by Neil Bauman, Ph.D.
Have you ever wondered whether there are any significant differences in the performance results you could expect, depending on which cochlear implant (CI) you chose?
Doctors, and cochlear implant centers typically tell you that all CI brands are good (and this is true). Thus, you might assume that they all give equal results. Likewise, on some on-line cochlear implant lists, everyone proclaims that all cochlear implants work well leading people to believe that all cochlear implants essentially give the same performance results.
Thus the average person is left with the feeling that it doesn’t really matter which cochlear implant brand they choose—that they can’t go wrong with any brand—because they will get similar results no matter which one they choose.
No one wants to think that they chose a brand of cochlear implant that won’t perform as well as another brand. Each person likes to think they made the best choice.
So, what is the truth? Is it true that all cochlear implants perform equally well, or have some historically performed better than others?
Logic alone tells you that some cochlear implants must perform better than others—that all cochlear implant brands will not give equal results.
Think of it this way. In an Olympic race, you have the best runners in the world competing. However, you don’t get all the competitors tying for first place. It just doesn’t happen. One runner will come in first. One runner will come in last. The rest will fall somewhere in between.
In the same manner, the four major brands of cochlear implants (Advanced Bionics, Cochlear Limited, Med-El and Neurelec) because they are all different and use different mapping strategies, will not give identical performance results. One is bound to be better than the others, and conversely, one is bound to perform worse than the rest with the other two somewhere in between.
In truth, this is exactly what researchers found. (That’s good news if you chose the best performing CI brand, and not so good news if you chose the worst performing brand.
According to a comprehensive retrospective study (1), when they pooled the results of all brands of cochlear implants to get an average result, two brands performed above average, and two performed below average.
The results showed that the “best” brand performed about 7% above average, while the next best performed about 3% above average. On the other hand, the “worst” brand performed about 7% below average, while the second worst brand came in at about 2% below average. Thus the difference in performance was about 14% between the best and worst cochlear implant brands in this study.
Now I know the question you are dying to ask, “Which was the best performing brand?” Wouldn’t you like to know? That’s the one you want to choose, right? Unfortunately for you, the authors of this study deliberately refrained from revealing this fact so no companies could get competitive advantages over the others.
Although it may seem unfair to you to keep the results secret (and I agree), bear in mind that this study only looked at people who received cochlear implants between they years 2003 and 2011. If they had looked at people who had received cochlear implants say between 2012 and 2015, or prior to 2003, the results may have been different. This is because technology is rapidly changing, and cochlear implant companies regularly leapfrog each other with their technical advances.
Since studies can only be done after the fact—once your brain has had a chance to adjust to a new cochlear implant—any study results will always only show past results. They will not show what results you could expect with the newer, current crop of cochlear implants. Thus, you have to choose a cochlear implant based on what is currently available.
Furthermore, realize that all cochlear implant brands do work well—some just work a bit better than others. To put it in perspective look at it this way.
Lets hypothetically assume that the average performance results showed that recipients understood 80% of what people said. That would mean you’d understand 80 out of every 100 words spoken. The difference between the best brand and the worst brand would be that you’d understand 87 words out of every 100 words spoken for the best brand rather than only 73 words for the worst brand. Both are pretty impressive results considering that pre-cochlear implant, you probably understood closer to 0 words!
Therefore, if you are considering getting a cochlear implant, choose your brand based on the best information available to you for the current models. Perhaps you think one technology will be better than another. Perhaps you like the shape of one CI more than another. Or perhaps you like the battery life or kind of batteries one uses. Or perhaps being waterproof is important to you. Make your choice based on the factors that fit your lifestyle best and the one that you are most drawn to. Only time will tell if you made the best choice regarding performance or not. And with continued competition between cochlear implant manufacturers, the performance results will hopefully continue to improve with each new model. In the meantime, enjoy your new-found hearing.
And if you already have a cochlear implant, don’t beat yourself up wondering whether you made the right choice in your cochlear implant brand or not. Instead, enjoy the greatly improved hearing you now have!
(1) Lazard, Diane S., et. al. 2012. Pre-, Per- and Postoperative Factors Affecting Performance of Postlinguistically Deaf Adults Using Cochlear Implants: A New Conceptual Model over Time. PLOS One. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048739.