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.
Hi. I will very much thank you since you could let me know why is it that I lost my right side hearing after episode of very stressful night and 4 hours airplane trip and after visited several specialists they have failed to lead me for a solution to my problem. What is going on?
Why I , with my insurance, was not adequately treated? Please, if there is any thing you can suggest me , let me know what to so. Thanks
Hi Carl:
You haven’t given me enough information to be very specific. One possibility that comes to mind is that your extreme stress shot your immune system down. This allowed any virus floating around to quickly multiply and attack your inner ear. The plane trip provided a good environment for any virus from any of the people in the plane to infect you. Viral attacks can lead to sudden hearing loss. Sometimes hearing returns, but often it doesn’t, especially if the hearing loss was almost total.
Another possibility is that if you had a cold, the mucous in your throat was drown up into your Eustachian tube and thus caused some degree of conductive hearing loss. If this is your situation, your doctors should have found it. Typically hearing returns to normal when the “gunk” finally drains away–which could take several weeks.
How long ago did this happen? Treatment for a viral attack needs to be done within a day or so of the hearing loss. It sounds like it was maybe a couple of weeks or more now. That is too late to treat the cause. If that is the case, then you should see an audiologist and possibly be fitted with a hearing aid.
Cordially,
Neil
Dr. Bauman,
Thanks for the article, and thanks for giving us your precious time. I have a question. What are our options, if any, if we were to find that we made the wrong choice? When I got my hearing aids, I was given a 70 day trial period during which I could exchange them for another model or receive refund. I realize that cochlear implants are more complicated, but was wondering if there are different brands with compatible exterior and implanted components which would enable a switch at sometime.
Thank you,
Frank
Hi Frank:
No, the external and internal parts are not interchangeable between brands, but they are typically interchangeable within a brand. For example, if you have MedEl internal electrodes, when they come out with a new processor (external part), typically you can upgrade to the new processor while still using the old electrode array.
If the internal part goes bad, you sometimes can have it explanted and a new electrode array implanted. However, sometimes that won’t work if your inner ear calcifies around it.
Or you can have a different brand implanted in your other ear. I know of a lady with two different brands–one in each ear.
However, how will you know you made a mistake? You’ve never tried the other brands to see if they would perform differently/better? So what you do is take your time checking out the 3 main brands used here–and see which features you like the most. Then make up your mind and go with it. It’s like getting married–know the person well before you say “I do.” Then be happy with your choice and don’t keep wondering whether you could have made a better or different choice. That is just counterproductive in marriage and in successfully wearing your CI–whatever the brand.
Cordially,
Neil
Dr. Bauman,
Thank you for your prompt reply. Your marriage analogy makes a lot of sense. Your advice is well taken.
Best regards,
Frank
My 6 years old son has been already operated on right ear in 2017 with cochlear, now we are planning for left ear also, so whether we should go with same company implant in right ear or we may choose another company Implant also?
Hi Altaf:
You can go with two different brands–one in each ear, and I know a few people that have done so. But, I think you’ll find it better to stay with the same brand for both ears. There are a number of advantages in doing so. I think you’ll find that his brain will work better with two of the same brand because both work the same. Each brand uses different processing strategies. Thus the brain receives slightly different signals and that can be more confusing than having the same kind of signals from both ears. Also, you’ll only need an audiologist familiar with one brand for programming (mapping) it from time to time. And upgrades will be the same for both ears.
So, all in all, I think there will be more benefit to having both the same brand, unless there is a good reason not to do so.
Cordially,
Neil
This is dumb, no offense but if there is the best brand out there why not tell us?Some people’s lives depend on these devices and that 4% to 14% is a big difference when your spending over $15,000 for a hearing device, like people have that type of money laying around. I mean if I could spend $15,000 to buy the best Mercedes who wouldn’t jump on that? Rather than spending $15,000 on a Nissan car. That’s the problem with hearing aid manufactures though they all want money and the cost for their devices shows that, even in the repairs that your going to have to pay for that come with it, your hearing aid breaks sorry, have to send it out for a couple of weeks to get it repaired, wait you can’t go to work with out it, too bad you can buy an extra at the low price of a car at $7,000. Three weeks later…Your hearing aid came back from repair oh sorry it’s not working again, we have to send it back for another 3 weeks hopefully they’ll get it right this time. Most insurance companies won’t pay either because it’s a cosmetic and not a heath issue you can always go to Costco for a cheap aid that may or may not work.
dear dr / NEIL BAUMAN
thanks a lot for ur beautiful article
but i am in deep thinking what type is better fro my 1 year old child
he needs cochlear implant and our dr hear in middle east till us to choose between two types
Oticon zti
Cochlear nucleus 6
both hear are same price but which is better performing and become more natural
please give ur opinion even on mail not in public
plz plz as soon as possible
Hi Dr. Modammed:
That’s a good question, but I don’t know enough about Oticon’s ZTI to make a good comparison.
On the one hand, Cochlear has had many years of experience in making CIs and has an excellent track record.
Oticon is a great company, but is brand new to CIs. They purchased the French CI company, Neurelec, and now are releasing their first CI under the ZTI name. It may be wonderful, but at this point, it has no track record.
Thus, you may want to be “conservative” at this point, and go with Cochlear. Or if you think the features of the ZTI warrant it, go with it. After all, Neurelec had been making CIs for some years so they are not new it making CIs.
Cordially,
Neil
The Oticon is a very good device, my buddy had to have two of them implants and it seemed like he heard better with those devices than a person with the regular Cochlear to be honest. Oticon always has great devices with less repairs in my opinion, I worked with all manufacturers and they all produce different results but Oticon always seemed to care about people. Their sound quality may not be the best compared to other brands but their hearing devices are sturdy and can handle a lot versus other brands that will need repairs every month.
Dear Dr Bauman ,
Thank you for this article.
My son aged 20 months has been diagnosed with deafness on right ear & 70 db on left ear after running a BAEP test.
After these tests we have done an MRI & a CT scan the results of both are alright.
The Surgeon decision is “cochlear implant” on right (deaf) ear.
My questions are:
1- Do we have to re-do the BAEP ?
2- Is Cochlear implant the only solution for the deaf ear ?
3- Which option is better
1- improve the 70 db side,
2- implant the deaf one or
3- treat both sides?
4- If we have to do cochlear implant, which brand is best & less visible ?
Thank you so much,
NBL
Hi Nabil:
1. You can redo the BAEP if you want to get a second opinion from another source, or confirm that the original one was correct from the same source. I don’t think you NEED to get a second one, but since you are concerned, it would give you peace of mind if the second BAEP shows the same results as the first one–especially if done by someone different.
2. At this point it is. There is continuing research on regenerating hair cells in the inner ear, but this is not ready for regular use. It could be another 10 or 20 years, so in the meantime, a CI is the basic way for him to hear sound NOW.
3. If it were me, I’d implant the deaf ear and fit a hearing aid on the other ear. The two can work together synergistically. I know numbers of people that do that. My second choice would be to implant both sides at once.
4. All CI brands are good. At any given time, one may leapfrog the rest, but a few months later, someone else leapfrogs them. So you won’t really go wrong with any of them. What I’d do is focus on the features they have that fit your lifestyle, etc. such as how long the battery lasts, is it comfortable for his small ears, etc. For example, the MedEl Rondo is all behind the ear–there is nothing to hang on the ear like there is with the Cochlear and Advanced Bionics brands. So that may be one consideration.
Don’t just make your decision on visibility–you want to major on what works the best for him no matter how big or small it is. After all, the reason for getting one is to hear better–not to be invisible.
Cordially,
Neil
Dear Dr Neil,
Thank you very much for feedback.
I really appreciate your professional views and opinions.
Kind regards,
NBL
Dear Neil,
Thanks for article!
My 22 years old young brother currently has Rondo cochlear implant. It’s old and not efficient much.
Please advice which is the best (#1) and latest cochlear device in the world nowadays (same like Apple 7)?
Hi Kairat:
It’s not that easy. Each brand of cochlear implant has an internal part that stays in your head. It is also proprietary to the same manufacturer’s external speech processor. Thus your brother has to stay with the MedEl cochlear implant company.
What he can do is as MedEl comes out with never speech processors, he can upgrade the speech processor to the latest model. But the internal part stays the same and will not work with competing brands of speech processors.
Besides, the Rondo isn’t all that old and it certainly works very well.
Cordially,
Neil
Hi sir
I have kids she is using hearing aids(profound-90DB) since she was 1.5 years and now she is 5 years old ,she still cannot make sintence more than 4 words and can not Pronunciation the (S,C,Ch and R in beginning of words) do you think the hearing will be worst with age (I heard it will be worst in 20)do you think it is better to make the CI for her,if she was you kids wich brand you will use
Thanks and regards
Hi Saad:
It sounds like your daughter needs more help that her hearing aids are giving her. Thus, getting CIs is a good step. I’d do it sooner rather than later as her auditory system is still plastic. This stops being the case around 6 or 7. After that, it is not as easy to adapt to the CI and gain language as before this time.
Her hearing may not charge much, or it may get worse, but it is almost guaranteed to eventually get worse as she ages.
Which CI brand you choose is up to you and her and your lifestyle. There are a number of different options with each manufacturer. You need to decide which is something she needs or would like. I say this because all the CIs are good and they keep leapfrogging each other so at this time, I might choose one and tomorrow I might choose another.
Another consideration is which brand is your CI surgeon really familiar with? And just as important, which brand or brands is the CI audiologist familiar with. You want to go with the brand that those two professionals are particularly skilled in implanting and programming.
Cordially,
Neil
Dr NEIL
Thank you for this helpfull articles; I myself have a 17months old baby boy who was born deaf and we are planning to do his implant soon; my question is which type of CI is the most required for a child? and is that the best age to receive one? and if yes if we are implanting 1 for now and the 2nd one in few years; will he be able to talk as a normal child still with is New CI to be done soon? and definitely I would appreciate if you can tell which model is much better for a child like my son. thanks lot
Karen
Hi Karen:
You should be discussing this with your pediatric audiologist as CIs have changed and continue to change since I wrote this article. So you want access to the latest information and your child’s CI audiologist will be the person to guide you.
If you child is truly deaf, then you want to implant him as soon as possible–any time after 1 year old. And I’d do both implants at the same time–unless there is a really good reason for only doing one now and one later.
The sooner you get him implanted, the sooner he will learn to speak and understand speech. If you get him implanted in the next couple of months, by the time he is 4 or so, he should be able to speak normally and have a normal vocabulary. Right now is when a child’s brain is really working on learning language so you don’t want to miss this opportunity for it to learn language.
Cordially,
Neil
Thanks for the article. Can you speak to the risks of an implant. I watched a surgery on Youtube and it looks very risky, scraping away and drilling through bone, threading the device into the cochlea in such close proximity to the facial and taste nerves. I am a borderline candidate, though, Johns Hopkins have agreed to go forward. I’m 62 and have been wearing hearing aids for the last 12 years. My right ear has really declined and it is affecting my job as I miss so much during meetings. The tests in crowded environments showed that I am understanding next to nothing in that type of environment and the audiologist and doctor don’t think any hearing aid on the right side will help further. I am in otherwise good health though I am on Coumadin which I understand will need to be stopped, but other than that is this a risky surgery?
Hi John:
CI surgery is surgery and there are risks to any surgery. However, many people that have CI surgery are treated as outpatients–they go into the hospital in the morning and are home that evening. That alone tells you that it is comparatively risk-free minor surgery.
With any surgery there is always the risk of infection, but this is not very common. If you do have an infection, a course of antibiotics typically clears it up.
Another risk is meningitis. That is why they require you to be vaccinated for meningitis before you have the surgery. You almost never hear of anyone having problems in this regard anymore. In the past 20 years only 118 people have gotten meningitis from CI surgery. That is why they now require the vaccination which has reduced the incidence of meningitis.
You mentioned two more common problems. One is that the facial nerve is in close proximity to where they are working and thus there is the risk of damaging this nerve. The result can be weakened facial muscles on that side, although the most common side effect I hear is your sense of taste is messed up for a few days to a few months. Numbers of people complain of a metallic taste. Some even have some numbness on their tongue. But this usually resolves itself in a few weeks as the damaged nerve heals itself.
Pretty well everyone experiences some numbness where the implant is–but this too goes away in time.
Some people find they have dizziness and or other balance problems for a day or two.
Many people notice they have tinnitus when they wake up after the surgery. Generally this tinnitus goes away when the implant is turned on. And a few have Musical Ear Syndrome (MES) instead of tinnitus for a bit.
Not all CI surgery is ultimately successful although this percentage is very small. Sometimes the implanted part moves if it wasn’t anchored down properly. Sometimes the electrodes go bad and have to be replaced so they are explanted and re-implanted.
Some people are not as successful with their CIs as others and are thus disappointed with the results, but the VAST majority say, “If I had it to do again, I’d do it in a heartbeat!” That is how good the results are for most people.
If you are worried about losing any residual hearing you have, just wait until you have nothing to lose (and everything to gain). Then you won’t be any worse off if something goes bad, and the overwhelming chances are that you’ll be ever so much better off than you were before.
Those are the risks and problems that I hear most about and I’ve heard the stories of hundreds and hundreds of CI recipients.
So, when you’re ready, go for it.
Cordially,
Neil
I am 65yo and deaf for practical purposes. My left ear has some hearing on some days. I have suffered meniere’s for 35 years as well as worked in noisy environments for most of my life. The limited hearing I have is distorted and I must assist it with lip reading. Would they most likely put the implant in my totally deaf ear? And would you recommend brand preferences? I am going to try to get medicare assistance.
Hi Rick:
If your deaf ear had hearing in the past, then they will test it and if it proves ok, they would most likely implant that ear, so you could wear your hearing aid in your other ear. However, if your deaf ear is not viable, then they’d have to implant your left ear.
All the CI companies make good CIs–so you need to base your decision on practical things like which implant will your implant center do? Which implant is your audiologist familiar with to do the mapping (programming)? and then think of your personal preferences and lifestyle. For example if you wanted a C that was all behind your head and not on your ear, then you’d have to chose either Cochlear’s Kanso or MedEls Rondo. So compare the features of the current CIs and decide which make has most of the features you relly want.
Cordially,
Neil
My daughter is one and half years old. she has profound hearing loss in one ear and severe in other. we are going for cochlear implant but confused for the choice weather its should be MedEl or COCHLEAR
Plz guide which one is better
thanks…
Hi Umair:
Neither one is better. They both perform well. But each one is different. You need to decide which features and lifestyle functions make the most sense to you. For example, one may have longer battery life than the other. If this is important to you, go for that model. Both of them have on-the-ear processors or processors that are all on the bone behind the ear. Do you like the accessories that come with one more than the other? These are the kinds of things you have to decide on. Read the literature for both and compare them.
Another thing you have to consider–perhaps even more important, is which make does your implant surgeon mostly implant. You want your surgeon to be very familiar with the kind of implant you are getting. Also, don’t forget the audiologist who programs the implant. You want your audiologist to also be VERY familiar with the implant you choose. So if both your surgeon and audiologist mostly implant MedEl, then go for that brand,or vise versa, go with the Cochlear brand.
Cordially,
Neil
I reuest you to suggest me between Med el Rondo & Cochlear Kanso. I am aware that you are unable to do so publicaly here on this platform.Therefore i request you to suggest the same in my e-mail Please.
Hi Suraj:
I can say whatever I want publicly. But the truth is that both are good CIs. You need to decide based on the features each has that are important to you. Another important think to consider is which brand is your CI surgeon most familiar with. Also, which brand is the audiologist that will be programming the CI mot familiar with. These two questions are more important than the brand of the CI itself.
Cordially,
Neil
Dear Neil, I received CI in 2015 and could hear following switch on. I developed FNS and unwanted head noise. it was decided to explant reimplant. I have FNS with second one and the Audi has been trying to tune it out but it is not a good result compared to the first one. I’m very disappointed and the head noise is unbelievable.
Hi Pauline:
What is FNS? Don’t assume I know every acronym known to man. There are at least 32 different meanings for FNS.
Cordially,
Neil
Dr Bauman
I am 77 years old and using hearing aids ins both ears, This week my wife and I went to an ENT Doctor and he suggested a cochlear implant. At my age is it worth it.
Hi Michael:
Your age is not a problem. People in their 90s have been successfully implanted. If you have reasonably good health and plan to live for a few more years and want to hear again, and are willing to do the work to relearn to hear again, then by all means go for it. I think you’ll be really happy you did.
Cordially,
Neil
I need some honest answers. About 8-10 yrs ago suddenly loss left ear hearing. I only feel/hear some popping when given hearing tests. So that ear is shot and its the one they will implant. 7 months ago right ear dropped where a hearing aid is of little or no value and could not work any longer. I cant hear granddaughter cry and the clarity is terrible. 1st question: No one said anything about having vaccines PCV13 and PPSV23 before surgery which is scheduled in 5 wks yet I see it all over the internet and on the CDC site to have them. Should I have been informed and get them? Next AB has up to 120 SR compared to 22 for Cochlear, 460 compared to 161 potential pitch percepts and the IDR is up to 80 compared to 45. It seems AB beats Cochlear by a landslide. I want to be able to hear in groups, on the phone, better one on one, appreciate music and hear children. Will I get that with Cochlear which is the most popular or is AB better. One thing I don’t like about AB is that I have their best Phonak aid and has never been good in noisy evironments and used the mic and was not impressed at all, did not help and returned it. If you can respond as soon as possible because of the short window before surgery. Thank you.
Hi Paula:
It is conventional wisdom to get vaccinated against meningitis before you get a cochlear implant. Many doctors won’t do the implant if you have not had the appropriate vaccinations. However, if you are against being vaccinated, that is up to you, but you may find it difficult to find a doctor to do the implant.
To answer your second question–each of the three main cochlear implant companies use different (read proprietary) ways to achieve the same goal–to help you hear with a cochlear implant. Thus each one of them trumpets their own proprietary solution. Thus AB has their 120 virtual electrodes as opposed to CAs 22 or 24 electrodes. Is one better than the other? Probably. Is this difference significant? Not likely. People that have CA or AB or MedEl all have good results and each person swears by the brand they chose.
That alone should tell you something. They all work well–just like some people like Fords or Chevs or Toyotas. Each has their little advantages and their downsides–but they all work well.
So look at all three of these cochlear implant brands and decide on the things that mean something to you. It may be weight, or size or shape or accessories or compatibility with your hearing aid, or kind of batteries it uses, or the remote it uses, or the controls it has, etc., etc. rather than on the internal proprietary technology.
Each of these companies leapfrog each other with their new innovations in each new model–so at any given time one CI may have a slight edge, but with the next model another company leapfrogs them. So go with the one that has the features you most value–and that is going to be different for each person.
You won’t go wrong with whichever one you choose as far as your ability to hear is concerned. The difference between them is largely insignificant in that respect.
Cordially,
Neil
Thank you Doctor for your time and patience. My surgery was scheduled without anyone informing me that I needed to be vaccinated, I just found it doing research. I will cancel and reschedule so I can get vaccinated. I am 58 years old and the way I am reading everything is: I will have to have the PCV13 first, followed by the PPSV23 no earlier than 8 weeks after; and then having them all done at least 2 weeks before surgery. Is that correct? A few last questions: My tests results: Right ear: Warble-tone through soundfield testing indicates moderate hearing loss at 250-500Hz w/no responses above 500Hz. SRT at 45 dBHL is consistent. HINT recorded sentences aided at 50dBHL in quiet, I could only repeat 11% words correct. 20% speech recognition, 60 reception, 90 dB LEVEL HL. Left ear like I said previously, only popping once in a while during test. Now, I was informed that I am not a candidate for the Cochlear hybrid because I lost high frequencies yet that is what they advertise, that it brings in the highs. Am I a candidate for any hybrids? Will I hear a baby cry, doorbells’ or telephones’ ring? The majority of implants done here are Cochlear but I read some say Cochlear’s storage space is almost maxed out. Will it be able to handle all the upgrades and new technologies that come out in the years to come? Will they work well with my Phonk aid? I know implants at the beginning sound mechanical and mickey mousey, and I also know it will take a longer time to adjust (6-8 months), since my hearing in that ear has been gone for 8-10 years. In your experience, on an average, typically how long does a person without hearing for 8-10 years take to understand and also hear the little things people so often take for granted? Does it ever sound “real” again? Once again, thank you for all your help. You don’t know how much it puts my mind at ease. Sincerely, Paula
Hi Paula:
The best thing to do is ask the surgeon who is going to do the CI. That’s the only person who matters. If he says you need it, get it. If he says to get one or the other or both on none, follow his advice.
The hybrid CI is only for people with fairly good low-frequency hearing. Your low frequency hearing mus be relatively stable too. If it is dropping, then the hybrid would only be good for a limited time. Thus they would want to implant the regular CI rather than taking a chance on your low-frequency hearing remaining at a reasonable level.
Which ear are they implanting. If they implant your left ear, you may still wear a hearing aid in your right ear. But if they implant your right ear, then you’ll be CI all the way.
If the CI works, you should be able to hear a whole range of sounds especially the higher frequency sounds.
I wouldn’t worry about Cochlear’s CIs not having enough “space”. They are always changing and improving each model and you’ll probably upgrade to a new processor every few years anyway. It’s just the implanted part that stays with you “forever”.
I can’t tell you how well it will work with your Phonak aid. I’m not sure exactly what you are asking here. Numbers of people wear a hearing aid in one ear and their CI in the other–and their brains put the two together to make sounds, especially music, sound better. Is this what you wanted to know?
That varies so much. Some people understand from day 1 and others take several months, but hearing continues to improve for 5 years or more. So some people hear these little things sooner than others.Hearing a new sound is called a CI moment. You can expect them to happen for years to come.
There is no “race”. Just take it one day at a time, and you’ll notice you are understanding more and more all the time. It will go faster the more you practice.
Many people say that in time voices sound normal again, but often music is still “off”.
Cordially,
Neil
Dear Dr Bauman,
Thank you for the article and addressing queries of patients. My daughter is 7 years old and she has a moderate hearing loss on one year and a profound hearing loss on the other. She has developed speech and converses well but lacks clarity and misses high frequency sound. She has not used hearing aid on either ear all this while. Recently, we got her fitted with hearing aid on the better ear. She has shown signs of improvement. Now we are considering a cochlear implant on the worse (profound loss) ear. Considering she has not worn a hearing aid on the worse ear, how do you see her chances of listening and comprehending from this ear? She already has good speech and hearing from her better ear. What would be your advise on cochlear implant?
Hi Pat:
My understanding is that as long as at least one ear has worked well in the past, then a cochlear implant in the other ear can work quite well. The secret is that your brain knows what to do with sound–no matter which ear it comes from.
So, if you want to consider a CI, go for it. A CI center will be able to tell you whether your daughter is eligible or not. (Her good ear may be too good and preclude her getting a CI.) The only way to know is to have her tested at a CI center. They will also tell you what they think of the chances of a CI working in her bad ear. I’d listen to them.
Cordially,
Neil
dear dr / NEIL BAUMAN
My daughter is very severe deaf ears, age 10 months, hearing test is greater than 97. China’s latest is cochlear N6 +512, you think we should implant two ear cochlear implant, or unilateral implantation, the other side of the equipment Hearing aids If only one side of the cochlear implant, a few years to install another whether there is an impact? How many years to do better?
Hi Ethan:
You need to check with a cochlear implant doctor at a cochlear implant center to see what he recommends. But since implanting both ears has advantages and kids implanted in both ears at a young age such as your daughter is, pick up vocabulary and talk normally with their peers by the time they are 3 or 4, that would probably be the best method.
If the doctor agrees, having her bilaterally implanted now would be ideal–before she even turns 1 year old.
Cordially,
Neil
Dr Bauman,
Im ~30 years old and currently looking at a cochlear implant for SSD as a result of labarynthectomy to relieve vestibular symptoms of Meniere’s Disease ( that surgery was less than a year ago). I am currently undecided on which company to go with and cannot really find any research on whether any company’s hearing technology or accessories are most useful for someone in my particular situation. My surgeon and audiologist all say they’ve work with all 3 companies on a regular basis and that the decision is mine. I know that I cant go wrong with any of them, but beyond that point I’d still like to make the smartest decision. Any suggestions/thoughts on the situation?
Hi Mo:
Since all three brands give more or less the same results, I’d go with the brand that has the features you most like. Some have remotes with controls you might like, or you might like fewer controls, etc. Some come with different accessories. And never forget how experienced your audiologist is with the brand you choose as you will have to rely on her to map your CI from time to time–so you want a nearby skilled audiologist for your brand. Apart from that, it is mostly what turns your crank.
Cordially,
Neil
Are there any invisable cochlear implants and if so, when did they come out? Thanks
Hi Amanda:
There are no totally invisible cochlear implants at this point–meaning that all the components are implanted so there is nothing external to see.
However, Both MedEl and Cochlear Corp make CIs that fit behind your ear–there is nothing on you ear or in your ear. With these, if you have hair (and women do) you can totally hide the processor in your hair. So from that point, they are invisible. MedEl was the first out with their Rondo. Then Cochlear Corp. came out with their Kanso.
So there are two good choices if you are worried about invisibility. Me, I’d be more concerned about hearing better and choosing the solution that gives me the best hearing.
Cordially,
Neil
Hi Dr Bauman,
Can you please advise if vestibular assessment is important when considering unilateral implant- is it a deciding factor. Also, if 2 ears are audiologically meeting CI criteria but one is weaker on vestibular assessment, would we prefer the weaker side or the stronger side and the basis for it.
Much thanks and Regards,
Manuj, learning Audiology
Hi Manuj:
I’m not qualified to answer your questions. You need to ask a CI expert, However, I do know that in the past vestibular assessment was given more importance than it is today.
Cordially,
Neil
Hello
I am a father of 4 year old boy. He has severe-to-profound hearing loss.
I want to raise funds for his cochlear implant. can you suggest how can I raise funds for this cause.
Hi Ashish:
Fundraising is not an area of my expertise. Sorry. You might want to look into crowdfunding via the Internet. Just Google the word crowdfunding to learn more about it and how to do this. I’ve heard that some people have raised money for CIs this way.
Cordially,
Neil
What will be the cost of Med El Rondo in india?
Hi Jagdish:
I don’t have a clue. You need to go to a cochlear implant center in India and ask them.
Cordially,
Neil
My daughter 1 year 3 months is likely to undergo CI Surgery on Left Ear and we are confused with the brand.We have been given options between Cochlear N6, AB Naida Q90 and Med-EL Synchrony.While Med-EL is 3 Tesla MRI Safe except Brain MRI and Sales Rep of Med-el is also saying it is easy to do surgery to eject Magnet incase of Brain MRI in Medel while others have a chance to destroying the device.On other AB appears to produce best sound quality but we are more inclined with N6 because it is more widely used by others and offers good accessories such as Mini Microphone etc.Which one is recommended?
Hi Arindam:
All three are good CIs, so you basically decide on the features that are important to you. If having MRIs is important, then the MedEl is the best in that regard. If accessories, or battery life or size or popularity, or whatever is important, then go with that brand. It’s always a compromise and it changes all the time.
So you have to make up your own mind after weighing all the factors of each one.
Cordially,
Neil
What about aural rehabilitation for adults after implantation? Is it a good idea?
Hi Donna:
Definitely. You need to work to train your brain to understand the new cochlear implant signals. The more you do aural rehabilitation, the faster and better your brain makes sense of the new sounds you hear.
Some people are exceptional and understand very well with little practice, but others–especially if they have had longstanding hearing loss, need a lot of aural rehabilitation practice.
Cordially,
Neil
Hello Dr. Bauman,
I have a 32 year old son who has severe to profound loss from birth. who previously refused to have a cochlear implant because of being too self conscious but now I’ve read that MIT was developing an invisible one – any news on that as I can’t seem to find anything since the article of 2014. Any info would be much appreciated. Thank you
Hi Frances:
They have been working on a totally-implantable cochlear implant for some years now. There were problems like how to charge the internal batteries, how to get the microphone sensitive to sounds when it is behind the skin, etc. When they get these problems solved, I think you’ll see such a cochlear implant. But I’ve not heard anything lately that one is imminent.
Your son needs to get over being self-conscious about being hard of hearing. That is even more important than getting an invisible CI. This is because, if you are self conscious about your hearing loss, you are not comfortable in telling people what you need them to do so that you can hear/understand/speechread them–and even with a CI, he will still have to do that because they do not give normal hearing–especially since he hasn’t heard much since birth. It could be a long road to reasonable success.
When you are comfortable with your hearing loss, you are not concerned about “invisibility”. You are glad to use/wear visible devices that let you communicate better.
Your son needs help in overcoming this self-consciousness. Most people don’t even notice hearing aids or CIs, but they DO notice when others have problems hearing them. In other words, not wearing a hearing aid or CI or using an assistive device is MORE NOTICEABLE than wearing one because it makes communication much more natural.
Cordially,
Neil
Hi Dr Bauman
Thanks for your advice above. My 5 year old son is due for Cochlear Implant Surgery in Left ear (worse ear) (profound hearing loss) in a few weeks time. He currently wears hearing aids for moderate to severe sensorineural hearing loss in Right ear and severe to profound SNHL in Left ear. We are still undecided about which brand to use but may go with Cochlear, as our ENT and audiology teams are recommending it due to their experience with it. Do you think that’s a reasonable choice?
How do the different ‘channels’ in AB vs Cochlear vs Medel work? I cannot understand the fact that even though AB has supposedly more channels, its performance in real life is almost same as Cochlear and Medel. Is it a matter of good brain perception of the signals coming through rather than the sheer amount of signal coming through?
Our son will continue to wear the hearing aid in the right ear. I know that Phonak and AB Naida can connect up. But if we choose Cochlear, will there by ‘harmony of sound’ between the Phonak hearing aid and the Cochlear Nucleus Implant?
Also, our son was diagnosed with Auditory Neuropathy Spectrum Disorder earlier this year (based on ECOG testing/Cochleography). Is there any medical evidence or experience of experts regarding benefit of Cochlear Implantation in ANSD patients?
Thanks
Izhar-ul Haque
From Sydney
Hi Izhar-ul:
You won’t go wrong with Cochlear. And you want to go with a brand that your doctors and audiologists are familiar with. So I’d follow their recommendations.
All three use different strategies to produce the sound, but they all have approximately the same number of physical electrodes. AB also has virtual electrodes, but they are all produced by signals on adjacent physical electrodes. Probably that is why they all have approximately the same results.
I’m not sure how well the Phonaks will “pair” with the Cochlear CI. You need to ask your audiologist about that. I’m not up to date on that at the moment.
As for ANSD, I seem to recall that getting CIs really can help such people. So I think you and your son will be happy with the results once the CI is activated.
Cordially,
Neil
Dear Dr. Bauman
I come from Uzbekistan. I’ve got three sons, 14, 12 and 1 year old. My eldest and youngest sons are deaf. My 1-year old youngest son is deaf. We had him examined in the clinics and the result was he is deaf. In my country cochlear impant costs about 16 thousand dollars, which I can’t afford to do it for my son. I’d like to acquire cochlear device implant directly from the manufacturer. Can you help me in this? Can you advise me ways I could get the device cheaper? Thanks a lot. I’ll be looking forward to your reply.
Hi Botirbek:
Sorry, I can’t help you with this. As far as I know, no cochlear implant manufacturers sell directly to the consumer. You have to go through and approved cochlear implant center, and as you know that cost money.
Since you need help with the cost, I suggest you contact some philanthropic organizations for help.
Cordially,
Neil
Hello Doctor
I want to thank you for your time and effort with this Blog.
I am considering a CI and the thread was very helpful. I will keep checking for additional updates.
THANK YOU again for your insight.
Happy new year to you and yours
Kind Regards
S. Mcled
Dear Dr Bauman
I am a medical physicist which a genetic hearing deficiency which has increased over the years. I have substantial low frequency hearing but lost all higher frequencies. Over the years, my speech understanding decreased from almost 90% (say 87%) to 80, then to a little more than 73% and without the high frequency it is below 50% so that I am now a CI candidate. However, what you state in you otherwise very helpful article should be updated somewhat as the difference between brands found in 2011 is not as irrelevant as you make it. Yes, it is small compared to 0%, but considerably larger for candidate with a remnant of 50%. Moreover, with 87% one understands a lot more than with 73%: it is for instance the difference between being able to converse easily by telephone or not. So I really, really regret, that the information on brand type is kept secret, even if current brand performance might be different. Moreover, as it is now almost 2018 I really feel that the information ought to be published now. With kind regards, Sara Muller, Amsterdam, The Netherlands.
Hi Sara:
I agree with you. The information should have never been kept secret–but it was and I have no access to it, so there is nothing I can do about it. I gave the best information that was available to me so everyone can be aware of this.
Cordially,
Neil
Hello sir,
I am very much influenced with the above details regarding CI. My daughters age is 6.8 years . She has severe hearing issue in both ears from birth. Due to financial issue I am unable to made the surgery. Now I want do the surgery. please advice me which model will fit for her . I am confused with the price due to financial issues. Now I want to surgery for one side. & other will after one /two year .Is it possible or any problem,please advice.
Hi Soumya:
You need to look at the current features of the various cochlear implants that are available in your country and decide which ones are important to you. Then you need to find a cochlear implant surgeon that is experienced with whatever implant you choose. Or choose the implant your surgeon suggests as that will be one he is most familiar with.
At the same time, you need to find an audiologist that is also very familiar with the implant brand you choose.
Both of these things are more important than the particular brand you choose.
Since you can’t afford both now, you have a good plan–one implant now and a second one in a couple of years.
Cordially,
Neil
Hello Dr.
I have a few questions for you. When my 2 years old boy install CI for 2 months, if any chance, one day to cure ears with stem cells, to pull back CI outside without any consequences. How deep and clear sound looks on Cl, does have horrible distorsion like robot digital with hi pass sound without low pass or just natural with little distorsion, can you desribe little more. Sorry on my bad EN. Regards
Milan
Hi Milan:
They are making the electrodes they implant less and less damaging to the structures in the cochlea so as to preserve any residual hearing. However, at this time, I don’t think they can remove the implanted electrodes without causing more damage to the ear. I know some people have had a bad electrode removed and another one inserted at the same time, but because of damage and scar tissue forming, etc, I don’t think stem cell therapy will give hearing back so they don’t need a CI. Maybe by the time stem cell therapy works, technology may have advanced to the point they could pull out the electrodes and use stem cells to restore hearing–but its not there yet (and may never be).
People who have had normal hearing and then lost their hearing and had a cochlear implant say that for a few days/weeks depending on the person that voices sound distorted/MickeyMousey/robot sounding, but then their brains associate these sounds with what they once knew and from then on, voices sound normal. Young children like your child seem to hear voices pretty normally ofter a few days or weeks. It’s a modern day miracle how well they work in children because their brains are still developing and learning and they develop to work with the CI.
Cordially,
Neil
Hello Dr Bauman! I’m age 42 SSD about 14 months ago. After mentally recovering and coming to terms with the condition, I am debating between a cochlear implant vs waiting for technology to improve. How long do you think it will be before stem cell rehabilitation will be a viable option? Just wondering whether to perform surgery now or wait. Thank you, Jason
Hi Jason:
I’d go for the CI now instead of waiting for stem cell therapy. It is still some years away. They need to get all the bugs out and prove that it will be safe before I’d recommend it. With this kind of thing, you don’t want to be on the leading edge. You want something tried and true.
I noticed that in India they are advertising stem cell therapy–but in the small print it says it may not work much or at all–so you know that it really isn’t ready for prime time.
Cordially,
Neil
I consider getting a cochlear implant in near future. The cost is definite the deciding factor for me. The info of the overall cost before and after surgery, mapping & speech therapy are very invasive. Unable to get a ballpark info of the costs.
Hi Justine:
You don’t say where you live, but if you live in the USA and have medical insurance, work with whatever Cochlear Implant company you choose. They most likely will be able to fill out the paperwork to get you approved at no cost to you. But you may still have some associated costs for the audiological services you will need for mapping, etc. They should be able to give you a clue what that will be.
You could join one of the several CI on-line support groups and ask around what costs people had to pay themselves. That should give you a good idea.
Cordially,
Neil
Dear Dr.
You are doing really a great job. I went through all the comments also. I am from India. Drs. have suggested my 3 years daughter for CI as she is detected with profound hearing loss in both the ears. My question is that should we go with Kanso of chochler company or nucleus CP 810 of the same company ?please elaborate difference between these.
Hi Satish:
The basic difference between the Kanso and the Nucleus is that the Nucleus is a 2-piece device–a behind-the-ear processor that looks like a BTE hearing aid and a separate coil that magnetically attaches to the corresponding implanted magnet behind the ear.
The Kanso has the processor and the coil all in one unit–so there is nothing on/in the ear–just the behind the ear unit. The Kanso is thus a “slicker” unit.
There are a few other minor differences such as the microphone on the Kanso picks sound up from behind the ear, rather than having a forward-facing microphone on the BTE processor, etc.
Cordially,
Neil
Neil Bauman. I am writing from Mexico where I volunteer and teach english at an orphanage. We have a small boy that is profoundly deaf and we have met with specialists and are currently working to raise funds for a cochlear implant. In that the costs involved are more than 1 years budget for the entire orphanage this is being a challenge. Are you aware of any of the manufacturers who will give discounts or at cost devices? That would clearly determine our choice. After much effort I have not been able to get any info from the companies themselves. The boy has just turned 6 and time is running out.
Hi Grant:
I’m not aware of any “free” CIs like there is with some hearing aids–for example, the Starkey Foundations “So the World May Hear” program.
It looks like you have asked around in vain. I have two suggestions. One is to see whether the hospital and/or doctors will waive their fees for the operation–or at least greatly reduce them, and second, see if you can raise the money via crowdfunding–one of the on-line ways of raising capital for specific projects. If you make a “good appeal”, you might get all the money you need.
I wish you well in this endeavor.
Cordially,
Neil
So my three-year-old has been implanted for 2 years and is doing great. I got him the nucleus 6 uses both KANSO and behind the ear. It’s just always in the back of my head if I should have gone with an Advanced Bionics. Some engineer I told me not to go with cochlear….. she had asured me that Advanced Bionics and Medel performed better??? Is there really one that has better sound quality especially with my son who has ANSD and wardenburg .
Hi Marilyn:
All three brands work well. But like all things, some work better in one aspect and others in another aspect. I’d like to take the best things from several brands of hearing aids and make an “ideal” aid for me–but that’s not the way it works in real life. Thus you have to compromise. Therefore, you choose the features you most want and go with it. You have made your decision on the Nucleus. So just go forward. Don’t try to second guess things now because it won’t help. The difference between the 3 brands isn’t much. We’re not talking about one being 75% better than another. The differences are maybe 1 or 2% which is not all that significant when you think how poor his hearing was before he was implanted.
I also think that each brand leapfrogs each other with each new model–so which brand you chose then may be different than what you’d choose today and different from what you’d choose in 3 years.
Don’t worry. You did not make a mistake. Your son hears ever so much better and that’s what counts.
Cordially,
Neil
Hello Dr. Neil,
Hope you are doing great.
I need your suggestion / advice.
My Baby boy has been diagnosed with Profound hearing loss 90 Db at an age of 1.5 years.
He is now 3 years old and from past 1 year he is wearing Resound Enzo 2 (12 channels) and going through AVT Therapy. He seems to be getting benefited from hearing aid from hearing perspective (he is responding to sounds in quet rooms) but his speech development is slow….he can speak few words like mama, abble, ba-ma-ma, etc..
With his recent aided audiometry test we found his hearing range is within mild to moderate listening with the hearing Aids and his speech evaluation corresponds to a baby of 1.7 years even though he is of 3 years now.
With due respect, I seek your advice on:
1. Whether a Cochlear Implant is going to give him reaching a normal speech
2. What are the chances that he can lead a normal life without the implant but wearing the best available hearing Aid in the market? Kindly guide me.
3. Also in case you suggest CI, please suggest what CI (2-3 options if possible) can i go for which can have compatibility with maximum range of available processors in market?
Thanks again for your guidance.
Hi Susobhon:
There are no guarantees that a CI will give him normal speech development, but children that get implanted at an early age typically have normal speech development by the time they have had their CI for a year or two. So, yes, I think a CI would really help him. Obviously, his hearing aids are doing the best they can, but it is not enough for him to hear reasonably normally in other than quiet situations–which are rare in our noisy world.
I think he will have a better chance of leading a “normal” life with CIs than with hearing aids. I think it will make things much easier for him. He won’t have to strain to hear so much.
Any of the three main CIs are good. So he should do well with any of them. Choose the CI brand based on which one his doctor is most familiar with and which one the audiologist who will program it is most familiar with. Their skill with the CI brand has a lot to do with his ultimate success. If you still have some choices, then go with the one that has the features you think will most benefit him in his lifestyle, ease of use, battery life, etc. Some people think one feature is more important than another–so it boils down to personal preference at this point.
Cordially,
Neil
Hello Dr Bauman,
We’re looking for an unbiased view as the 3 companies obviously are trying to sell their products. My daughter (age 4 in August) with EVA and Mondini incomplete partition type 2, is getting close to the need for a cochlear implant in her right ear. I asked the surgeon about brand/electrode array preference based on her anatomy as well as our desire to preserve residual hearing and not cause additional vestibular deficits (as she has balance issues). Our surgeon said she could implant any brand with her anatomy. Based on my research, I understand best speech perception outcomes and less chance of vestibular loss has to do with preserving the structural integrity of the cochlea and not causing trauma. I understand this is best accomplished by the array staying in the Scala tympani vs moving into the Scala vestibuli. And the best way to achieve this is using a straight flexible lateral wall array vs precurved. She’s doing astonishingly well with her degree of loss, in a mainstream preschool, speech and language is above average. We of course want to keep her progress on this path and are trying to be very diligent with our research and choices. Of course we are looking for best outcomes and are willing to go with whatever brand/array is recommended but we’re not getting much direction from our team. Would love any feedback you may have. Is my research accurate or am I falling into the marketing trap?
Thank you,
Pam
Hi Pamela:
As you know, every manufacturer claims theirs is the best–whether process, or electrode implanted parts or programming, etc. And often the studies reported have so few participants, it is hard to know how reliable the studies really are. For example, one manufacturers study using the soft straight electrodes only included 5 subjects. That is far too few to conclude anything.
One retrospective study concluded, “Data seem to suggest that cochlear function is less sensitive to mechanical trauma during implant surgery than was thought. Besides, electrode array stiffness seems not to influence preservation of cochlear residual functional integrity.”
Therefore, don’t worry to much about the electrodes and how much residual hearing may or may not be preserved. All all pretty good. A lot depends on the skill of the surgeon–so finding a very experienced surgeon with a better than average track record is probably far more important than the exact electrode array used.
Thus focus on finding that good surgeon and go with the implant he most often implants. That’s one way to solve it.
But you also need to look at the three brands and decide what features are most important to you–that could influence your choice too. Don’t just focus on the electrodes.
Cordially,
Neil
I am 66 yo with profound hearing loss in both ears, almost all in the high range. My ENT says that i will become a candidate for CI – just a matter of time. I have tinnitus which is causing problems hearing higher pitches. Can CIs cause the tinnitus to become worse than it already is? Is there a brand that deals with tinnitus better? I currently have very high end Starkey Halo 2 aids connected to iPhone which helps with phone calls and listening to music. However, what is interesting is that with Apple airbuds, i can hear phone calls and music on phone better than with aids! $149 compared to $8k! You have any idea why? Does that mean CI may not be helpful? Going next month to start evaluation. This blog very helpful!
Hi James:
Most people that get cochlear implants (CIs) find that they have a reduction in their tinnitus when they are wearing them, but their tinnitus comes back at night when they take their CI off.
A few people have increased tinnitus due to the CI being implanted. So there are no guarantees when it comes to tinnitus, but the odds are really in your favor that your tinnitus will be reduced, but it could stay the same or get worse.
I’m not aware of any brand differences in regards to tinnitus.
As regards to hearing better on phone or music, this can be because the Apple earbuds and phone have better frequency response than your hearing aids do. And if you still have some hearing “up there”, the result is that you hear better. Also, some people just like less-processed sounds than what you get with hearing aids. That is why many older people like the sound of analog devices rather than what they hear via their digital hearing aids.
Cordially,
Neil
Hi doc Neil Bauman, I am searching for brand of CI, many references i read still confuse to choose. I wanna focus to hearing preservation, my low freq is mild hearing loss.. and i am a doctor. Which one do tou recommend? And i am going to bimodal solution.,
Hi Annisa:
Since you still have good low frequency hearing, you are wise to look for a cochlear implant with a short electrode array. This will hopefully preserve your low frequency hearing while giving you high-frequency hearing via the CI.
Therefore, choose a CI manufacturer that makes these hybrid electrode arrays. Each manufacturer has their own differences in their arrays. I’d talk this over with the surgeon that is going to do the implant and take his recommendations. You want to find a surgeon that is skilled in implanting the array that you ultimately choose. I think this is even more important than the brand of CI that you choose since all of the are good.
Cordially,
Neil
Dear Dr. Neil,
My son is 6.5 years old with severe hearing loss. He was fitted with hearing aid in both ears since he was 9 months old. The progress rate for his language development is not sufficient and we are considering the option of cochlear implant. I am hesitant to choose between MEDEL and Cochlear. I would like to get your recommendation which to choose and is my child age going to be a barrier for him to benefit from this technology or is it too late. Should I take the risk at this age?
Appreciate your reply.
Thanks
Muhib Shamsan
Hi Muhib:
It’s not too late for him to get a CI (or 2). It’s not like he hasn’t heard at all–he’s worn hearing aids for 6 years now so his brain has developed his auditory processing circuitry. So if you are considering get him cochlear implants, go for it. The sooner the better so he can catch up to his peers in language development.
Both MedEl and Cochlear are excellent CIs, so it doesn’t really matter which one you choose. Base it on the features you want rather than on the brand. Also, base it on the experience of the CI surgeon. If he mostly does MedEL, go with that (or vice versa). The experience of the surgeon with a particular make is very important. So too is the experience of the audiologist who will do his mapping with that same make of CI.
Cordially,
Neil
But what if the manufacturer of my choice today, ended the business or bankrupted in the future. What will my son do then. The device is not exchangeable . Meaning I can’t change the brand of the external device if I have to. What about the long term effect of electric pulses shooted into to my son’s head for many many years. I know that there are people wearing it for long time now, but it might come up and who knows what is not even reported.
Hi Muhib:
That’s a risk you have to take. So far, this has not happened to any of the big three cochlear implant companies and I don’t foresee it likely happening.
It is possible that the implanted electrodes can be explanted and new electrodes implanted. This has been done in cases where something went bad with the implanted part–so replacing it with a different manufacturer’s implant wouldn’t be a problem. In fact, I think I’ve heard of this being done in the case of implant failure and implanting a different manufacturer’s electrode array.
I’m not aware of any long term side effects from the electronic impulses. Some people are sensitive to certain electrodes causing problems, but then the audiologist turns those electrodes off and the problem goes away.
Personally, I wouldn’t be worried about “hidden” future long term side effects. None have surfaced as far as I know and cochlear implants have been around (and approved) since 1984. That’s 34 years now. You’d think they would show up by now if they were going to.
Cordially,
Neil
I kown that products from Three brand AB , Cochlear and Med-el . They all perform well. I kwon about Med-el implant electronics array hurt much less when insertion. Such as : round window entrance , incidence rate from ST(scala tympani) to SV( scala vestibuli ). Even that , the disadvantages of pre-curved MH electrodes will be solve well by an expert surgeon.
What I worry about is the hurt when it pulling out if it need to be removed off in future about 30 or 50 years becuase of new technology, It’s that ture that pre-curved MH electrodes will hurt a lot more then Straight lateral wall (LW) electrode arrays when pulling out?
Hi Cuimingfei:
That’s a question you should ask a CI surgeon. He’ll be able to give you a much better answer than I can.
Cordially,
Neil
Hello,
I love the article but as a mother of a 3 year old having a baha and now have to change for a cochlear implant I would like to know what company is the best. Her doctor gave me the names and manuals to read and decide but for me they all sound the same with some differences but minimal. I’m really looking to do the right choice, if you can help me I would appreciate very much.
Hi Ana:
I can’t tell you which is the best CI to get. They are all good. As as you found, their differences are generally minimal–it really comes down to what features you like the best, and who is the best CI surgeon and CI audiologist in your area.
You’d be better to go with the surgeon’s favorite CI–the one he has the most experience with if you don’t have strong feelings for one of the others. And the one the audiologist is most comfortable with too.
Cordially,
Neil
Hello Dr.
My 23 months old son was identified with Auditory neuropathy. He hears sounds but does not speak or understand speech. We tried low gain hearing aids but no improvement. We were advised to have CI. Which kind is the best for his condition. Any advices regarding his condition? Thank you
Hi Reetta:
I’m not too familiar with auditory neuropathy so can’t really answer your question, but from what I know, I don’t think it makes too much difference which brand of cochlear implant you choose. They all work well. Better to choose the brand based on the expertise of your CI surgeon and the skill of the audiologist that is going to be programming it for your son. That will make a bigger difference than which brand you choose.
Cordially,
Neil
Can you at least tell us who did the research that showed the difference in CI’s? Has the research been repeated on new models? I never believed that they really all were equally good, nor do I believe that the new technology will somehow make the rankings will change that much.
Hi Leah:
I’d do so if I knew who did the research, but I don’t. The article I read carefully kept such things a mystery. I’ve not heard of any more research on new models to see which one is the best. So it remains a mystery.
Cordially,
Neil
Dear Dr. Neil,
My son has severe to profound hearing loss at both ears and he has been wearing hearing aids since age of 7 months. Currently, he is 5 years old but he didn’t develop a good vocabs that match with his age. The doctor recommended to do CI in the right ear and keep the left ear equipped with hearing aid. Do you recommend the same or shall we go for CI for both ears? He stated that having both hearing aid and CI would play a better benifit in his speach development and also he would avoid the shock he would face when both ears Implanted. Please advise.
Hi Ahmad:
Your doctor has given you good advice. And you can always add the second CI later if that seems to be efficacious at the time.
Cordially,
Neil
Hi Dr Neil
Thanks for your valuable advice.My daughter had a ci surgery in her right ear at age of 5 in 2007.Implant was of ab hires 90k.My ward is doing average now.I wanna a honest suggestion should I upgrade to new technology or go for surgery in her left ear at age of 16 right now.Waiting for your reply
Hi Hemant:
I don’t see it as an either/or situation. Upgrading the external processor can sometimes yield very significant improvements, so it is worth considering this. I’d probably do this first.
Then, in a year or so (after she gets used to the new processor’s capabilities and her brain adapts), you’ll see how much improvement there was. At that point, you should evaluate her situation and if all is well, I’d probably have her second ear implanted.
Cordially,
Neil
Please advise ,which Brand is best for Cochlear implant .Kanso or Naida CI90
Hi Niraj:
The question is not which one is better, but which one do you prefer. It really comes down to a personal choice, and I can’t make that decision for you.
Cordially,
Neil
Hi Dr. Neil Bauman,
I have a unique question to ask you. I am 42 years old and have been implanted with a cochlear implant (cochlear) in 1993. I immediately recognized speech and could talk on the phone on activation day. Around 2013 the internal stopped working and had to be replaced (cochlear). A word of caution for all the readers on this website, getting your internal component replaced with one that has improved technology does not guarantee improved hearing. My hearing actually got worse with the new internal. Having said that, I still hear good enough to talk on the phone with people who’s voice i am familiar with. My other ear has been completely deaf all my life. I want to get that ear implanted in spite of the small chances for success. I have talked to some experts and they have said that there has been some success with people that have been deaf longer than I have. I just don’t want to become a senior citizen and look back on my life and regret of not giving it a try. I think the odds of success are still much better than winning the lottery! Having said that, do you know of any company what would be willing to give it a try?
Hi Thomas:
The good news concerning your deaf ear is that you may have good success (relatively speaking) with a CI. This is because if even one ear heard well at one time, your brain built the infrastructure to process sound and that is still being actively used by your other ear/CI. Thus, it’s not as if your didn’t have any sound processing capability at all. So if you are wanting to try and see how well a CI in your long-deaf ear will work, go for it.
I’m not sure what you mean by “any company willing to give it a try”. All you need to do is find a CI surgeon that is willing to give it a try.
Cordially,
Neil
Wow! This is huge! What I meant to ask was, which company has the most successful track record in activating life-long deaf ears in middle aged adults?
Hi Thomas:
I don’t keep track of such things, so I can’t answer your question. But I still think it has more to do with the skill of the surgeon and the programming ability of the CI audiologist than it has to do with who made the CI.
Cordially,
Neil
Hi Dr. Neil, how long does it take the brain to adapt and become normal to the new sound after CI surgery/ recovery?
Hi Allen:
It really varies. Some people hear fairly normally within 2 or 3 days (not all that common). Others take a few weeks (common), and for some it takes months.
I think a lot of this depends on how recently you lost your hearing. If you suddenly lost your hearing and got a CI a month later, you would probably have very good success almost immediately. However, if you haven’t heard from that ear in 25 years, you could expect it to take much longer for you to understand speech.
Incidentally, for many people, hearing with their new CIs continues to improve for a number of years–even after it sounds “good”–up to 5 years or more as your brain fine tunes itself to the CI signals.
Cordially,
Neil
Hello Neil,
Thank you so much for all the information. My nephew had Meningitis and was treated with antibiotics. But after the treatment he could not hear anymore. After multiple confirmations he is being advised for CI in India. He is 9 months old. what care should we take as there seems to be risk of Meningitis from CI. Also as per study CI’s with support pad seems to have more probability for post CI Meningitis. do AB or Cochlear have any such support pads now ?
Hi Sai:
As far as I know, all CI manufacturers have redesigned their CI implants to reduce the risk of getting meningitis so I don’t think you have to worry any more. At one time it was a problem with certain implants, but I haven’t heard of recent problems. To be sure, ask the surgeon at your CI implant center about your concerns. He should be able to advise you of the latest information.
Cordially,
Neil
Hi Dr. Neil,
How long do the implants last? I’m just wondering when you implant a CI in a young person, how many years before they would need additional surgery to replace the CI components?
Hi Mary:
The internal implant can last indefinitely. I know people with implants that are more than 20 years old. The external processor can be upgraded as new processors come out. Typically processors are backward compatible with the internal electrodes.
Be aware that the internal components can fail. I think that happens in up to 3% of them over time. When that happens, they typically explant the failed unit and replace it with a new one.
Cordially,
Neil
Dr. Bauman,
I am a 44 yrs old male who had perfect hearing all my life. Then due to labyrinthtitis, my right ear has gone deaf in Aug 2019.
After 3 months with no improvement, my doctor recommended CI.
Is CI a good idea for SSD? If I wait a couple of years is there *any* chance my hearing may come back??
Hi Thomas:
Using a CI for single-sided deafness is a new thing. Med-El was the only manufacturer to be approved by the FDA for using a CI in single-sided deafness. This just happened a month before you lost your hearing (July, 2019).
It should make a big difference to your hearing in noise, and it will give you directionality of sound.
The other option–a CROS hearing aid won’t give you those two benefits. Basically, all a CROS aid does is pipes the sound from your deaf side into your good ear so you can hear better from your deaf side–but doing this doesn’t give you directionality so you still can’t tell where sounds are coming from.
If there has been no improvement for three months, I sincerely doubt you will get any hearing back in the future. So, if you like the idea of a CI, go for it.
Cordially,
Neil
Neil,
I am SSD through a complicated series of events: Micro vascular decompression surgery for trigeminal released a virus (probably some variety of shingles/herpes) that attacked my nervous system. I ended up with Bells Palsy, hearing loss and some balance issues. The Bells Palsy mostly resolved but I continue to have numbness on the affected side of my tongue and an uncomfortably unmoving section of the area below my lip. Despite steroids, steroid shots, etc the hearing loss is profound and hasn’t returned. I see a doctor next month about the possibility of a CI and really like the idea except I am terrified of the idea of another surgery so close to the one that gave me all these problems. I also have a plate in my head where the MVD was so not sure if the placement can be in the normal spot for the receiver. Have you ever heard of someone having CI after MVD or other brain surgery on same side? Any special things I should ask the doctor? I already plan to insist on antivirals before and after surgery prophylactically to ensure that the same thing doesn’t happen. Are steroids usually prescribed after the surgery in case of swelling?
Hi Valerie:
Too bad you hadn’t contacted me before you had the MVD on your trigeminal nerve. I could have put you in contact with the world’s expert on eliminating trigeminal neuralgia without surgery. But that is in the past now.
Why is your doctor recommending a CI? If I understand it, you have profound loss in one ear and I assumed normal or near normal hearing in your other ear. Normally, you aren’t eligible for a CI if you have normal/near normal hearing in one ear. The non surgical solution for this is to wear a CROS hearing aid that takes the sounds from your deaf side and transmits it to your good ear so you can hear from both sides of your head via your good ear.
I don’t know of anyone that had MSD and then got a CI on that side. I do know one lady that had brain shunts and multiple brain operations–and she has a CI, in fact, I think she has two and they work for her.
I also don’t know whether they normally prescribe steroids for such surgery. I’m not a medical doctor so don’t necessarily know such things.
Cordially,
Neil
Hello Dr. Bauman,
my son’s Advanced Bionics internal device failed and now we are deciding if we should re-implant him with the same or different brand (Cochlear). Do you have any experience with re-implantation and what would you recommend? His audiologist is fine with either option.
Hi Damira:
Reimplanting a CI sometimes doesn’t work as well as the original implant. I think it is because of damage done in explanting and reimplanting the internal piece.
Often, what people do is get their other ear implanted. Then it doesn’t matter which brand you choose. I know people that have different brands in each ear, however, I think it best to stay with the same brand in both ears–so you get better balance sound as each brand of CI processes sounds a bit differently.
Both Advanced Bionices and Cochlear (and MedEl) are all good CIs so go with the one with the features you like the best–and the one that has a surgeon experienced in that brand, and even more importantly, with an audiologist experienced in mapping the brand you choose.
Cordially,
Neil
I had a Bionic CI put in about five years ago, and it took over two and a half years, and it never worked. Then they replaced it with a new one and it still isn’t working, my hearing is even worse now than it was before. I cannot understand phone calls or conversations at home, and in restaurants. I have even had to quit going to church because I couldn’t understand the preacher or any one any place I went. I have to admit that it was plenty loud enough, but the clarity was totally horrible and there are very few people I can understand at all. The audiologist said the was nothing else he could do for me. He told me he could put another one in the other ear, but I declined to do so because if that on didn’t work I would be totally deaf. Perhaps it was the Doctor, and if it was a bad choice without checking out the Doctor, how could I have picked a more experienced Doctor? I enjoyed reading your blog