How to choose a cochlear implant product?

I have profound hearing loss on both ears (see image below), and I asked questions on how to choose a cochlear implant surgeon last week. I am going to have an initial consulting this week. Before I go, I am wondering how a specific cochlear implant product is chosen. I searched online but so far it is hard for me to tell the difference between the three brands and their models, and which one would fit me. My insurances are Medicare and Medicaid, and they should cover most if not all the expense, but I don’t know if there are limitations on the models. Is it usually decided by the doctor based on my hearing loss condition? Any suggestions and advices are highly appreciated!

Have you found an audiologist you are comfortable with that programs CI processors? That is who you will spend the most valuable time with.

Does that audiologist prefer one of the 3 CI brands?

Does that audiologist prefer a particular surgery group or surgeon?

Do you use Android or iOS devices? This may steer you toward a particular CI brand.

Medicare should cover practically 100% of your CI implants. They did for me.

Good luck.

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I called a few audiologists and was told they don’t fit CI. After talking to an ENT doctor and my hearing aid audiologist (who doesn’t fit CI), my understanding is that here (New York state) each CI surgeon has a team that includes an audiologist, whom I will work with after the surgery. I guess I can find a nearby audiologist who fits CI and is not associated with the surgeon, but not sure if that’s how it works. Right now I am following a first-surgeon-then-audiologist path. Did you find an audiologist first who is not necessarily associated with the surgeon? How did you decide your CI product? Thanks a lot for your help!

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On this page you can find a comparison chart that shows the features of all three CIs in a handy format. The chart is 10 pages long so fairly comprehensive.

Your audiologist and surgeon will certainly have preferences that they work with most often and that familiarity will work in your favor. The surgeon may also have a recommendation if imaging shows something unusual with your cochlea, each manufacturer has different implants for dealing with irregular structure when it happens.

Having said all that, the one study on this found that all three preformed within 10% of each other after rehabilitation so don’t worry too much about which one has the best performance. And your audiogram has no bearing on it, as this will bypass all that anyways.

Each manufacturer has people to answer whatever questions you may have. Yes, each will tell you theirs’s is the best but in my experience they will honestly answer what you ask, and they can give you some feel for what the company’s customer service is like because the one downside of a CI is that unlike hearing aids you are pretty much committing to a life time relationship with the company…

So look at the options, get recommendations from your Audi and surgeon, and make a decision. You will never now if you made the perfect choice, and I saw options in all three that I wish I could have combined, but in the end you will (most likely) have such an improvement in understanding that you won’t worry about it.

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My first CI evaluation was a big flop.

After reading lots of posts here on the forum I decided to contact Cochlear for a second. A Cochlear representative contacted me and got me in touch with a Cochlear audiologist. That same Cochlear representative got me in touch with a group of CI surgeons that I reviewed on the internet.

Going this route was absolutely easy and smooth. All questions were quickly answered and the support was fantastic. Even after the implants and activation this Cochlear representative stayed in touch to help as needed.

The CI members here on the forum are very helpful and knowledgeable about the CI process. As you learn more about CI they will be even more help.

Good luck.

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I am actually upstate from you, my surgery was in Syracuse but while my surgeon has an has an audiologist in his office my audiologist is an independent practice. I wasn’t even really looking for a CI when I got evaluated. Of course Upstate Medical Center is a teaching hospital so that may have factored into it.

What decided me was really two things. One the Cochlear rep was much better at getting back to me when I had questions then either the AB rep (I had ruled out Med-el for technology reasons that no longer matter with their latest release). And all the local Audis were familiar with Cochlear, so if I went with one of the others I would either need to talk one of them into affiliating with who I wanted or drive to Albany or Rochester for every visit.

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Thanks for the comparison chart! It is very comprehensive, and some parts are quite hard to understand. I plan to contacts the manufactures after I talk to the surgeon this week. I’ll also need to choose between two surgeons once I talk to both. I guess only after that the surgeon will take images and look into them. I’m glad that all CIs’ performance are close to each other and hopefully the surgeon and the audi will help me choose. Thanks for your help!

I am sorry to hear about your first CI issue. I’ll get in touch with manufacturers. Yes this forum is extremely helpful, sometimes I feel overwhelmed by all the info, and I am still going through all the posts. Thanks for the advice!

Thanks for sharing! It seems that customer service is actually an important part of the process. I thought I will deal with the surgeon only initially and then the audiologist only after the surgery, but based on many replies, it seems we need to talk to the manufacturer fairly often in the whole process. Is this correct, or we only talk to the rep when we choose the product? Thanks!

I would say that I have felt with the reps more during choosing, they are very good at answering questions. The Audi or surgeon could probably answer most of them but that is the reps job so the answers are often faster.

Afterwards the need for customer service depends on how things are going. I think I have contacted them once in the 21 months since my first implant, but my audiologist also solves most of my issues directly so.

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I know you wanted CI implants but have you tried the Phonak Naida Paradise U aids? You might want to use a hearing aid for right ear and CI for left ear. The sounds you hear from an implant will not be similar to sounds from a hearing aid.

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@Terost The sounds you hear from an implant will not be similar to sounds from a hearing aid.

Not sure if I agree with this statement.
The only thing I have found to sound different is music and it’s getting better.
As far as practically every other sound it is way better than hearing aids but my hearing loss was pretty bad. Everyone is different and the need of CI is judged carefully. That’s why the CI evaluation is done. The last thing you want to do is give someone with not so bad of hearing a CI.

Hope this makes a little since.

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I just got a Phonak Naída P90 UP for my left ear, which is slightly better than the old hearing aid, but still I can’t hear much. My right ear has little hearing left, so I plan to have CI for my right ear only this time. I think I will want CI for my left ear if the right one works well. Thanks.

Hello dislab,

there are several ways how to choose for the (right) implant.
In my case I knew that I will have several sessions with an audiologist. So that is the person I meet most of the time concerning my CI. So I have choosen one in my nearby. Here in my area the most experienced audiologists work in implanting hospitals. My next step was to find the right nearby hospital (there are some in and around munich, germany).
Since the success of implanting is very important and depending from the surgeon I tried to find a very experienced surgeon. From local CI-groups I got some recommendations for a specific surgeon and that was the one who has implanted me two times. I am very happy with his results.
This surgeon mostly implants 2 models and preferes one of them. I went with his preference.

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@Dani there are several ways how to choose for the (right) implant.

Thanks for sharing. I haven’t figured out how to find a good audiologist, and plan to rely on the surgeon to recommend one. I am trying to find a good surgeon right now. An ENT doctor recommended a doctor, but she is a little far (well, just an hour driving, but it is in New York City, terrible traffic all the time). There is a cochlear implant center in a nearby hospital (Long Island Jewish Medical Center), which should be pretty good too, but I am not sure. I am going to have an initial consulting with the doctor today, and want to ask for the doctor’s opinion on the nearby hospital/doctor. I am still searching for a Long Island local cochlear implant group.

I have the Phonak Naida P70 UP aids. I have it set to 100 percent gain. I hear the TV fine. If you can’t hear much then has your audiologist set it to 110 gain? I programmed a P30 UP left aid for a client and set it at 110 gain and made some adjustments. Client was so happy with the P30 UP aid results and decided not to get the P50 UP aid.

You do understand that just because an aid can provide enough amplification doesn’t mean that they will provide understanding.

The audiogram in my profile was the last one before implantation. There are a lot of aids that will amplify to meet that easily, but it wasn’t do me any good. Even with streaming I needed captions, and if there was background noise trying to have a conversation was pointless. With the CIs, well yesterday I just used a phone, no streaming, no captions, no tcoil. Just held it a little higher and used it.

Look, I am agnostic as far as what people choose, if you are happy with a power aid and it gives you what you want great. If you want to go full Deaf and embrace ASL, good for you. But in this case the poster’s ENT suggested a cochlear evaluation, I doubt that would have happened if they were satisfied with what they were getting or what the doc thought would be achievable with aids.

I apologize if I am reading you wrong , pretty much any adult who is considering a CI has plenty of experience with hearing aides. We have tried them and found them wanting, but there is always someone (and this is not exclusive to online) who thinks that if we just try one more that suddenly all will be well.

As I said if power aids work for someone I am happy for them, but for some of us it just isn’t going to do it.

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I don’t know what percent gain my P90 was set, but it is set at a volume that I am comfortable (not too loud). I think for my case, my hearing loss is so bad that hearing aids are not very helpful now. Thanks.

After you get the CI implant, let me know if you plan to sell your P90 UP aid. Good luck with the CI. I can’t have one for my left ear because it’s not trained the first 25 years of my life. The sounds l hear with my left ear are not the same as l hear with my right ear. Maybe l might get an evaluation.

@Terost sorry I didn’t see your last post earlier. I have only one P90 UP for the left ear, and CI will be for the right ear, so I don’t have an extra P90. Sorry & good luck!