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Which Cochlear Implant is Best?

If you have recently discovered that you need a cochlear implant, you may be wondering which one is best.  How to pick a cochlear implant is one of the top questions we get at the SayWhatCub, and we understand how stressful choosing one can be.  Knowing that we will be stuck with whatever brand we choose for the next twenty or thirty years, we all hope to pick the best one. Surgeons and audiologists are rarely helpful when it comes to choosing a processor.  There are no independent studies indicating which cochlear implant is best. Unless you have a background in electrical engineering, understanding how they work can be confusing. Most surgeons have never tried out the cochlear implants they place in their patient’s heads.  Few people with cochlear implants have experienced more than one brand.  Comparing brands seems all but impossible.

In this post we’ve interviewed three of our SayWhatClub members.  We’ve asked each of them the same questions about their cochlear implants. Ilene wears two Advanced Bionics Marvel processors.  Ann Marie wears a Med-El Sonnet with a hearing aid, and Pat wears two Cochlear Americas Kansos.  We hope this post will enlighten you and help you make the best choice that is right for you.  People with cochlear implants tend to talk in technical jargon related to their devices.  For clarity, I have written notes in italics.

When did you get your first cochlear implant?

Ilene (Advanced Bionics) I Got my first CI in January  2020 after a decade of resisting the notion.

Ann Marie (Med-El) October 2014.

Pat (Cochlear Americas) I got my first one in 2016 and my second one in 2021.

Do you have one or two?  Why?

Ilene (Advanced Bionics) I found the first one to be such an improvement that I started thinking about doing the other ear about 4 months in and had the surgery in December 2020.

Ann Marie (Med-El) I have one. I hear well with one and don’t feel the need to go bilateral. I have a little bit of low pitch hearing in my other ear and use a hearing aid just so I have some sound on that side.

Pat (Cochlear Americas) I have two. I stopped wearing a hearing aid in my unimplanted ear, because it seemed like it actually worsened the clarity of my hearing. My doctor told me that was a sign to get the second one. I wanted to hear in stereo again.

Why did you pick the brand that you went with?

Ilene (Advanced Bionics)  I spent too much time agonizing on which brand to choose and ultimately went with Advanced Bionics.  I felt their internal device is well suited for advances in the future.

Ann Marie (Med-El) MED-EL. The reasons I chose it in 2014 were at that time they were the only company that had an off-the-ear processor and the only company who made implants that were MRI compatible and didn’t require magnet removal. I also thought their longer electrodes seemed like a good idea. (Note:  All brands currently offer MRI compatibility on their newer electrode arrays.)

Pat (Cochlear Americas) I chose Cochlear America for several reasons. My accessories that went with my Resound hearing aids that I already owned like TV streamer and Mini Mic would work with them. Also at the time they were the only company that had direct streaming to your phone. I hated carrying a remote. I talked to several people with different brands and it at least seemed that the Cochlear users were the most satisfied. I was also impressed with their customer service.

How long did it take to get used to?

Ilene (Advanced Bionics) I did a lot of training the first month and speech normalized quickly by the end of it.

Ann Marie (Med-El) Not long.  I understood speech when I was activated but it took about 3 months for the robotic cartoonish voices to sound more normal.

Pat (Cochlear Americas) I was understanding language within a day and things began to sound more normal after a few weeks. I did the work and wore the processor all day. At 2 months I had 82% word recognition. It was pretty quick for me.

How well can you hear with it compared to how you heard with hearing aids?

Ilene (Advanced Bionics) There is no comparison between my hearing aid hearing and my CI hearing.  I struggled for years with power aids. Now I hear  pretty naturally.  I don’t have to think much about it.

Ann Marie (Med-El) By the time I decided to get tested for a CI, understanding speech with hearing aids had become very difficult. With my CI I hear and understand well in most situations.

Pat (Cochlear Americas) Night and day difference!  My last testing had me at 98% word recognition. I could basically not understand anything with my hearing aids unless I was lip reading at the same time.

Are you able to able to converse in noise, such as at noisy family gatherings or at restaurants?

Ilene (Advanced Bionics) It is much easier to hear in noise now, but not perfect.  I use my old coping skills of speechreading  when needed.

Ann Marie (Med-El) Yes.

Pat (Cochlear Americas) I do pretty well and it is getting better. I like using forward focus in these situations. (Forward Focus is a program on Cochlear processors that cuts background noise and focuses on sound in front.)

Can you watch TV without captions?

Ilene (Advanced Bionics) I can watch without captions but like to use them anyway.

Ann Marie (Med-El) In the first years of having my CI I relied on the captions.  As my brain continued to adapt over the years, I still keep the captions turned on but I understand a lot of what is being said so I’m not totally dependent on them.

Pat (Cochlear Americas) Yes, though I keep them on most of the time out of habit. I adore my TV streamer.

Can you hear on the phone?

Ilene (Advanced Bionics) I stream calls directly to my processors from my cell phone.  I also use a special phone program for landlines at work.  I can hear very well.

Ann Marie (Med-El) It took a few years for this to happen but I would say most of the time I understand phone conversations.  I do like having a CaptionCall landline and InnoCaption on my cell just in case I need them.

Pat (Cochlear Americas) Yes!  It took me a long time after implantation to get over my phone phobia with hearing aids but now I don’t even think twice about calling someone.

How does hearing with a CI compare to normal hearing, if you previously had normal hearing?

Ilene (Advanced Bionics) I have had declining hearing loss since I was eight years old.  I lost all high frequency sounds first. I now enjoy birds singing.  Speech and music sound very natural to me now.

Ann Marie (Med-El) I have a progressive hearing loss that began in my late 30’s.  My CI doesn’t give me back what I had before but it’s close enough.  I always say it’s my new “normal”.

Pat (Cochlear Americas) It seems pretty comparable to me. I don’t notice a difference. Music might still be a little off, but I love understanding lyrics now.

Is your cochlear implant company supportive when you have questions or a problem with your device?

Ilene (Advanced Bionics) My Advanced Bionics representative was very helpful during the selection process.  She came to my home and showed me all the accessories and how to use them.  Advanced Bionics has email, phone and chat support.  They are very responsive.

Ann Marie (Med-El) Thankfully in the nine years I’ve had my CI I haven’t experienced any problems with my devices. In the few times I’ve had to contact customer service they have been helpful.

Pat (Cochlear Americas) Yes. They have promptly taken care of my few issues.

Did your device come with a warranty?

Ilene (Advanced Bionics) The processor has a five year warranty, that I think is standard for the industry.  Most accessories have a one year warranty.

Ann Marie (Med-El) Yes.

Pat (Cochlear Americas) Yes.

What are some of the things you like about your cochlear implants?

Ilene (Advanced Bionics) They gave me back my hearing, I am grateful every day for the technology.

Ann Marie (Med-El) For the most part, it enables me to live my life as I did before losing my hearing.

Pat (Cochlear Americas) I love having my off the ear option. I love getting my life back to normal with pretty normal hearing. I  weirdly even love the option of silence at night, on planes, or whenever I choose.  They also rid me of my tinnitus.

Are there things about your cochlear implants that you do not like?

Ilene (Advanced Bionics) Nothing comes to mind.

Ann Marie (Med-El) I can’t think of anything I don’t like.

Pat (Cochlear Americas) I really cannot think of anything. I mean I would prefer to have natural hearing without all the equipment but this comes pretty darn close.

If you wear two, do you hear better with one ear or the other?

Ilene (Advanced Bionics) They work together like stereo speakers do.  I can hear with just one, but 2 is so much better with a full, rich sound.
Ann Marie (Med-El) I only have one.
Pat (Cochlear Americas) I always wear them together which sounds better than alone.

How easy is it to charge your device?

Ilene (Advanced Bionics) I have a spare set of batteries so I can always swap them.  The electric/USB charger is small and takes about 7 hours to fully charge a set.

Ann Marie (Med-El) Very easy.

Pat (Cochlear Americas) Super easy. My Kanso 2’s go in a charger/dryer at night and are ready to go in the morning.

Do you have different programs on your devices to accommodate different listening situations?

Ilene (Advanced Bionics) I do have different programs, but use “autosense” ninety-five percent of the time.  I also have a “speech in car” program and  a “speech in noise” program. (Autosense is a program that automatically detects the listening environment and self adjusts accordingly.)

Ann Marie (Med-El) I have a few different programs, but I always use the same program which adapts well to my listening environment.

Pat (Cochlear Americas) I have 4 programs but never change from Scan.  (This is similar to AB’s Autosense program.)

How do you change programs?

Ilene (Advanced Bionics) I can toggle through programs using the processor button, or I use the AB app on my phone.

Ann Marie (Med-El) With a remote.

Pat (Cochlear Americas) I can change on my phone app or Apple Watch where I really do everything CI related.

does your brand offer a “swimmable” option?

Ilene (Advanced Bionics) I have the waterproof battery for the Marvel processor and the older Neptune processor that is submersible.

Ann Marie (Med-El) I don’t swim but Med-El makes waterproof covers called WaterWear.

Pat (Cochlear Americas) I have the aqua kit for swimming, but never use it. Mine fell in the deep end of a pool once, and it took about ten minutes to locate. I was shocked when I put it on and it worked perfectly. I snorkel deaf.

Does your brand offer an off-ear option?

Ilene (Advanced Bionics) Advanced Bionics does not offer a totally off ear processor because they find their T-microphone that needs to be worn by the ear opening gives better results than a microphone on your head does.

Ann Marie (Med-El) Yes.

Pat (Cochlear) Yes.

Does your brand offer other extras, such as disposable battery option, Assistive Listening Device, TV streamer, swimmable protection?

Ilene (Advanced Bionics) Advanced Bionics offers a full range of accessories for different listening situations.  I use a Roger microphone to stream  entertainment  on plane trips.

Ann Marie (Med-El) My Med-El Rondo 3 has an internal rechargeable battery.  I can use either rechargeable or disposable batteries with my Sonnet.  Med-El has AudioLink which is a universal connectivity device which can be used to connect Rondo 3 to phones, tablets, TV’s and other devices. Phones calls and music can be wirelessly streamed to the Sonnet or Sonnet 2 using the Audiostream battery cover.

Pat (Cochlear) All those options. There is no disposable battery option with Kanso 2 but there is one with the Nucleus models.

Final Thoughts

One of the challenges of comparing brands is that none of us have similar hearing backgrounds or situations.  These three cochlear implant recipients were each considered late-deafened, as they all became deaf after learning to speak.  All wore hearing aids successfully before getting their cochlear implants, until hearing aids were no longer helpful. When someone wears two cochlear implants of the same brand, they may find their hearing is different on each side.  Hearing well with a CI has as much to do with the individual ear as it does with the technology.

They are all good.

All of the cochlear implant companies provide the best opportunity for hearing when hearing loss is so severe that one becomes a cochlear implant candidate.  All three of the cochlear recipients said they preferred their cochlear implants over their hearing aids, and that they heard better than they did with their hearing aids in the past. None of them wish they had chosen another brand, or had any complaints about their cochlear implants or their cochlear implant companies.  The special programming strategies for communicating in noise, on the phone, for watching TV or when in water are comparable for each brand.  Two of the brands offer completely off ear options.  Not everyone likes that option, while others are very happy with it.  All current electrode arrays are MRI compatible, but those who were implanted in the past may not have MRI compatible electrode arrays.

For more information, you may wish to look at this comparison chart at Cochlear Implant Help Online.  Be sure to check back often, because the comparison chart is updated frequently, as each company constantly strives to improve their products.

Though this is by no means an independent study, we hope this article will offer some reassurance as you begin the process of selecting a cochlear implant.  If you have more questions about wearing cochlear implants, the SayWhatClub has an active cochlear implant email listserv with several cochlear implant recipients who will be happy to answer any questions you may have.  No question is too silly.  We have all been in your shoes and know exactly what it’s like. Join here.