Choosing a Cochlear Implant Manufacturer
At USAIS we offer a choice of 3 manufacturers:
Advanced Bionics (AB)
Cochlear
Their implants (internal components) are called:
HiRes 90K Advantage
Nucleus CI24RE (Freedom)
Med-el
Concerto Flex28
The Speech Processors (outside parts) are called:
Naida CI
D:\533581912.doc
Updated November (SC)
Or
Neptune
Nucleus 6
Opus 2
Help! What if I can’t decide which make of implant to choose?
We recommend that you:
 look at the manufacturers’ websites
http://www.advancedbionics.com (for Advanced Bionics)
www.cochlear.com (for Cochlear)
www.medel.com (for Med-el)
 read their literature
 consider the following differences listed below
 discuss your own requirements with the team and ask any questions.
If you are unable to decide, do not worry! Patients do well with all systems otherwise USAIS would not offer a choice.
Frequently Asked Questions
Implants and internal workings
Which make has the most reliable internal part (implant)?
All manufacturers strive to maintain high reliability levels and all have occasional failures.
Which implant requires the smallest amount of drilling during surgery?
Cochlear’s CI24RE (Freedom) requires slightly less than the Advanced Bionic’s HiRes90K and Med-el’s Concerto Flex28 implants. The
HiRes90K implant also requires a slightly larger surgical entry into the cochlea.
Which cochlear implant sounds better?
This is impossible to answer. All implants sound very strange at first but the user gradually gets used to them. The implants from all 3
manufacturers are adjusted through tuning to make the sound audible and comfortable. The implant will normally sound better over time.
Which implant is better in noisy conditions?
The 3 implant manufacturers use different techniques to help implant users in background noise. There is a very wide variation in people’s
outcomes so it is difficult to say which is best.
The latest Med-el speech processing incorporates ‘FineHearing’ which gives more fine-structure information which may give better speech
understanding in noise. The Advanced Bionics processing uses a ‘current steering’ technique which creates additional ‘virtual channels’
between the electrodes. This gives a ‘crisper’ signal which may help in background noise. They also use ClearVoice and Ultra Zoom which are
noise reducing techniques. Nucleus uses 2 microphones which facilitate a noise cancelling system called BEAM which enhances sounds from
front. Nucleus also uses autosensitivity (ASC), a noise reducing technique, which helps to eliminate steady background noises.
D:\533581912.doc
Updated November (SC)
Which implant performs best with music?
There are limitations with all implants with music perception as implants are generally designed to give the best speech intelligibility. Recently
there has been more of a focus on music appreciation and the implant companies have come up with different ways of improving the quality of
music. Med-el’s implant speech processing incorporates ‘FineHearing’ which gives more fine-structure information which may give better music
appreciation. The Advanced Bionics processing uses a ‘current steering’ technique which creates additional ‘virtual channels’ between the
electrodes. This has been shown to give more musical appreciation to implant users who had been changed over from a previous strategy.
Cochlear have recently developed a map setting aimed at improving music appreciation.
Which manufacturer is easier to tune (programme or map) for Children?
Advanced Bionics and Med-el users require fewer measurements to tune their implants as they only require measurements of the loudest
comfortable sounds on individual electrodes. Cochlear’s implant requires measurements of the loudest comfortable sound and also the quietest
level at which they can hear on individual electrodes.
Where are the cochlear implants made and which company has been making implants for longer?
AB is an American company, Med-el is Austrian and Cochlear Corporation is Australian. Cochlear has the longest history of implant
manufacturing.
Are there differences in the designs of the electrode arrays (the part that enters the cochlea)?
The HiRes90K array has a slightly curved tip which is designed to go around one whole turn of the cochlea but not so closely to the inner part
of the cochlea (modiolus). Its active electrode length is 17mm. The CI24 RE (CA) has a tighter curve to fit around the middle of the cochlea.
Its active electrode array length is 15mm. The Concerto Flex28 has the longest array (28mm) which is designed to go deeper into the cochlea.
Can I have an MRI scan with any of the manufacturers?
It is important to check with your surgeon before having an MRI scan regardless of the make you choose. An MRI scan can be performed with
any of the implants in place (with the surgeon’s permission) up to a certain magnetic field strength without removing the implant or magnet. The
HiRes90K and the Cochlear implants are designed so that the magnet can be removed when undergoing an MRI scan, rather than the whole
implant if necessary whereas the Concerto Flex28 has a fixed magnet. With the magnet in place an MRI can be performed at up to 1.5 Tesla
for the Concerto Flex28 and the CI24RE implants. With magnet removed the HiRes 90K is compatible for MRI at 0.3 and 1.5 Tesla.
D:\533581912.doc
Updated November (SC)
Speech Processors (outside parts) and accessories
Are there different colours for each manufacturer?
Yes, but we ask you to choose a “base” colour for each of the manufacturers.
Do any of the speech processors have a remote control?
Yes, the Nucleus 6 has a remote assistant/remote control but nearly all the functions of the remote assistant are accessible by pushing some
button on the processor. The Opus 2 comes with a Fine tuner (like a remote control) which is used to change programmes etc. The Neptune
does not have a remote control. Naida CI comes with comPilot and my pilot. MyPilot is an optional extra.
Do all the manufacturers have in-built Telecoil “T” switches, for use with loop systems?
The Nucleus 6 has a button on the processor or on the remote assistant/remote control; the Opus 2 has a button to press on the Fine Tuner.
On the Naida CI, need to use the program changing switch to activate telecoil.
Are all speech processors waterproof?
The Neptune is waterproof and the Naida CI is splash proof - it can tolerate rain, humidity and sweat. Waterproofing equipment can be bought
for personal use, the cost will be in the region of £500-00. The Opus 2 has not been through IP ratings but Med-el claims that very few Opus 2
processors have been returned for repair due to moisture damage. The Nucleus 6 is splash proof to a standard of IP57 and cochlear aqua
accessory a waterproofing option can be bought from Connevans.
Can you directly plug into Stereos, MP3 players etc using accessory cables with each manufacturer?
With Medel and Nucleus 6 you can connect a lead to listen to battery operated equipment. Advanced Bionics and Med-el do not produce a
mains operated cable but Connevans makes a compatible cable. Naida CI uses compilot to stream music into your processor/s.
Are the microphones the same?
No. The Naida CI has several different earhooks/microphones for different uses. Its T mic is an ear hook which positions the microphone in
the concha of the ear which takes advantage of the natural collection of sound. The microphone for the Neptune is on the headpiece. There
are 2 omni directional microphones on the Nucleus 6. The Opus 2 speech processor has one omni-directional microphone.
Do all systems have an alarm to alert you to the fact that the batteries are low?
Yes
Advanced Bionics – HiRes 90K
Advantage
D:\533581912.doc
Updated November (SC)
Cochlear – CI24RE
Medel – Concerto Flex28
Housing of implant
Number of channels
Diagnostics
MRI Safety
Tuning




Titanium case
Silicone enclosure
16 channels
Makes use of current steering to
create virtual channels



Titanium case
Silicone enclosure
22 channels



Titanium case
Silicone enclosure
12 channels






Telemetry (implant test)
NRI
Integrity testing
Need to check with surgeon first
Internal magnet is removable
With magnet removed, MRI can be
performed at 0.3 and 1.5 Tesla






Telemetry (implant test)
NRT
Integrity testing
Need to check with surgeon first
Internal magnet is removable
With magnet in place, MRI can be
performed up to 1.5 Tesla






Telemetry (implant test)
ART
Integrity testing
Need to check with surgeon first
Internal magnet not removable
With magnet in place, MRI can be
performed up to 1.5 Tesla

Measurements of loudest comfortable
levels only
Uses current steering to create virtual
channels – reports of help in
background noise situations and
music appreciation

Measurements of quietest levels and
loudest comfortable levels
Uses Zoom or BEAM – reports of
reduction of background noise

Measurements of loudest comfortable
levels only
Uses fine hearing – reports of help in
background noise situations and
music appreciation

Number of
programs
User controls


Advanced Bionics – Neptune
processor
Advanced Bionics – Naida CI
Cochlear – CI24RE with
Processor
NUCLEUS 6 processor
Processor information
Medel – Opus 2 processor
3
5
4
4
 On/off control button on
processor
 Program selector
 Volume wheel



 Push button: on/off, program
selector, volume, sensitivity
 Lock function
 Remote assistant with LCD
display with help messages
 Pocket-sized remote control,
with a handy display screen
allows you to adjust simple
settings

D:\533581912.doc
Updated November (SC)
Off: disconnection of battery
Program selector
Volume button


On/off control button on
processor
Fine tuner: program
selector, volume, sensitivity
Lock function
Battery type

AAA batteries
Average battery life

Change batteries every day
Range of colours
available***
 Processor: black, white
 Colour covers: black, sand,
ocean blue, sky blue, tropical
sea, lime green, violet, red, pink,
white
Wearing options
 Off the ear on an armband,
harness, lanyard, swim
headband or swim cap
Accessories
available
 Telecoil via Tcom (for use
with a loop system)
 Microphone on headpiece
 Cables to link up to external
accessories
 Built-in indicator light
 Monitor earphone (to check
microphone)
 Coloured covers for coil and
processor
 Radio aid compatible
Reliability data for cochlear implants
D:\533581912.doc
Updated November (SC)
 3 rechargeable batteries
(processor needs one at a time)
 Optional disposable
batteries
 Power cell Batteries
available in 3 sizes: up to 16
hours
 Optional disposable
batteries up to 30 hours
 Processor: Silver,
Caribbean pirate, Ruby, Sand,
Pink, Chestnut, White and
Black.
 Various colour caps for
headpiece
 Behind the ear (BTE)
 Off the ear option using
Naida Clips, Light wear option
 2 zinc air batteries or
 standard rechargeable
batteries


 Zinc air: up to 2 days
 Standard rechargeable: 17
hours
 Remote assistant: 1-2 wks


 Processor: Carbon, Maize,
Mocha & Smoke
 Processor covers available
in various colours

 Behind the ear (BTE)
 Body worn option (two
battery racks needed if bilateral
CI)


Behind the ear (BTE)
Off the ear option (active
wear)
 Splash proof processor
 Built in telecoil (for use with
a loop system)
 T-Mic: microphone that sits
in the ear
 Standard earhook
 Built-in indicator light (can
be switched off if not required)
 LED: to check coil and
microphone
 Coloured covers for coil
 Radio aid compatible via
comPilot
 Monitor earphone (to check
microphone)
 Splash proof processor
 Optional cochlear aqua
accessory for waterproofing
 Built in telecoil (for use with
a loop system)
 Standard earhook
 Cables to link up to external
accessories
 Built-in indicator light (can
be switched off if not required)
 Monitor earphone (to check
microphone)
 Coloured covers for
processor
 Radio aid compatible

Built in telecoil (for use with
a loop system)
Standard earhook
Auxillary microphone
Cables to link up to external
accessories
Built-in indicator light
Signal check (to check coil)
Monitor earphone (to check
microphone)
Radio aid compatible








3 zinc air batteries or
3 rechargeable batteries
(processor needs one at a
time)
Zinc air: up to 5 days
Rechargeable battery: 16
hours
Battery for fine tuner: 6mths
– 1 year
Processor: Anthracite,
Bordeaux red, Pacific blue,
Nordic grey, Beige, Sienna
brown, Crème, Baby pink and
Baby blue
All the companies have experienced some problems with their implants at some time. The table below lists the reliability data as
defined and published by the companies for their most recent implants (the ones which are being used at the moment).
Company
Implant
Date information
issued by company
Advanced Bionics
HiRes 90K
Still awaiting data **
Company reliability data for the
implants
(this includes data for implants that
have failed and those that needed to
be explanted due to accident related
issues)
USAIS reliability data for the implants
99.2% survival rate at 6 years*
Advantage
Cochlear
CI24RE
February 2012
98.8% survival rate at 7 years
MED-EL
Concerto
July 2013
99.07% survival rate at 3 years
* This data showed 99.2% survival rate at 6 years. Besides total failures, we have also experienced some partial failures for this
implant at USAIS. This means that the implant is still being used by the patient but we needed to make changes to their settings.
9% of our patients using the CI24REhave a partial failure and we are monitoring these patients closely.
** Since this implant has only been in use for less than 1 year, we are also giving you the data published by the company for the
previous implant they used – the Hi Res 90K implant – this is not the implant that you would be getting should you choose the AB
device. This data showed 98.08% survival rate at 6 years.
*** These are the only colours AIS offer; there might be other colours the manufacturers offer.
D:\533581912.doc
Updated November (SC)