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Cochlear vs. MED-EL for SSD: Processing lag vs. noise cancellation

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Processing lag vs. noise cancellation after 6 years of being single-sided deaf

Hi everyone,

I’m looking for some honest feedback from anyone who has had to make the choice between Cochlear and for single-sided deafness. I lost almost all hearing in my left ear suddenly 6 years ago () and am getting ready to go through with surgery.

I’m really struggling to decide on the brand. Based on my past experience trying out a single hearing aid on my deaf ear which is terrible cuz the brought huge noice with echo, my priorities are clear: Processing Lag > Noise Cancellation > Bluetooth Connectivity.

I ended up throwing my hearing aid in a drawer because even in quiet rooms, the processing delay on that side created this awful echoing effect with my good ear. It gave me terrible listening fatigue. My biggest fear with a CI is that a noticeable time lag will prevent my brain from fusing the sounds from both sides.

I have two main questions about how the tech holds up in real life:

1. The Processing Lag: ACE vs. FineHearing From what I‘ve known Cochlear’s ACE strategy is frame-based, meaning it processes sound in blocks and introduces a hard-wired delay of about 10–12ms. MED-EL’s FineHearing, on the other hand, uses continuous parallel processing, keeping the delay down to 0.5–3ms, which is more like a natural ear.

For those Cochlear SSDers, did that 10ms+ lag drive you crazy at the beginning? Did your brain eventually truly “fuse” the time difference, or did you just get used to it and start ignoring the echo (like a background breathing effect)?

For MED-EL users: Is the zero-latency experience really as seamless and instant for dual-ear integration on day one as they claim?

2. Noise Reduction and the “AudioLink” Accessory I’ve known Med-el Rondo2 has only 1 microphone so its noise cancellation should be weaker than Cochlear’s K2 which owns 2 micros, but I know they have a clip-on accessory called AudioLink—the black one that looks exactly like a standard Bluetooth earbud with a stem (like AirPods) which acts as a remote mic and streamer. Does it work well for you?

I really want to get a sense of how this plays out long-term before making a choice. Any insights on your daily wear time and how your brain adapted would be incredibly helpful.

6 people in this conversation9 min readJump to latest

Hey there Jue,

I have a single-sided Cochlear branded N8, previously an N7, and normal hearing on the other side. I did notice an audio latency initially. It would have been more than 10ms but not by much. I’m guessing 20ms perhaps? It was just noticeable when listening for it (& less obvious to how I used to mix audio tracks with a 20-30ms cross side audio delay). It was never really a problem & not noticeable in everyday life. I haven’t listened specifically for it with my N8, but i certainly don’t notice anything on a day to day level now.

What is definitely more noticeable is the latency of hearing enhancement systems, such as . They would probably be in the order of 50-100ms sometimes. Someone tried to sell me a wifi-based system in a building I was renovating, but when I tested it with its 200-300ms latency, I turned that option down immediately.

Your lag question is almost impossible to answer because none of us people have used both brands to compare. What I do know is the brain is a very flexible plastic learning device. It can make things normal that may not be at first. Hearing is a great example.

I can not compare noise reduction between MedEl and Cochlear. I have N7 and K2 processors. I wore Phonak before and liked Phonaks noise reduction better than Cochlear but I have read from CI people the N8 and K3 are better in wind and general noise reduction.

As far as Bluetooth Cochlear is hands down better than MedEl.

You haven’t mentioned Cochlear’s new Nexa implant system. It’s by far more advanced than the other CI manufacturer’s. The implant firmware can be updated with new technology without being taken out of the patient. It also saves mappings so new processors can be loaded with mappings without an audiologist and software. Impressive new technology.

Welcome to the forum June

@Dani has Med El and has used the audio link. I can’t comment on its quality of sound or latency. Hopefully he will chime in on this. But Dani has said he’s had to replace the Audio link several times over the last 4-5 years.

Are you not able to get the latest model of from both Cochlear and Med El? Both CI companies that you have mentioned have released a newer version of the processor than you have mentioned? Med El has the Sonnet 3 processor and Cochlear has the new Nycleaus Nexa system with the N8

Thanks Piper！Looking forward to Dani’s reply. About the latest verison question, yes you’re right. I’m right now in Beijing and the social medical policy has changed in a good way for hearing loss people: It allows people to get and covered some main domestic brands and foreign big brands which is Cochlear and Med-El, and then the cost was reduced straight down to about 2k dollars, but only older versions like you said are covered. The new ones probably get into the national medical pool within 4-5 years. Before all these happened only both-side-deaf people were actually allowed to get CI implanted.

In reply to @bcarp

Thanks for sharing！What do you mean by 20-30ms delay when mix audio tracks？Is it about when you wore and at the same time？Besides what do you mean by hearing enhancement system and wifi-based system？Is it some offcial device rolled out by Cochlear?

@Jue said:

What do you mean by 20-30ms delay when mix audio tracks？

Ahh, my comparison was to a known value for me. Before I developed single sided deafness, I could audio engineer live music sets in stereo. One of the standard tricks to enhance a single instrument was to have it exit one speaker 20-30ms after the other speaker, giving it more presence without increasing its volume. You’d notice that delay only if you specifically listened for it.

So, using this as my benchmark, I think my cochlear processor on my deaf side has introduced a 10-20ms audio delay compared to what I hear in my other good ear.

@Jue said:

Besides what do you mean by hearing enhancement system and wifi-based system？Is it some offcial device rolled out by Cochlear?

I mean systems that are built into buildings that allow their audio amplification systems to feed sound directly to hearing aids & cochlear processors. So, instead of singer → microphone → audio system → audio speakers → sound waves → cochlear microphone → cochlear processor, the sound can shortcut from audio system → hearing enhancement system → cochlear processor. This might be magnetic embedded around the building walls, or an RF transmission system, or infrared, or wifi-based. Just different ways to get the sound to the processor while bypassing actual physical sound waves. It’s gives much better clarity to speech and music. They are not unique to Cochlear; they are standardised. However, the hearing enhancement/augmentation system processors sometimes run slowly and introduce their own latencies.

Edited
@Jue said:

Based on my past experience trying out a single hearing aid on my deaf ear which is terrible cuz the HA brought huge noice with echo,

That was probably from poor fitting, not hearing aid itself. What was the model of the haering aid? Did you have open domes or earmold with large vent? Inserting values in your profile setings could help in providing you more accurate informations.

You can ask also in the Facebook group - Single Sided or Unilateral Deafness:

Facebook1

Speaking from me - I have not any problems, but I am biased because my better ear has also ~2-7 ms delay from depending of quiet/noise situations and program used. program introduces ~15 ms reportedly, but it is no problem, I don’t perceive any echo, particularly when I have tight fitting (small vent).

Edited
@Jue said:

what you said about the huge lag is new to hear. That’s too bad

Why huge lag? I don’t understand. Ordinary Bluetooth devices can have much more lag than even that 15 ms which is activated ONLY in large noise ~70 . Other situations (most of our lives) is that 2-7 ms

I understand that you can have bad experiences with former fitting, BUT:

  1. When was it?
  2. How tight was the fit? How much ventilation?
  3. Which hearing aid model?
  4. Have you sought a second opinion?
  5. Do you realize that mechanism of action of hearing aid is different than system? With CI, after digital processing, there’s almost straight electric current almost directly to the cochlear nerve.
    With HA, you have sound air conduction to the eardrum (lag), and then mechanical conduction through the ear ossicles (malleus, incus, stampes) - that’s another lag.

I think you have the same problem as many people with tinnitus - you worry too much about this problem. Many people with tinnitus have got great improvement when they stopped caring so much about it and thinking about it every day.

That issue with lag, have not to occur at all, it is not even specifically mentioned when describing the side effects of CI. You also don’t take into account the brain’s ability to adapt with training. I understand that often it requires some commitment to training, but it isn’t that bad as someone can think.

I apologize for being blunt, but based on my experience, sometimes we need that straightforward notice.

@Jue said:

. I just googled it’s like basically the most foundamental improvement of Kanso3,

Kanso 3 Nexa - off the ear () sound processor in Nexa system

Nucleus 8 Nexa - behind the ear () equivalent of Kanso 3 Nexa

Another equivalents:

Kanso 3 (without Nexa) = Nucleus 8 (without Nexa)

Kanso 2 = Nucleus 7

Kanso = Nucleus 6

I am and received Cochlear Nexa N8 in Nov; activation in December.

Going into surgery with right ear masked my left (impacted) ear even with top of the line Oticon fitted properly had 0% wrs.
I am not familiar with what lag you would be anticipating. I could have gone with Med El or Cochlear; surgeon does both. Audi that would be in charge of all programming for the advised that in my area Cochlear has a lot more support and resources. She asked if I was planning to move in the near future (if so she would check which Brand is most established in that area). I was not planning to move so went with Cochlear.

As part of my learning/training, I have the tv set up to stream directly to the CI and no sound picked up by my good ear. However, in the instance that I have both sounds on even directly after activation I did not pick up anything that was a lag.

Good luck with your surgery!

@nicmger said:

However, in the instance that I have both sounds on even directly after activation I did not pick up anything that was a lag.

I am the same way, never noticed any lag what so ever.

I believe the manufacturers are advertising things that make zero difference for us CI people. Kind of like high fidelity music equipment. The sounds advertised from each brand are so far away from human hearing it’s pretty much nonsense. You would have to be a dog to hear these advertised specifications. Just selling advertisements.

I’m , the only time I notice a lag is when I make a phone call. My comes in straight away on the first phone ring. My comes in on the second phone ring. When the person answers the lag has gone. This lag doesn’t bother me at all as it’s only noticeable when I make a phone call.

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