I'm considering a MED-EL cochlear implant. What is best hearing aid to wear with it?

Audiologist in Phoenix

25 May 2017 - 3.3K Views

While the MED-EL cochlear implant is a good product, it does not currently have a partner hearing aid company that is compatible.  If having compatibility between technology is something that is important to you, you may want to consider the other implant companies that are out there.  Both Cochlear Americas and Advanced Bionics have partner companies, Resound & Phonak respectively, that make compatible hearing aids that allow for the use of assistive listening devices in both ears at the same time.  Advanced Bionics has taken it a step further by developing a hearing aid (the Naida Link) that allows for communication between the devices to provide additional benefits aside from assistive listening devices.

If you choose to stay with your MED-EL decision, wearing a hearing aid in the opposite ear will still be beneficial, but you will give up some of the additional benefits of the other assistive devices that can have a dramatic improvement in a variety of situations including background noise and telephone.

 

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Chris Harmon

Professional Member

25 May 2017 - 3.3K Views

I am not familiar with the Med-El implants. Saw a terrific presentation from a representative from Advanced Bionics and I believe they have a partnership with Phonak, I looked on the Med-El website and it mentions the ROGER pen microphone. While it is compatible with other manufacturers, I would have to say that Phonak would be the best option. Best of luck to you!
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Discussion

Dan S
Dan S 25 May 2017
I tend to agree with Chris on using the AB/Phonak solution, especially since the implant circuit is only operating at maybe 30% capacity, while Med-El & Cochlear are at 100% capacity. The externals are all upgraded every couple of years; but it's what's installed into your head that will be there for the next 20+ years, so choose wisely. If you insist on Med-El, if you've worn hearing aids more than about 15-20 years and like the old analog sound, then the basic ReSound Enzo² 598 set to linear for speech envelope preservation is your best bet. Most important is choosing the right surgeon so that your residual hearing is preserved, i.e. uses residual hearing preservation techniques, for the best results. For more, see Selecting a Cochlear Implant Surgeon.
Member
Member 26 May 2017 Replied to Dan S
One of reasons I'm looking at MED-EL is that they offer hybrid hearing for people like me who still have residual hearing. Only problem is that MED-EL, like you all said, does not have a compatible hearing aid for me to use in my other ear. I looked at AB but they don't offer hybrid. Any recommendation which CI you would use if you had residual hearing?
Member
Member 12 March 2018 Replied to Member
Please read the comment below which gives a link to MED-EL's bimodal solution and compares it to the AB and Cochlear bimodal solution.
Dan S
Dan S 12 March 2018 Replied to Member
Yes, AB has a hybrid; but it uses a full-length electrode, so that even in the case of excellent surgical technique, sometimes residual hearing goes away anyway; but at least with a full electrode, you're not screwed/
Member
Member 26 May 2017 Replied to Dan S
Dan, Just read article on Selecting a Cochlear Implant Surgeon and will definitely print a copy when I see my surgeon next week to go over which brand implant I want. Hopefully, the surgeon I chose (Dr. Wade Chien from Johns Hopkins) has good track record with preserving residual hearing) since I have no way of checking. In your opinion and insight into the different CIs, which would you recommend would be best for someone like me who has residual hearing ? Thanks
Member
Member 12 March 2018 Replied to Dan S
Please don't tell people implant cut hits are at 100%. Not correct.
Dan S
Dan S 12 March 2018 Replied to Member
WTF are you talking about?! If you're talking about capacity, Cochlear's implant is strained at 30k forward updates/sec, they only have one current source; and even current shorting didn't work. Med-El has separate current sources for each electrode; and they are up at about 55k forward updates/sec. However, their implant can only fire (signed) + or - charges simultaneously. Oticon Medical's CI has 20 electrodes, and also runs at about 55k forward updates/sec. AB has a completely different architecture for the Clarion and shortly thereafter HiRes 90k: When the implant is switched on, or a different stim is selected, it takes about 1.5 seconds to load the data tables into the RAM in the implant itself; and then the ASIC (which cost tens of millions of dollars to design) decodes a short code from the speech processor, which tells each of the 16 electrodes to fire, which polarity charge, and how wide and strong the pulse should be. Because of this coding scheme, they are able to race along at 88k forward updates/sec; and can deliver a very advanced portfolio of stims, including low power, and with ClearVoice noise reduction technology. However, even with the most advanced stim, the on-board RAM in the implant circuit is only about 30% full, as in 2001 when they started design on the HR90k implant ASIC, they didn't know what the future would hold. Mike Marzalek broke the code back in 2007, and wrote his own stim with 1024 channels for high fidelity music. He's an adjunct at Arizona State in Mike Dorman's lab.
Member
Member 16 May 2018 Replied to Member
Hi Dan, I'm trying to gather information before getting implant as I was frustated with my current hearing as I can heard but these sometimes are mumbling over the speaker/TV. Cannot listen to speech clearly. I was told to get implant. What do you mean with these strained and electrode? Sound like Cochlear implant (Australian nucleus 7) is not good enough?
Member
Member 25 May 2017
I do have residual hearing so I'll be asking my surgeon to preserve as much of my residual hearing as possible. At present, only Cocklear and MED-EL offer hybrid hearing with Cocklear partnering with Resound for their HA. I like AB but they don't offer hybrid hearing for those of us with residual hearing. Having said that, I understand a lot of AB recipients like their Phonak HA which may be better than opting for a hybrid. Thank you for the feedbacks.
Ruslan K
Ruslan K 27 October 2017 Replied to Member
Advanced Bionics also offers an all-in-one (Hybrid) cochlear implant and hearing aid solution already two years. You may want to take advantage of this option if you continue to have hearing in your implanted ear.1 With the Naída CI Q90 sound processor and its built-in Electric Acoustic Stimulation (EAS)* capability, you get the best of both worlds. link
Member
Member 07 December 2017
I'm considering a bilateral (yes, both ears left me) cochlea implants. I do not know of any other assistive devices that will help me if I have the two implants. Are there any? I understand Med EL is the only device where a person with implant can still have future MRIs. If I have a history of joint pain and joint surgeries or a meningioma that has to be monitored, is the Med EL the only or best alternative?
Member
Member 12 March 2018 Replied to Member
Yes. They have been the MRI leader for CIs for a long time. MED-EL SYNCHRONY implant has a revolutionary magnet. See article below. link
Member
Member 12 March 2018
Please read the article on the MED-EL blog which describes what MED-EL believes is the best bimodal approach. Link is below. It discusses why the AB and Cochlear approach is limited. link
Dan S
Dan S 12 March 2018 Replied to Member
That blog article is pure ***: AB's "Link" (actually a reflashed Phonak Q90) also has stereo zoom to match the Q70 & Q90 speech processors. What's more, the "compression" (actually wide dynamic range compression, WDRC), can be easily disabled by selecting Linear, or in between, "semi-linear." Also, although the *default* prescriptive fitting formula changes from Phonak's proprietary "Adaptive Phonak Digital" (APD) when a Naida Q90 is plugged in, to "Adaptive Phonak Digital Bimodal" (APDB) when a Link is detected — But these are only the "idiot-proof" defaults, and can be overridden with a click of the mouse. As the late Sam Lybarger — who invented the prescriptive fitting method — drilled into my head 25 years ago at PHAA, these fitting "prescriptions" are just the starting point, not the "be-all and end-all." [Just ask any reverse slope SNHL patient what happens when the audiologist "chimps it" by entering the audiogram and hits "Auto Fit" — and it's exacerbated by using a probe mic to "verify" that the "targets" have been hit.] Since you seem to know so much, get a Link and bring it up in Target 3.3 or later: It's not in the menu, but just like the Costco Brio, it will be properly detected and the correct parameters loaded. Also, the new Naida Belong is out, which has full Bluetooth 4.2/Low Energy ("BLE") support (but is not yet compatible with Roger -03 (adult) or -02 (ped) as well as 10.6 MHz for inter-ear high data rates; but a little birdie told me it will be; and that's it's the platform that AB's next speech processor will be based upon. By The Way, I wear a pair of Naida Q90 UP HA's with Roger receivers [actually it's a pair of Costco Brio's sans Echo Block and tinnitus masking, which I took in trade], and I can tell you the Stereo Zoom is unbelievable, as it puts the speaker's voice in the center of the head. In case you didn't guess by now, I'm an Electrical Engineer with 30+ years experience in the industry. ;-)
Vasan D
Vasan D 13 April 2018 Replied to Dan S
Hi Dan, You seem to have quite a bit first hand knowledge of AB/Naida Q90. I just had AB implanted 2 days ago waiting for activation. So far so good. Hoping to use Naida Link HA in my un-implanted right er after the activation. I am also hoping to take advantage of the ear hook for EAS If there is enough residual on the implanted ear. Keeping my fingers crossed. I am also hoping to get Roger "select" with multi-beam technology that was released a month or so ago.
Dan S
Dan S 14 April 2018 Replied to Dan S
The Roger Select is awesome — I tried one of only three in the US a couple weeks ago at Phonak training. AB's "Link" (actually a reflashed Phonak Q90) also has stereo zoom to match the Q70 & Q90 speech processors. What's more, the "compression" (actually wide dynamic range compression, WDRC), can be easily disabled by selecting Linear, or in between, "semi-linear." Also, although the *default* prescriptive fitting formula changes from Phonak's proprietary "Adaptive Phonak Digital" (APD) when a Naida Q90 is plugged in, to "Adaptive Phonak Digital Bimodal" (APDB) when a Link is detected — But these are only the "idiot-proof" defaults, and can be overridden with a click of the mouse. As the late Sam Lybarger — who invented the prescriptive fitting method — drilled into my head 25 years ago at PHAA, these fitting "prescriptions" are just the starting point, not the "be-all and end-all."
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