Cochlear implant pros and cons

31 03 2017

boom cochlear implant pros and cons

7 cochlear implant pros and cons that will make you think

Many people assume that when you get a cochlear implant, you are “cured” of deafness. This is complete nonsense. It just doesn’t work that way. A deaf person receiving a cochlear implant remains a deaf person; they don’t miraculously become a hearing person. There are many cochlear implant pros and cons to consider before committing to the operation.

Being deaf is not an illness that needs to be cured. It’s true that cochlear implants (CIs) can help some severe or profoundly deaf individuals improve their way of communicating in the hearing world. However, not everyone has positive experiences; some deaf people actively protest the use of CIs.

Many people in the deaf community resent cochlear implants for the effect it has on the hearing people in their lives. When a deaf person gets a CI, and it works to a certain degree, their friends and family assume they can stop putting in the effort to effectively communicating with them, because you can hear now right?


4 year bilateral cochlear implant review

5 06 2016

I’ve just had my 4 year review of my cochlear implant hearing. My hearing is a straight -20db after turning down the volume a little, and it feels natural now to have such super hearing.

I work from home a lot these days; I can hear the neighbours on one side when they argue and the neighbour’s TV on the other side. Hearing well is not always a good thing! My new hearing dog Bailey has a very loud bark so all in all, it can get very noisy sometimes! This “overload” of sounds has been the hardest thing to get used to and I do like to take the processors off occasionally so I can get some peace!

I pick up the phone now and again when it’s an emergency or I’ve had to make a call and there isn’t a hearing person around to ask. Using the telephone takes a lot of confidence and interestingly the most difficult ones are where I had to phone people in Southern Ireland and struggled with the accents (I’m Northern Irish so didn’t expect this!), the easiest ones are where I listened to a digital voice and had to take down a pin number (and got it right! Wowser!).

audiogram 2016

Red: My hearing in 2016 with bilateral cochlear implants

Blue: My hearing in 2010, before receiving cochlear implants



hearing test 2016CUNY lipreading test – 24 sentences of varying length and complexity presented in auditory and visual condition – lipreading with sound

BKB sentence test – 32 short sentences of simple syntactic structure presented in auditory alone condition


I’ve been able to converse with a relative stranger when she was talking to me from the next room, because her voice was loud and clear enough for me to follow, and she wasn’t speaking too fast. I take great pleasure in understanding public announcements on the London underground, on trains, and in train stations.

The most surprising sound was water dripping from the ceiling to the kitchen floor when the builder forgot to secure the radiator flow upstairs – I was in the lounge! I was able to react immediately and run upstairs to alert the builder.

Another sound was (hearing this from the lounge again) water dripping from the kitchen sink into a bucket below, inside a cupboard. It sounded like a double popping sound. Investigating this, I watched – the first pop was the water drop hitting the surface of the water, the second pop was the water bubble bursting. Awesome!

hear speech

Being able to hear sounds well has made me much more relaxed about communication, and I now understand why hearing people don’t really comprehend the complexities of deafness. When you can hear well, it is so effortless and easy, it’s like breathing. Many hearing people don’t understand that hearing well is not just about volume. It’s about clarity, understanding, processing the sounds that you hear and knowing what a sound is, being able to translate heard sounds into speech and making sense of them.

The most frustrating thing is I still need communication support as many speak quickly and mumble, many environments are too noisy and have poor acoustics, and I am just not used to processing sounds into speech. I will always be deaf. But hey, that’s okay.

Some people speak too fast for me to listen to them and decipher what they’ve said, or they are simply too far away – lipreading is often a much easier tool for me to use. I had some people visit recently to give me quotes for roof repairs, and they all had (hilarious) cockney accents. Listening and lipreading, I had the pleasure of understanding every word they said and trying to keep a straight face at how they spoke. Recently I’ve travelled to the Midlands and the north of England, Paris, Gibraltar, Granada, Barcelona, Budapest, and Qatar – I have enjoyed experiencing and listening to all these accents and easily understood everyone I spoke to, without worrying about whether I would be able to or not. Communication is now enjoyable, and that has been a truly amazing gift.

HLAA Convention 2015

28 06 2015

We attended the HLAA convention in St Louis and we had such fun! It was great to see many old friends again and catch up on our amazing cyborg-ness.

The photo shows the Japanese delegation, I was so pleased to be able to practice my Japanese.  今日は!

Japanese delegation

One of them kept asking why Jacob had to raise money for his cochlear implants when CI recipients have insurance in the US. In Japan, the national health care system, like the UK, completely funds cochlear implants.

One of the guys in the photo is a jazz musician. He’s looking for any other jazz musician CI recipients to connect with – do leave a comment and contact link if you know of anyone or you’re a jazz musician yourself.

Every workshop at the event was captioned – which is fantastic. In Japan, they are not so fortunate with access for deaf people. Japan has turned to digital broadcasting, depending on the late night programming and region, but there are often no closed captions, and the DVDs and BluRays for Japanese movies and animation, as well as internet broadcasts are rarely closed captioned.

There are few places where Japanese films are screened with Japanese closed captions, and those screenings usually happen within a couple of days, and in many cases are only screened once. Film making in Japan often has a low budget and tight timeline, so low budget late-night broadcasting and UHF stations are rarely closed captioned. Since it costs television stations money to close caption broadcasts, they use a legal loophole. In order to escape having to add captions in any case, they will broadcast late at night or on UHF stations. And of course the country is pretending not to see this.

The process of closed captioning has been kept hidden from the country’s inhabitants, and in order for the majority of the society to be kept out of the know, they are not putting effort into developing people capable of providing captioning services. Broadcast and cable television stations are more likely to have closed captions. There is a small number of Japanese captioners working for the deaf.

The country, media, NPOs and even organizations who work with disabled people won’t consider requests for closed captioning and won’t do anything about it. The younger generation in Japan have an openly disablist attitude. However there are both disabled and non-disabled people working towards life for disabled people to become a little more enjoyable.

HLAA delegates and USA inhabitants, count yourselves very fortunate!

Advanced Bionics Naída CI Q70 Review

25 08 2013

naida processor

Here is the definitive, in-depth review of Advanced Bionic’s latest processor, the amazing Naída CI Q70!

My new processor, the Naída Cl Q70, is smaller, lighter and even more discreet than the Harmony processor. With the battery is installed, it is much lighter on the ear. To be honest, it is so small that I almost forget I am wearing it! …

Naída CI Q70 after the jump, in English, and in French!>

FDA approval – Now What?

6 08 2013

MED-EL recently rolled out the RONDO processor.  Cochlear has just received FDA approval for the Nucleus 6.  And AB is awaiting FDA approval for the Naída CI.  Why isn’t the new hardware available as soon as it has been approved?

Read on ….

AB launches Naida CI Q70 in Europe and Canada

23 05 2013


“Sonova Holding AG, the world’s leading provider of hearing solutions, announces today that its subsidiary Advanced Bionics (AB) is launching its new Naída CI Q70 (Naida CI) sound processor. The device is now commercially available in Europe, Canada and several other countries in the world.”

Naída CI Q70 User Guide

Advanced Bionics – A quantum leap forward

In the UK, your NHS audiology clinic will decide whether they can afford to stock the Naída CI Q70. Some hospitals are offering a free upgrade immediately, some are offering upgrades after 5 years (or longer), some are unable to offer this processor. Check with your audiologist for further information.


Cochlear announces Nucleus 6 system

23 05 2013

Nucleus 6

Cochlear Americas have launched the Nucleus® 6 System, their most advanced hearing solution to date, designed with a clear purpose – to help you simply enjoy smarter hearing.

The announcement doesn’t say when the processor will be available.  It is awaiting FDA approval in the US.  Key features of the processor include combined electro-acoustic stimulation, and wireless connectivity (when the accessories become available).

Cochlear: Nucleus 6 User Guide



26 04 2013

by Joe Duarte /


RONDO is the world’s first single-unit processor for cochlear implants.

Initial impressions

RONDO is a single-unit “button processor” compared to a BTE that has a separate coil. Because my hair is short, the RONDO is more noticeable than the OPUS 2. People have asked me more questions about the RONDO in just a few weeks compared to the OPUS 2 in a year. For some reason, people are more fascinated with the RONDO and seem more comfortable asking about it.  I’m social by nature and have had great conversations with people who have approached me to ask about the “thing on my head.” This could be a minus for some people who don’t like to be noticed or are more introverted.  I believe that it appeals to some people with longer hair because it’s more discreet.  I personally never cared if people looked or not. I just love the convenience of the RONDO on my head instead of behind the ear like a BTE.  And, it’s much easier for me to wear glasses, especially thick sunglasses!

The device is so easy to use… just turn it on and plop it on your head. The only “hassle” is having to change the batteries once every 4 or 5 days depending on how long your day is. For me, this is an advantage compared to having to replace rechargeable batteries daily for the OPUS 2.  I put the CI on first thing in the morning and it only leaves my head before I hit the pillow at night. Everything about the device is neat. It is just a small “puck” on your head. The only negative that I have noticed so far is that when I have to replace the batteries I have to stop whatever I am doing and find a table to replace them.

Tour of the RONDO

RONDO tour guide

The microphone is at one end of the processor and has a protective cover over it. To each side of the microphone are LED’s that will flash to indicate different things about the CI. It will flash continuously, for example, if the battery dies. When it is powered on it will flash a number of times to indicate which program it is using. It will also flash anytime some action is taken with the remote.  It is important to note that this light activity can be “turned off” if the user does not want them to flash.

The RONDO has very small holes for a tether to clip the device to your hair or clothing, which I don’t use. It has a switch to turn the unit “on” and “off” which is also used to unlock the case to replace the batteries. Very easy and convenient switch the way it was designed.

Size of the RONDO

RONDO dimensionsIt is hard to compare RONDO with OPUS 2 as far as sizes are concerned because of their different form factors. I can’t hide it with my thin hair.  I think people with longer hair are able to cover it.  The color options are close to typical hair colors.  But, this doesn’t really make a difference if you are bald or wear your hair very short.

The processor is somewhat thick, but it is not that bad in my opinion. The D-coil is surely much thinner!  I use hard hats from time to time at work and even though I have worn the hard hat with the RONDO, I prefer not to. I plan to switch to the OPUS 2 when I am on the field all day working with a hard hat. If I am going to use the hard hat just for a quick site inspection then I don’t bother switching processors.


The RONDO uses disposable batteries only — three 675 size and I get more than 60 hours on them.  The OPUS 2 has both disposable or rechargeable options available.  I use the rechargeable battery pack with the OPUS 2.

I have only used rechargeable batteries with the OPUS 2 and I get 12 hours on the dot with each processor. I have not used disposables for a long time but I remember they lasted 3 days with the same 3 batteries as the RONDO. But that was before the D coil was available for the OPUS 2, and the D coil improves battery life by up to 50%. So the same batteries last longer with the RONDO than they did for me with in the OPUS 2, as expected.

The batteries are easy to replace by using the magnet to take them out of the sockets. After replacing them a few times, I’ve gotten better at it over time and now after several weeks with practice I can replace them rather swiftly.

When you change the batteries, RONDO retains the program and settings. This is a tremendous advantage! I typically don’t change programs very often.  However if I had the unit on Telecoil, switching the unit off and on brings it back to microphone mode (turns off T-coil function).

Mini Battery Pack with AAA Battery

Mini Battery Pack with AAA Battery

The Mini Battery Pack, which I use for Direct Audio Input, takes a single AAA battery.  It can also use a rechargeable battery (AAA or DaCapo Power Pak). The Mini Battery Pack for RONDO is slightly different than the Mini Battery Pack for OPUS 2, as a different connection is needed on the processor side.

Sound Quality

The mic is obviously in a different location than the OPUS 2 mic. Sound quality is almost the same for me. The differences are slight as far as I can tell. The RONDO appears to provide a somewhat more “normalized” sound. I prefer the RONDO sound a little better in quiet environments due to the way the microphone is positioned. I do a bit better in restaurants and at parties with the OPUS 2 compared to the RONDO. This minor decrease is somewhat compensated by the tremendous convenience and dramatic improvement in comfort that the RONDO provides. I’ve also noticed that for me, the RONDO seems to pick up a little more wind noise than the OPUS 2.


RONDO, FineTuner, and OPUS 2XS

RONDO, FineTuner, and OPUS 2XS

The FineTuner remote control has the same functionality as with the OPUS 2 – you can use the same remote with either processor. I use the remote mostly for T-Coil activation or to evaluate new programs or strategies. 

One remote controls both RONDOs for bilateral users. That is a terrific thing for me. I love the convenience. I also like the way the remote is designed with its buttons because I can switch just about anything in the dark and inside my pockets without looking at it. Very intuitive!

Keeping the processor on

I use the same magnet (standard) that I used for the OPUS 2. And I can run with it without a problem.  There are four strengths – soft, standard, strong and super-strong.  The processor stays on very well. It only comes off when I swipe it accidentally.

It comes with a retaining tether, but I don’t use it.

Comparison with OPUS 2

RONDO and OPUS 2 are identical in the functional sense, with the exception of one significant difference… the Telecoil orientation is critical for good receptoin, so if the RONDO is not in its proper orientation adjustments may be needed. I often have to tweak the orientation of the OPUS 2 to make sure it is perpendicular to the loop plane to get the maximum sensitivity possible. The RONDO can shift a little on your head and may not be in the optimal Telecoil angle. The same programs that were on the OPUS are used on the RONDO. There is no difference and maps work equally well for both the OPUS 2 and the RONDO. Like the OPUS 2, the RONDO has four program slots.

Also, I prefer to wear my RONDOs with the microphones pointed slightly differently than the normal operation, so when I use a hearing loop or neckloop, I have to make a quick adjustment. I have gotten used to do that so much that is now becoming an automatic thing for me.

With the telephone, I have developed a technique where I use two of my fingers to position the RONDO in an ideal position relative to the phone for maximum pick-up.  In the beginning, this was hard because the processor is on your head and not behind your ear. It took some getting used to. This is now automatic for me as well. I don’t use the Telecoil with the phone, just the microphone. It does look a little odd holding the phone to your head instead of your ears, but I do it all the time and I haven’t noticed any strange looks – yet!

People can still hear me well when I use the cellphone even with the phone’s microphone further away from my mouth.


To use the telecoil, activation is via remote only. To deactivate it you can either press a button on the remote control or if the remote is not handy, you can just switch the RONDO “off” and “on” and the Telecoil will go off automatically.

Direct Audio Input

Head - DAI Rondo

I use this all the time when I am travelling, in the airport lounges and on the plane. The RONDO has a special accessory that replaces the battery platform. This Direct Audio Input accessory has a cable attached to it. Then this cable connects to another small accessory called a Mini Battery Pack. This “pack” unit has a jack that allows me to plug another cable that then connects to just about any audio jack out there;  iPad, iPhone, laptop, plane audio jack, etc.

My bilateral DAI travel kit

My bilateral DAI travel kit

You can also connect an FM receiver via the mini battery pack. I just carry this same kit with me if I go to a theater or a movie and want to capture the best sound possible.  Loops don’t come anywhere close in terms of Hi-Fi listening.  However, if a facility has a hearing loop then I don’t bother with the kit.

Everything ready for bilateral DAI.  The audio cable has Euro connectors - the same ones that FM receivers use.

Everything ready for bilateral DAI. The audio cable has Euro connectors – the same ones that FM receivers use.

On the plane with my gear!

On the plane with my gear!

Warnings and indicators

There is a warning beep when the batteries are running low that lasts a minute or two to warn the person to replace them. This can be deactivated in your program, for instance if the listener is a child.

The lights flash for different programs and also for low battery, dead battery, etc.  I had my “lights” turned off to avoid distracting people when the battery is about to die.  When I turn on the processor the lights flash to tell me it is operational and which program it is in.

Unless you ask the audiologist to turn the lights off, they will show parents different statuses… when changing programs, changing volume or sensitivity, etc… basically, each time a remote key is pressed the light flashes to confirm the change. Also, when the battery dies, the light flashes continuously.


I was in the field all day using a hard hat with the OPUS 2 and I noticed that I had gotten so used to the RONDO sound quality that I instantly noticed that do have a preference to the RONDO quality.  Music does sound a little better with the RONDOs for me personally. It only confirmed my earlier assessment that the RONDO provides a more “normalized” sound quality. Switching back to the ROINDO came as a mild relief. Nothing dramatic but it is “somewhat different” as far as my personal experience is concerned.

I will use the RONDO probably 99% of the time. Comfort is the primary reason. I will use OPUS 2 with hard hats and for very active sports like soccer. When I go to my fitness club, I use the RONDO because I can jog and run and do all of my workouts without a problem. In fact, I find that I don’t have any sweat issues with the RONDO. I think the reason is because my hair is very short and the sweat never reaches the top surface of the processor. It seems to slide around the base. I used to have more problems with the OPUS 2 because the microphone would get wet and the sweat could easily find a way into the processor. That has not been the case with the RONDO so far. I am not sure if I will have issues when my hair gets longer and it starts covering the RONDO.

As an adult, I love the comfort and convenience of the RONDO!

Where the RONDOs came from

Joe and other members of MED-EL’s Patient Support Team (PST) received RONDOs from MED-EL to try out.  Joe decided to keep his, and worked through MED-EL’s exchange program to keep them.  If you have OPUS 2 processors, you may be eligible for an exchange, but the details depend on the age of your OPUS 2, if it has been opened, etc.  In some cases, it’s a simple exchange, in others there is a cost involved. If you are interested in an exchange, please contact MED-EL.

About the author 

Joe DuarteJoe Duarte has had hearing loss for most of his life of unknown causes.  He began wearing hearing aids when he was four years old, and now has bilateral cochlear implants from MED-EL.  Joe engineers and sells hearing accessibility solutions through his company, Duartek.

Joe is a member of MED-EL’s Patient Support Team (PST).  PST members include people who wear MED-EL hearing implants, their spouses, and parents of children with MED-EL implants.  They are a volunteer resource for people considering an implant and who are interested in learning more from actual users with real-life experiences.

MED-EL Launches World’s First Single-Unit Processor for Cochlear Implants

10 04 2013

RONDO processor combines control unit, battery pack, and coil into a compact, single-unit design.

Read MED-EL’s press release here and more news here.

Fully Implantable CI Patent Application from Cochlear

1 04 2013

Cochlear leaps ahead in the fully-implantable technology race.

Cochlear has submitted a patent application to the US Patent and Trademark Office for a fully-implantable cochlear implant.  While there are already many patents by all manufacturers for these devices, this one seems to go way beyond the state of the art.

The biggest advance seems to be in the surgical technique.  Because the electronics are on a flexible ‘board’ they can be rolled into a cylindrical shape.  Starting with the electrode array, the entire assembly is inserted through the nostril.  Conventional arthroscopic instruments are inserted through the opposite nostril, and also through a small incision in the ear drum.  There is no shaving of hair, no incisions other than the ear drum, and no waiting period before activation.

While the surgical technique is not claimed in the patent, it seems the surgery may be performed with a mild sedative and a local anesthetic.  Because there is no need for swelling to dissipate or incisions to heal, the implant may be activated on the day of the surgery.

To charge the battery (or super capacitor) just keep a charging box next to your bed, and the power is transmitted wirelessly while you sleep.

Key points in the claims:

  1. The electronics are on a flexible substrate, which may be rolled up for nasal insertion.
  2. Use of a supercapacitor instead of a battery.
  3. Insertion of the electrode array through the Eustachian Tube.
  4. Unrolling the substrate so it lies flat in a sinus cavity.
  5. Wireless radio-frequency charging.

Read the full patent application here.