Anil Patnala

Podcast Summary

What You Will Learn in This Podcast

Why Is Early Cochlear Implantation Important for Children?

How Does AI Improve Cochlear Implant Hearing?

Are Cochlear Implants Safe and Secure?

What is the Bionic Ear Evoked Potential (BEEP) system?

Need Expert Care?

Podcast Highlights

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