Which CI should I choose for my hearing loss?

[JohhnyBravo55]

Hello everyone,

I'm a HOH 37 years old male. My hearing has been declining for about 15 years. Before that it was perfect and I never had any troubles. I bought HA just a few years ago, but with continuous progression I've been struggling a lot and I think they are not enough any more, because I can only understand speech face-to-face with 1 person talking nicely. With group conversation it's over for me.

While being candidate for CI, I don't really know which type to choose. My low frequencies has been ok and I can talk to men without my HA. Of course they need to talk correctly, slowly and so on. I can also hear a lot of low frequencies voices, like some hard thing falls on the ground, keys on the keyboard as you type and so on. I also use HA only at work. Forgot to mention. Without lip reading it's not working for me. Talking to someone with a mask and me wearing HA or not, it's very very hard. It's impossible for me to keep up an conversation with anybody.

I've added my audiogram in the attachment. As you can see, I have nothing left in middle and higher frequencies. I don't quite understand it, but I can still hear some sound that I should not. Like a car horn or door creaking ... can't really remember anything else right now. So it's far from total deafness for me. On the other hand I cannot hear any type of birds or whistle or microwave last beep and so on.

With my low hearing beeing "ok", I'm very keen on keeping it for at least a few years. My HA is pretty expensive, so I personally think that I don't have much left in that specter. Maybe I can get another one or get better mapping, but won't gain as much as I want to. As much as I have discovered I can imagine that CI electrodes that are attached to cochlea can damage hair cells and you lose hearing, but if those electrodes are attached to brainstem, the cochlea is bypassed and you still have all natural hearing. The second option is to attach electrodes to cochlea, but only to the outside part, so the inner part with low frequencies hair cells with stay the same.

Is my thinking correct?

I'll probably choose hybrid implant, which means that electrodes will be attached to brainstem and I'll still have residual hearing which is great. Rondo and Kanso are my choices when it comes to appearance, but I don't know if they are suited for hybrid implantation. Is it possible to use on of those two t bypass cochlea, attached them to brainstem and also use HA?

Thank you for taking time to read my entry. Every comment will help, because I'm really struggling right now and I don't know how to decide.

Regards...

[Mary Beth]

@JohhnyBravo55

welcome to HearPeers.

When a system uses a combination of acoustic (hearing aid) and electric (cochlear implant), they are usually behind the ear processors because an earmold needs to be attached for the acoustic component.  Rondo 3 and Kanso 2 are both off the ear one piece processors so they use cochlear implant stimulation only.

 

Sonnet 2 EAS is the behind the ear processor that combines acoustic and electric input.  You can find more information at this link.

https://blog.medel.pro/eas-implant-system/
 

Wishing you the best.

[JohhnyBravo55]

Yes, I'm aware of EAS type CI. My problem is it looks pretty ugly to me. I don't know, maybe I'm not convinced yet. 

Could I use Rondo/Kanso for high frequency and retain my residual hearing and also use HA? Where would electrodes be attached in this case?

 

Thank you for your answer.

[Mary Beth]

@JohhnyBravo55

Maybe @MED-EL Moderator can give you some guidance.

 

There was a study at Vanderbilt years back which tested CI users wearing a Rondo set for mid to high frequencies and also wearing an in the ear hearing aid in the same ear set for low frequencies.  If you do a Google search you may find it.  As I recall, even people who benefited from the low frequencies chose to only use the CI (set for all frequencies) due to comfort.

Electrodes for cochlear implants are inserted in the cochlea.  There are great videos online showing how that works. Regardless of one piece processor or behind the ear processor, the internal components are the same.  I have both Rondo and Sonnet and can switch between them whenever I want.

[Dianna]

Hi johnny, i have sonnet2 eas, my processor is white, it does stick out but im so proud of it! I wear a hairstyle with one side shaved, which luckily fit the ear that was implanted!! I have stickers ive been using, and anxiously awaiting my pink parts to see how they look! So some think the sonnets are ugly, but i didn't match my hair on purpose, the white is like a canvas to be decorated! Yes the eas mold felt strange at first but now is more comfortable than any hearing aid like miracle ear ( gosh so bulky) i do stream alot, but i do believe i hear many more tones because of the eas. If i ever decide too, i can easily remove the mold. Also, the sonnet might look bulky but it is sooooo light weight, its not a bother to me. I put it on when i wake up and its the last thing i take off to sleep!

Welcome and let us know how you are doing!

[MED-EL Moderator]

Hi there,

our product experts would like to clarify that there is no ABI and hearing aid combination in the current clinical practice, as the indications don’t allow for this.

For the EAS, a surgeon would choose a FLEX electrode of appropriate length depending upon the cochlear duct length and hearing preservation requirements. With the SONNET 2 EAS behind the ear (BTE) audio processor, even though it looks bigger, the earmold would completely go in the external ear and then it'll be discreet in appearance. It would provide the possibility to fit both the acoustic and electric together in the same MAESTRO software with better fitting possibilities of adjusting the hearing aid and electric frequency range as the hearing loss changes over time. The processor is designed to bring best benefit to the user with their changing residual hearing over time. Technically, it may also be possible to use a single unit processor like RONDO 3 and use a separate hearing aid. The technical challenge here would be having to do electric and acoustic fitting with two different software, and depending upon the country, both the services may not be available at the same clinic.

Regarding preserving the residual hearing after the surgery, your specialist would be the best person to comment on this based on the audiogram and some extra diagnostic tests to confirm the same. With many published data, it is increasingly becoming evident that MED-EL FLEX electrodes offer a high probability of hearing preservation of the residual hearing, keeping in mind different factors which may also influence this outcome.

In general, it would be best to discuss the candidacy and prognosis with the surgeon, audiologist, and rehab therapist. 

We hope this helps clarify some of your doubts, please don't hesitate to reach out again, to us or your local MED-El team. 

 

Kind Regards,

Giulia

[pdk]

Three great replies. I'm no expert but I enjoy every day being bilateral.

If I had to wear an ariel on my head to be able to hear like I do, I would.

Hearing sound is not the same as understanding speech. Your residential hearing is deteriorating so in 5 years time it will probably be much worse.

Checking what device you choose will probably depend on your audiologist, your surgeon and your location and you will go with their advice. If you then put in the time for rehab you will be able to enjoy the world of sound again.

In spite of the spec saying low frequency cut off is around 200 Hz I can hear the bottom note on a piano and happily listen to an organ

I hope it all works out well. .