Can I get by with one CI?

I’m being evaluated in two weeks. And I’m pretty sure I’ll only do one CI too. I’ve been reading but am sure I’ll be posting with loads of questions!

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Oh yes, bimodal brings more natural sound and really improves speech in noise if your non implanted ear have good speech recognition in quiet.

A bit iffy on that one, but thanks!

I believe if a person has decent low frequency hearing with a hearing aid and a CI in the other ear they have an advantage over bilateral CI. This would also support music in my opinion.

CI is absolutely great for those that have lost their hearing that really want to hear better for social and work related issues.

I do know two hearing ears is way better than one.


Here in Canada our health system also only pays for one for adults. It’s a tension between public spending and evidence of benefit. Back when I was starting out they were still doing research in child populations to confirm that the benefit of a second was significant enough to be worth the cost, but now two implants to a child who qualifies is standard. We’ve also seen increases in ears being evaluated separately rather than together–that is, it used to be that if you had one relatively good hearing ear and severe loss in the other you wouldn’t be considered, but that is changing. I imagine that over time as more evidence is collected that a second implant is valuable for adults, too, our publically funded health system will cover a second more regularly. But there are benefits to being bimodal as well, particularly in the realm of music listening.

Of course, one always has the option to fly to the States and have the second one done, if one has the $$$.

Interesting case. My guess would be auditory nerve spectrum disorder (ANSD)? I don’t think they would have attempted to re-implant in the case of hypoplastic auditory nerve. ANSD is rare (I’ve only seen one case so far in my practice), but there’s a genetic component which would make it reasonable that a set of twins would both have it. We don’t have a complete understanding of the mechanism yet, but synchronous firing of the auditory nerve fibres seems to be disordered which leads to a wide range of disordered auditory experiences that hearing aids or cochlear implants may or may not help to resolve.


Correct, Nucleus Sound processor have a limit on what can be heard. For Nucleus implant system, it is 188 hz to 7980 hz, i find the music missing uber low bass component but it sound really good and far better than my hearing aid can provide… Hearing aid only give a little bit of bass music component but it is over shadowed by CI high freq hearing which provide clarity and great music quality, i would chose CI over my hearing aid any day if i am tired of wearing the one over the other.


Quite possibly. They are identical twins as well.

Would ANSD mean also their HA side not receive that much benefit as well?

They are both in the profound range but nearer to 90 dB rather than 120 dB.

A friend who has 1 x CI and 1 x HA and has a 110 dB to 115 dB loss and gets way more out of his Aid then the twins.

Is there a test for ANSD? If they have, they may have been tested but not told me.

I mean, alternatively if they were congenital profound losses late-identified and were unaided during the critical period to develop auditory language skills than that would also account for it. That’s probably more likely. There’s a window for auditory language skills that closes around four and another around 9. So, if for example someone from the Deaf community gets a cochlear implant and has never really had strong auditory experience, expectation is only environmental awareness and maybe some lip reading support, as opposed to someone who is post-lingually deafened and/or has strong, consistent hearing aid use.

I should have raised that option prior to ANSD, as it would be the much more common reason. ANSD is funny because sometimes you get elevated hearing thresholds and sometimes you don’t, sometimes hearing fluctuates, but even if hearing thresholds are “normal” hearing is disordered and speech understanding can be very difficult. Hearing aids may or may not help, CIs may or may not help. It’s a wide continuum that we don’t know as much about as we’d like because it’s rare and the population is small. Can be unilateral or bilateral. It’s weird to manage audiologically because it makes the ABR uninterprettable and you have to wait until the kids get older and rely on behavioural thresholds, which is never ideal when you are trying to get a kid into hearing aids as fast as possible. It often won’t even be caught in infant screening because otoacoustic emmissions, which we use to screen, are normal.

Rick I sure do agree with you on this. I put my being able to hear at activation down to having good low frequencies in my CI ear. Which I still have.

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They were both around 3 when they got body worn Aids and then around 7 when they got 1 x CI.

They say they pick up slightly more with their Aid rather then CI Altho still both are really poor.

I think one CI is smart bc your brain still has the ability to understand the sounds it’s hearing. Unless you’re deaf on both sides. Nobody can tell you what’s best for you, but there is a light at the end of the tunnel if you’re willing to train it like a muscle.
My CI is the best thing that’s ever happened to me. I’m back online and back in life! I don’t even have to tell everyone I meet that I’m HOH and here are the hundred rules you must follow if you want to communicate with me. What a pain that was!
Best of luck! You got this!


So glad it is going well for you. Sounds like it was totally worth it. Are you still noticing changes or doing any active rehab?

@Zebras i can understand why they pick up more with the HA. I have found in the 3.7 yrs I’ve been bimodal it’s virtually impossible to get an equal balance between both CI & HA. You could find that the HA volume is just ever so slightly louder. Therefore they hear better with that ear due to the volume imbalance.

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I had this issue, they had to give the bass electrode more power to make it balanced. Once they gave it more power it sounded like my hearing aid side bass wise…

Something tells me CI clinic could do more to find the balance. They can up the power to make it more balance. I think it could be the .bass electrode. you will notice during the programming / MAP session. I was like “woah, it sounded like my hearing aid” Quality/ same reproduction/ loudness of what the bass on speech… for me, It is impossible find the balance in the high frequency but it is definitely doable in for the bass frequency/electrode. (See my audiogram if you want to see why.)

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@ssa here in Oz we have 2 AuD’s, one for CI and a separate one for HA. They are not in the same office so don’t/can’t use the same computer, so neither can use the other settings. Both Government departments (run by Fed Gov) fight nail and tooth re not sharing software with one another. Resulting in an imbalance between HA & CI. I’ve given up trying to adjust bass volume to try and get a good balance between the 2 devices.

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Sometimes having an idea of what might help gives the audiologist a cue to helping you.

An example was my last audiologist appointment. My right side was 90% understanding and my left was 95%. I mentioned something about bandwidth helping some people so he gave it a try. I will say my right processor is much harder on the battery now and maybe I can hear a little better but not sure. My next appointment we will check numbers. If the bandwidth hasn’t helped I will ask to put it back as it was before.

So maybe what SSA is saying might be an example for you???

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I find the bass volume helpful in diagnosing the issue but it wasn’t enough but you can always ask your CI audiologist to see if increasing the the bass electrode will do the trick. I used to have 2 audiologist, it took me a few trips going to both audiologist but it can be done…

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@ssa my bass volume control has been on maximum level of 6 for years in the NS app. But this doesn’t seem to help get a good balance though.

I have numbers 1 electrode turned off and 2 set at a certain volume. Those 2 electrodes are lying next to my vestibular. If they are turned back on they would cause severe balance issues for me. So my array is working on 20.5 electrodes.

Do you know what the number is of the bass electrodesplease?

Think it is 11- 22

They turned off the very high frequency electrode .

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