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Nagaraju

Need information for Surgery Implant

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Hi 

My Name is Nagaraju, residing in California. I have been scheduled for an implant surgery on next week at Stanford Hospital in Palo Alto, CA. I have chosen MEDEL as implant and doctor suggested the MEDEL Sonnet Implant. The reason I have chosen MEDEL brand is mainly because of with this implant I can still undergo MRI if I needed any time in future.

I am planning to take one back-in ear device and one rondo (backup). but Audiologist suggested that rondo cannot be usable if any of the residual hearing is left in ear after implant surgery. and it will be a problem if back-in ear breaks for any reason. (As getting new one will be high costly and insurance can only replace for 5 years)

I didn't get much information on rondo or rondo2 devices.. But if In case I wanted to purchase the device my own how much it will costs. 

Also can you please advice how these external devices are usable with telephonic calls. (as I am in IT sector and will be having most of the telephonic meetings) Just trying to understand whether back-in ear ones/ rondo's are most suitable.

Can you please provide your advice.

Thanks

Nagaraju

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Welcome @Nagaraju

I tagged you in a topic that addresses your questions.

Wishing you the best.

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@Nagaraju I don't think that's the case, I have Sonnets and Rondo2s and (admittedly a teeny, teeny bit) of residual hearing in one ear and can use both processors.  In my discussions with my audiologist we discussed residual hearing a lot and she never suggested that if I retain my hearing I would have issues with any processors.

Perhaps there's some misunderstanding?  Can you contact your surgeon or audiologist for clarification?

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@Mary Featherston, you use Sonnet right?  Not Sonnet EAS with an earmold?

For people who fall into the Sonnet EAS fitting, they learn to hear with a combination of hearing aid amplification for low frequencies and CI input for mid and high frequencies.  If they then put on a Rondo 2, it only delivers CI input and will sound different to them.

I only know a few Sonnet EAS users.  Do we have any Sonnet EAS users in HearPeers right now?

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@Cara Mia

Are you still around?  Will you share your EAS experience again?

Hope you are well pal.

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@Mary Beth, yes, sorry, Sonnet only.  I think @Jewel has a Sonnet EAS but is using it as a CI only.

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No problem @Mary Featherston.  We don’t have many posts here right now about Sonnet EAS.

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8 hours ago, Mary Featherston said:

@Nagaraju I don't think that's the case, I have Sonnets and Rondo2s and (admittedly a teeny, teeny bit) of residual hearing in one ear and can use both processors.  In my discussions with my audiologist we discussed residual hearing a lot and she never suggested that if I retain my hearing I would have issues with any processors.

Perhaps there's some misunderstanding?  Can you contact your surgeon or audiologist for clarification?

Thanks Mary, Yes I will discuss with my doctor and audiologist again for confirmation and selecting the external device. My audiologist mentioned that external device can be selected after surgery and at the time of activation.

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Hi,

I met with my Audi today while prepping for surgery next month.  I am allowed to try both Sonnet and  then Rondo 2 for 30  days each.  After looking at my audiogram she recommended an EAS approach for Sonnet testing  Since EAS  requires FLEX24  arrays,  I'm thinking Rondo 2 would  not function properly with such an implant.  Am  I wrong? 

C T

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@C T lex

That’s very interesting.  I have read about people “trying” a processor in other countries when upgrading processors but have never heard about it in the US, nor with initial activations.  Interesting.

Which CI center are you using?  I go to New York Eye & Ear.

I would not have been able to make a judgement between two different processors during the first two months after activation.  Everything changed so fast.  My CI MAPs stabilized by 3 months.  At that point I could’ve compared two different processor options accurately.

If using an EAS Sonnet allows you to benefit from acoustic low frequency hearing, you may prefer the Sonnet EAS processor.  Rondo 2 is CI input only.

Rondo 2 does function with Flex24 electrode arrays.  My right electrode array is a medium array which is also 24 mm.

I am glad you will have options.

 

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@C T lex

Here is a link to some Med-El electrode array info in case you haven’t seen it.

https://www.medel.com/data/pdf/21617.pdf

 

I have friends with EAS Sonnets who have the Flex28 electrode array even though the Flex24 is listed for EAS.

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Thanks Mary Beth.  I am using Kentucky Clinic,  Cochlear Support Group.  It is part of the UK hospital.  Thank you so much for your responses.  Excellent point regarding  more time  may be needed to adequately test the EAS Sonnet and Rondo 2 alternatives.   Also that  Flex28  has been used with EAS.  I really like Rondo 2 and Sonnet EAS  must be significantly better in the end for me to opt to stay with it.  They were about to order today and I've put a hold on that until speaking with my  Audi.  My audi disappeared in Dec and my surgery is Feb 8,   hence the big rush.

I wish I could get more info from others about EAS experiences.  I haven't yet found others on this forum.  I'm thinking this method might not be often used.

Thanks again

C T 

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@C T lex

Let me reach out to a few friends with Sonnet EAS and see if they will jump in.

 

Many CI candidates do not qualify for Sonnet EAS based on their hearing losses.

 

@Sherri

@Cara Mia

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Thanks Mary Beth for the tag. I am not often on hearpeers, so nice to connect today.

I believe the reason there is not an over abundance of EAS talk is due more to the fact the procedure and EAS processor has only been FDA approved since September 2016

I have been implanted with my first EAS/flex24 array since 2010, as I was a participant in the clinical trial. I am now bilateral.

C T Lex if you have enough residual low frequency hearing to try the Sonnet EAS processor, I would encourage you to do so. 

Back in the day when I was implanted the surgery was a little different procedure, I think they called it soft insert, or round window procedure. It was just a little different array insert procedure than the traditional implant procedure. It all involved preserving residual. The traditional procedure did not take into account residual hearing or any attempt to preserve.

 Check with your surgeon on qualifying for EAS. Most surgeons today are working with procedures that try and preserve residual if you have enough to be beneficial in the low frequencies. 

Sonnet EAS processors can be programmed with Acoustic component activated or with it turned off if residual fails. 

I have 2 Sonnet EAS processors. One is Full electric now as I have lost residual after 9 years, and the other is programmed with acoustic and electric programming. 

I have no regrets and love my Sonnets.

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dumb question: How do you imbed @userid  directing a  post to  userid?  Or maybe I need to go somewhere in hearpeers for dummies for posting instructions.

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@C T lex

type @ followed without a space by the username

a window pops up

select the user

it should show up then as a blue box

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@Sherri

 

Thank you so much Sherri.  Always great to see you here.

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@Sherrie

Thank you Sherri.  Reassuring words.  Do you recall if the quality of sound is better with EAS active, as opposed when all electric? 

C T 

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@Sherri  see above 

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That's true that there is no way to use Rondo with EAS mold. I am even not sure if any RONDOs contain EAS component embedded. Anyway, I'd advise EAS users to get both Sonnet EAS and Rondo if there is such opportunity.

First, it is possible to program both types of processors with a special program that compensates the needed low frequencies in a form of electric stimulation instead of acoustic. In this case, Rondo can be used by EAS users with minimum time for adjustment for comfortable hearing. I have EAs and only electric programs on my EAS Sonnet. I use it when I want to be without the mold. For example, when swimming - you cannot put a waterwear on the processor with a mold. But heaving the program that compensate EAS function without EAS/ mold allows to spend a day on a beach without any hassle with assembly/disassembly EAS "paraphernalia" :)

Second, in situations when our residual hearing declines to the point when EAS provides no more help (it can happen over some period of time), it is great to have an additional set of processors that widen our options of use.

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@C T lex, I noticed how better is a quality of my hearing with EAS right away I get it activated. I used only electric stimulation for several months after surgery until EAS got approved in the US. So, I had a great opportunity to compare.

I was very comfortable with just electric stimulation, but EAS gave me even more clarity in noisy environments in regards of speech understanding.

But, in general, I'd say it is a matter of adjustment and habit.

Funny thing, when I got an EAS, everything sounded absolutely natural to me, except my husband's voice. It took several weeks for me to get used to it. But I enjoyed deeper and more reach tone of his voice until it got a new usual 😆

C T lex, if you have more specific questions regarding EAS and co., I would be glad to share my experience with you and everybody interested.

My best wishes,

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Thank you so much @Cara Mia.  I’m glad to read that you switch easily between EAS and CI only input for waterwear use or when you want a break from the earmold.  I was wondering if that would be difficult to do.

 

Thanks again!

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Mary Beth, the hardest part is to remove the earmold tube from a hook. Seriously. Mine sits so tight on the hook that i need to remove the EAS hook and replace it with a regular one rather than just pull out the mold tube from the hook. And thank you for dragging me back on the forum 😁

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@Cara Mia

 

So happy to have you back my friend.  Smile.

 

I didn’t realize it was so difficult to remove the EAS earmold tubing from the hook.  

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I also glad to be back!

At the beginning it was not a problem to remove the tube. But seems that over some period of time it has shaped to a form  of a hook grooves. Not a surprise considering that each night it is exposed to a dryer heat.

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