Choosing a Cochlear Implant Manufacturer
At USAIS we offer a choice of 3 manufacturers:
Advanced Bionics (AB)
Cochlear
MED-EL
Their implants (internal components) are called:
HiRes 90K Advantage
Nucleus CI512CA
Synchrony Mi1200
The Speech Processors (outside parts) are called:
Naida CI
Or
Neptune
Nucleus 6
Sonnet/Rondo
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?
All of the implants require the same amount of drilling during surgery. The HiRes90K Advantage implant 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; it also uses two microphones which can help in noisy environments. 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 6 uses 2 microphones which
facilitate a noise cancelling system called BEAM. Nucleus also uses autosensitivity (ASC), a noise reducing technique, which helps to eliminate
steady background noises and SmartSound iQ (SCAN) a fully automated sound management system.
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 Adults?
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. Measuring these quietest levels can be difficult for people with tinnitus. However, overall
tuning is not normally difficult for any of the implants.
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 Advantage array has a curved tip which is designed to go around one and a quarter turns of the cochlea mid-way between the
inner part of the cochlea (modiolus) and the outer wall. Its active electrode length is 15mm. The CI512 (CA) also has a tighter curve to fit
around the middle of the cochlea. Its active electrode array length is 15mm. The Synchrony 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 the implant centre 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 AB HiRes90K Advantage and the Cochlear CI512 implants are designed so that the magnet can be removed when undergoing an MRI
scan if necessary. However, with the magnet in place an MRI can be performed at up to 1.5 Tesla for the CI512CA implants. With the Medel
Synchrony implant, an MRI can be performed up to 3 Tesla with the magnet in place. With the magnet removed the HiRes 90K is compatible
for MRI at 0.3 and 1.5 Tesla. The limits specified are those at which the scan will not lead to damage of the implant or tissue damage. Some
people may experience some discomfort during scans at these levels with the implant magnet in place.
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 but nearly all the functions of the remote assistant are accessible by pushing some button on the
processor. The Sonnet and Rondo 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 comPliot and myPilot, both are optional extras.
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 Sonnet and Rondo have 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 us, the cost will be in the region of £500-00. The Sonnet is splash proof to a standard of IP54 and a pack of “Rondo WaterWear”
covers can be purchased separately for around £20 per pack. The Nucleus 6 is splash proof to a standard of IP57 and the cochlear aqua+
which is a waterproofing option is provided free by Cochlear (although there is currently no baby worn option for this), USAIS does not
guarantee to replace the Aqua+ if it becomes faulty.
Does CI equipment effect implanted Pacemaker/Defibrillator systems?
Some CI equipment radiates electromagnetic energy that will affect Pacemaker and Defibrillator systems if they are operated in close proximity
of each other. Please discuss this with us at your assessment appointments if you or someone close to you has one of these systems
implanted.
Can you directly plug into Stereos, MP3 players, mobile phones etc using accessory cables with each manufacturer?
With Cochlear Nucleus 6 you can connect a lead to listen to battery operated equipment or you can choose one of three different wireless
options: The MiniMic, The Phone Clip or the TV Streamer. 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. Medel Sonnet processor can use a
neckloop to stream to other devices wirelessly; this may need to be purchased separately.
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 Rondo speech processor has one omni-directional microphone. The Sonnet
processor has two omni directional microphones.
Do all systems have an alarm to alert you to the fact that the batteries are low?
Yes
Housing of implant
Number of channels
Diagnostics
MRI Safety
Tuning
Advanced Bionics – HiRes 90K
Cochlear – CI512 CA
MED-EL – Synchrony




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
without implant or tissue damage






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 without
implant or tissue damage






Telemetry (implant test)
ART
Integrity testing
Need to check with surgeon first
Internal magnet is removable
With magnet in place, MRI can be
performed up to 3.0 Tesla without
implant or tissue damage

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



Advanced Bionics – Neptune
processor
Advanced Bionics – Naida CI
Cochlear – NUCLEUS 6
Processor
processor
Processor information
MED-EL – Rondo processor
3
5
4
4
 On/off control button on
processor
 Program selector
 Volume wheel




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
 3 rechargeable batteries
(processor needs one at a time)
 Optional disposable
batteries
 Powercel 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
 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
 2 zinc air batteries or
 standard rechargeable
batteries
Accessories
available
 Water proof processor
 Telecoil via t-com (for use
with a loop system)
 Microphone on headpiece
 Splash proof processor
 Optional waterproof
accessory available
 Built in telecoil (for use with
Number of
programs
User controls
Off: disconnection of battery
Program selector
Volume button

On/off control button on
processor
Fine tuner: program
selector, volume, sensitivity
Lock function

3 zinc air 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


Zinc air: up to 5 days
Battery for fine tuner: 6mths
– 1 year
 Behind the ear (BTE)
 Body worn option (two
battery racks needed if bilateral
CI)
Off the ear, the processor, coil
and battery pack are integrated
as one unit.
 Splash proof processor
 Optional cochlear aqua
accessory for waterproofing
 Built in telecoil (for use with


Processor: anthracite, nordic
grey, crème and ebony

Built in telecoil (for use with
a loop system)
Optional waterproof
accessory for waterproofing
 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
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)
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


Data logging
capability

Not currently available
 Yes
 Provides information on
hours of use, program usage,
environmental loudness, feature
usage, control usage and
number of times the coil is off.

Not currently available
Average monthly
return rate (this is
the percentage of
processors that are
returned for repair
over a 6 month
period (MayOctober 2014) #
Holiday loaners

8%

 Yes
 Provides information on
program usage, accessory
usage, different listening
environments, number of times
coil is off and environmental
loudness.
 1%

Not currently available



£25 per trip for one
processor
Processor sent to you
before your trip and needs
to be returned after
Standard loan period 30
days
If the processor is lost or not
returned within the agreed
loan period there is a £1000
charge.
 £30 per trip for one
processor
 Processor sent to you
before your trip and needs to be
returned after
 If not returned in 30 days
after the loan period a charge of
£10 per day will apply for 10
days
 If not returned within 40
days invoice for £2,500
15%

£30 per trip for one
processor
 Processor sent to you
before your trip and needs to be
returned after
 If not returned in 30 days
after the loan period a charge of
£10 per day will apply for 10
days
 If not returned within 40
days invoice for £2,500


Options
Annual cover plan – loaner
shipped to you if a problem
– 1 year cover - pp£95
pfamily - £135
Single trip plan – loaner
shipped –£20pp, £40 per
family (duration of plan 2
weeks)
Full back up plan – loaner
provided –£80 per






Auxillary microphone
Cables to link up to external
accessories via mini battery
pack
Built-in indicator light
Signal check (to check
processor)
Radio aid compatible with
Mini battery pack


processor, £30 for second
processor (bilateral
recipients only) (duration of
plan 2 weeks)
On the annual cover and
single trip plans the sound
processor will be with you in
approximately 2 days
If the processor has been
damaged, misused or lost
there is a fee of £2000.
SPECIAL OFFERS FROM ADVANCED BIONICS
1) Adults who choose a Naida between 15 June and 31 October can choose between getting one Mini Powercel battery or the Phonak
Easycall wireless accessory free of charge. The Mini Powercel is smaller than the standard battery size while the Easycall makes use
of Bluetooth to stream phones calls to the processor.
2) Advanced Bionics are offering their Aquakit for 50% off, in conjunction with their certified retail partners, before 30 September 2015.
Number of
programs
User controls
MED-EL – Sonnet processor
4

Fine tuner: program selector, volume,
sensitivity

Battery type


Average battery life




Range of colours
available***
Wearing options
Accessories
available



2 zinc air batteries
Rechargeable batteries – not currently
available
Zinc air: up to 60hrs
Rechargeable battery: 10 hrs
Battery for fine tuner: 6mths-1 year
Processor: Black, Nordic grey, Beige,
Anthracite, Ebony and White.
Behind the ear (BTE)
Splash proof processor
Built in telecoil (for use with a loop
system)






Data logging
capability
Average monthly
return rate (this is
the percentage of
processors that are
returned for repair
over a 6 month
period (MayOctober 2014) #
Holiday loaners
Standard earhook
Dual microphone
Cables to link up to external accessories
Built-in indicator light
Signal check (to check coil)
Radio aid compatible
 Yes
 Provides information on processor
usage, program usage, number of switch
ons per day, overall days logged, volume
control range, sensitivity control range
 Data not currently available




£25 per trip for one processor
Processor sent to you before your trip
and needs to be returned after
Standard loan period 30 days
If the processor is lost or not returned
within the agreed loan period there is a
£1000 charge.
Reliability data for cochlear implants
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 reliability data for the implants
company
Advanced Bionics
HiRes 90K
Nov 2014
(this includes data for implants that have failed and those
that needed to be explanted due to accident related issues)
99.81% survival rate at 1 year
Advantage
Cochlear
CI512CA
Awaiting data*
MED-EL
Synchrony
Awaiting data**
* 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 CI24RE – this is not the implant you would be getting should you choose the Cochlear device.
This showed a 98.8% survival rate at 7 years.
** 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 Concerto – this is not the implant you will be getting if you choose the Medel device. This showed
a 99.07 survival rate at 3 years.
*** These are the only colours AIS offer; there might be other colours the manufacturers offer.
# data is presented to the nearest percent. This is from both adult and paediatric returns.