Skip to content
HearingTracker
Log in

Advise me on 1st time CI for senior

17 replies488 viewsLast reply

Link to this topic
Reply

Your advice for ?s to ask during upcoming evaluation with specialist audi – I know I’ll meet criteria for CI. [More detailed ?s below RE: 1) Pros/cons of vs Nexa; 2) Pros/cons of continuing indefinitely. Primary goal speech clarity; secondary music enjoyment, sounds of nature.

81-year old male in good health, using 10 years (currently Phonak Audeo Sphere, often with Roger On 2 mic; tv-streamer). Iphone with Phonak app.

Adult onset of sensorineural hearing loss steep ski slope W residual <1K; has declined significantly in last 3 years to 36R 32L 40 .

In quiet environment or with Spheric prog in slight noise, or with use of Roger external microphone my aided hearing is generally satisfactory yet requires focus which is NOT tiring. Until now most (important) interactions are with 1 or 2 people; yesterday moved to retirement community so there’ll be many interactions in more complex settings, and I expect many of these’d be unsatisfactory for me / others (asking them to repeat).

Your comments on ?s below, and any general advice/strategy greatly appreciated (I’ve read a bit in this subforum, and elsewhere so know the basics of CI, as well as AB vs Nexa.)

1) Pros/cons of AB vs Nexa I’m very comfortable with tech so stepping away from what I’d expect is easier/better integration of Phonak with AB, and embracing Nexa would be OK option.

2) Pros/cons of continuing bimodal indefinitely I believe audi recommendation might be; 1st 3 months: CI for left, and to be bimodal with right continuing with Phonak Sphere. Then either a) continue bimodal and possibly change R to Marvel aide; OR b) 2nd CI.
My own slight inclination is: CI implant from AB, based on assumption/reading that most improvements come about from the external processor so the 2018 AB CI tech, might not be too limiting. However, I see in “Which factors influenced your decision on brand?” that Raudrive indicates most in forum are CA device users. I have found the HA forum invaluable in solving issues from custom ear moulds to connectivity issues to all of the other “inevitable” issues that arise that participants here have direct experience with versus even an excellent audi who usually knows vicariously. I also note that Phonak/AB have not yet adopted LEaudio and are behind the BT trend. I’m also recalling many comments in threads about HAs brands pointing out that most mid to high tier HA will be a “good choice” but what really makes a difference is the skill and experience of audi doing the fitting. If CI + processor have similar range of adjustments that interact with each other, I will ask audi proportion of his clients with each mfg.; and similarly will ask surgeon. If for any reason ad mfg is < say 25% of their client base, I’ll probably favor what they have more familarity with, AND their own “recommendation” based on conversation and might indicating the rank order of my priorities. I know in “factors in choice” thread one person indicated their highest priority was “reliability” but as far as I can tell the cochlearimplanthelp.com finds the adverse events database “...only modestly useful …” and the graphs they show to me, don’t conclusively point toward a reliability winner.

While appointment with MD is in Sept., the 1st availability for surgery would be Jan. 2027, so I have time to educate myself. Robotic assisted surgery will be at Oregon Health & Science University. This forum will become my new home so thanks in advance to all of you for cutting my learning curve, which along with CI training will be huge focus for next year.

6 people in this conversation15 min readJump to latest

There will be new devices announcement by Advanced Bionics soon, probably autumn 2026. Definitely a new sound processor and a new Naida Link hearing aid (both 2018 technology now), they will have Spheric feature, I'm not sure if there will be new internal implantable device.

For now, the most future-proof is Cochlear Nexa system. Its internal part will have ability to perform FMS (Focused Multipolar Stimulation), which is more precise to stimulate particular nerve fibers.

Thank you @Bimodal_user ... Your coment gives several extra points to Cochlear Nexa as "FMS ready". Reading a tiny bit about FMS poistive impact on music appreciation (one of my priorities) is exciting news. Any speculaion on when Nexa might utilize FMS?

As always the collective insight and wisdom of this forum is wonderful; grateful to you and all others.

In reply to @Edma

Great info from .

Something else is Bluetooth. The Cochlear Nexa implant, K3 and N8 processors are LE Audio ready. A firmware update would get them going.

If you go bimodal the Cochlear system with a compatible Resound hearing aid links with the processor on the Nucleus Smart app.for full control of both.

Good luck on your decision. Both brands are good and should give very similar hearing results.

So far the huge value for me in this thread is that I am leaning strongly toward Nexa whereas when I started it was toward and the likely easier integration with existing Phonak and Roger. I know this won't be a free lunch and dealing with two different brands and their apps, maintenance and quirks and gotchas might be annoying at times, hopefully that doesn't turn out to be a huge downside.

I'm open to all other comments and thoughts from those with far more experience, AND advice of audi CI specialist who will do all of the followup will also be very important. While it will be nice to know my trajectory now, it is clear that CI in left initially, and with training and experience of ~3 months (around mid March 2027) then decide whether to continue , and when to do 2nd CI.

Thanks for witnessing my decision making and strategy plan.

In reply to @Edma

@Edma said:

2) Pros/cons of continuing bimodal indefinitely

As far as I’m concerned being is the best of both worlds. I have a little bit of natural hearing left in my ear. My ear has a tiny bit of resident in it, which is not useful for conversation though.

The only con is getting both ears balanced if that’s what you want. My preference is to have my HA ear slightly louder than my CI ear. This gives me more natural sound.

Rehab is very important. I did 2 hours speech rehab a day. My went from 26% to 94% in the 12 months after CI surgery. For me speech was easier than getting environmental sounds. Eventually everything fell into place.

Music appreciation is a very tough gig after CI. It took me hours upon hours of rehab before music even sounded half like music. I kept music going and around 10-11 month post CI surgery music sounded good exactly how it should.

Good luck on your new hearing journey.

Hi Edma, just to add to your research, I'd like to suggest Vince Werner YouTube channel called Un-sound2 He's an audiophile and opted for with Phonak Link M and has a video about how he came to that decision and also a review after a year implanted. He praises the AB's T-mic and Acoustic Hook features that I believe it's unique to AB.

I'm also researching about brands and bimodal options, just wanted to share this so you can add to your information file :slight_smile:

In reply to @Edma

@Edma said:

Any speculaion on when Nexa might utilize FMS?

Unfortunately, no idea.

@Edma said:

Adult onset of sensorineural hearing loss steep ski slope W residual <1K; WRS has declined significantly in last 3 years to 36R 32L 40 Binaural.

You know that I am N8 (non Nexa) and Infinio Sphere 90 Ultra user. However, keep in mind I have 100% in ear.

If I were you (YMMV, so don't take it as written on the stone), regarding that you're probably eligible for bilateral , I would seriously consider waiting what Advanced Bionics will bring to the table soon in Autumn. There was Medwatch.com3 website article about it and one topic on this forum about that article

Even if you go , new Naida Link hearing aid is also useful in providing bilateral features like narrower beamforming, etc.

So grateful to each-all of you; this cuts my learning curve and gives solid info to consider. Since surgery very likely won't be til 2027, I have some time B4 locking into a brand.

@Deaf_piper Glad to read that your perseverance and commitment to rehab had great end results. RE: Music, I recall in forum commenting to person perturbed by music sounding "off" with that while that was also my experience at times, I used this strategy. Amongs musical forms I love is classical. I'd choose to just listen (not "multitask") and choose some piece with which I had a strong emotional connection, and could anticipate the unfolding of the composition. I highlighted in my experience the ebb and flow of my feeling response to and with the piece and let the sounds "heard" be almost an accompaniment to the feeling tone; this was very satisfying and any "oddness" about how instruments sounded might not have disappeared but had faded into the back ground.

@MayaL Thx for note about Vince Werner which I will check it out. The T-mic makes sense to utilize the architecture of the ear which "shapes" the sounds entering the ear canal. While my earlier comment emphasized my feeling sense of music, I am visually dominant and often visualize if appropriate a string or jazz quartet along with the sounds of the music - the physical location of players and instruments in a live performance (when my eyes are open) are vital parts of the total experience, and aides to localization of the source of sounds. Going back to my own audiophile days it is the ability of a speaker system (and room acoustics) to present a sound stage that is engaging and present-alive.

@Bimodal_user Thx for additional info on up and coming offering.

So now my guess is that AB and CA-Nexa are back to being a toss up for what I might prefer as the optimal set of trade offs. But unlike HAs there isn't a 90 day trial for .

I expect CI audi specialist I'll see later today will also have meaningful input and experience.

As I've always known, hearing starts in the ear and continues as listening in the brain-mind. I have a lot of influence over the brain-mind aspect. I expect I will have a deep experiential learning of that with the upcoming CI left ear as I imagine a lot of what rehab is about subjectively is exploring and working with these linkages (translations).

RE: music perception/appreciation and . I believe that from initial clinical trial that CA-Nexa with its potential for FMS in the future (some article I read estimates commercial roll out in 2030) that FMS will be better approach (versus the kind of improvements that Sonova -Phonak- are getting). Here are some notes from some of my own ai searches: I believe this ( https://clinicaltrials.gov/study/NCT05003674?tab=study ) is the key (USA) clincial trial being referenced. The CI dept at OHSU (Portland Oregon) which is where I will do CI, participates in various clinical trials so I will inquire whether they are one of the test sites for FMS. Also thisGerman clincial trial (https://drks.de/search/en/trial/DRKS000278171)

Focused multipolar stimulation (FMS) significantly improves music appreciation by fixing the primary limitation of standard cochlear implants: poor spectral (pitch) resolution.

Standard cochlear implants are designed primarily for speech. Because they spread electrical current widely inside the cochlea, different musical notes "bleed" into one another. This often makes music sound "sour," mechanical, or like unstructured noise to implant users.

Ongoing clinical feasibility trials and registered studies (such as NCT050036741 and DRKS00027817) target these exact issues. The specific impacts of focused stimulation on music appreciation include:

1. Sharper Melody and Pitch Recognition

  • The Problem: Standard implants struggle with pitch and melody, often leaving users at "chance levels" when trying to identify a song without lyrics.
  • The FMS Fix: By narrowing the electrical field, FMS isolates specific auditory nerve fibers. Clinical data shows this reduction in "channel interaction" yields significantly better pitch discrimination. This allows users to actually perceive the ups and downs of a melody rather than hearing a flat wall of sound.

2. Enhanced Timbre (Instrument Separation)

  • The Problem: In standard monopolar mode, a guitar, a piano, and a violin playing the same note often sound completely identical and muddy.
  • The FMS Fix: Timbre relies on the brain's ability to detect subtle harmonics and complex sound layers. The precise spatial stimulation patterns of FMS allow the user’s brain to separate instruments, making rich orchestral or multi-instrument tracks much easier to decode.

3. Increased Subjective "Pleasantness" and Mood Recall

  • The Problem: Studies tracking the emotional impact of music show that implant users often experience a "dampened" emotional response to music because the sound quality lacks fullness.
  • The FMS Fix: Quality-of-life and music appreciation metrics in focused stimulation trials show higher subjective ratings for sound naturalness and pleasantness. When harmony and dynamics are restored, the music regains its ability to trigger emotional responses and complex memory recall.

4. Reduced Listening Effort

  • The Problem: Listening to music with a traditional implant is hard work. Users must actively strain to mentally "reconstruct" a song based almost entirely on its rhythm.
  • The FMS Fix: Feasibility trials specifically measure listening effort. Because FMS delivers cleaner acoustic boundaries straight to the nerve, the brain does less cognitive guesswork. Users report being able to listen to music passively in the background for enjoyment, rather than treating it like a tiring concentration task. [1, 2, 3, 4, 5, 6]

Hi Edma

Another YouTuber you might like is Aidan Toominator @cochlearimplantlife2

He talks a lot about music rehab techniques with . I believe he has CA brand.

Unrelated to CI but for a full immersive musical experience he recommends a Woojer Strap 41

It’s a wearable haptic device that converts audio into vibrations, he says it works with any type of music including classical.

In reply to @Edma

Interesting, there is update from 21 Jul 2026:

FMS, MP SPACE researchMore information:

Basic reporting, version 1, 21st July 2026

@Raudrive, @Deaf_piper, @ssa, @bcarp, @studio.prawns_0q, it seems we could also gey benefits from new strategy, but not FMS (which requires special implant, which provides multiple current sources), but MP SPACE (monopolar spread precompensation ACE).

https://drks.de/search/en/trial/DRKS00027817

Hearingtracker put out a news letter recently that mentioned Phonak/ updating the Link and CI processor. These new hearing aids and processors would include Sphere noise control and . This is a very nice step for Sonova. I don't remember anything about a new implant though.

With this information I probably would still go with the Cochlear Nexa system but Sonova is moving forward.

Edited

Thanks for continued interesting and valuable posts. After meeting with audi, I am leaning quite strongly toward Cochlear-Nexa, because:

  1. While dept works with all 3 brands, audi estimated that 75% is Cochlear, followed by MedEl, and with the least. Of all the audis, he himself has more AB clients than others. Cochlear and MedEl have documented track record for successfully retaining residual hearing. I will discuss with surgeon if he has any strong preference for me for Brand, although I anticipate that my ear anatomy is fairly typical and its architecture wouldn't push toward a specific brand.

  2. Cochlear's upgradability path seems like a fabulous feature, and audi agreed that if I were to have same CI for a decade it'd be likely there'd be at least 2 significant tech improvements. I know that like the external processor of all 3 brands will be improved, but capacity to "improve" the implant itself seems like a good strategy (and I am especially interested in the research on FMS that Cochlear cold implement).

    These first two are probably the most significant factors in my evaluation and decision making.

  3. Since Cochlear user are quite prevalent on this subforum, ongoing support & mutual assistance for that platform might be more robust than for AB or MedEl. At least based on my Phonak HA exp. there seem to be inevitable gotchas with the tech that forum members are great at solving.

  4. Cochlear is already LEAudio, and while it is promising that AB per @Raudrive is about to do so, they are a bit behind the trend.

  5. OHSU in Portland OR is already participating in one Cochlear research study. so perhaps I might have opportunity to be part of some Cochlear FMS trial.

    I do realize that in comparison to AB, going with C-Nexa during time I'll be that the integration with my existing Phonak Sphere & Roger On will be a bit more cumbersome, that potential annoyance might be a minor downside.

    I still have a bunch more research to do, but above is current thinking. {Edit: I just saw that Phonak/AB integration for streaming would be best/easiest with Phonak Marvel, which would be a downgrade from current Phonak Audeo Sphere; so perhaps even for this driterion AB isn't any better than CA-Nexa.)

@Edma said:

I do realize that in comparison to AB, going with C-Nexa during time I'll be bimodal that the integration with my existing Phonak Sphere & Roger On will be a bit more cumbersome, that potential annoyance might be a minor downside.

Really minor downside. I have two icons side by side on the main screen of the phone, one for , second for Phonak. Both are closest icons to my thumb.

Sensible approach with hearing preservation. Who knows, you may be able to be in hybrid mode.

Surprising and pleasant surprise that you live so close to where the FMS research study is.

Thanks @Bimodal_user for your continued input. Note that OHSU in Portland Oregon participates in some Cochlea trail/reserach studies, but there is no indication (yet) that that will be true for FMS. I will inquire of surgeon, and hope that might be "yes" which would be very interesting to me.

Hi there - just seeing this post. You are doing a great job at researching your decision! Kudos to you. I am a happy 4 years post implant /Phonak Marvel user. @Raudrive is correct in pointing out the new processor/HA combo coming soon from AB. It is already available in much of Europe and awaiting greenlight for US. I am excited to upgrade a year from now when insurance (US) will cover the CI upgrade. I will purchase the new HA that pairs with it for best results. Here is a link to info about the new version: You could also join the AB Germany Facebook page to gather info. It has a translate option. Note: link is to the "Sky" which has some extra features used in classrooms by children, but MANY adults choose because the colors are awesome (teal for me).

I wonder, what will be new Naida Link. I hope that will be at least Infinio Sphere, not Lumity.

However, given that Integro sound processor has Autosense OS 5.0 (old, 2022 Lumity technology), I am rather pessimistic...

 

That would be no revolution for severe losses who especially need improvement.

Related discussions