You are the first person that has said this and it's one concern I have--but, most people that have written about their experience never really had "normal" hearing so it's hard to tell.
What is your concern?
I read through the site--maybe you can answer questions I have??
1. Channels---Cochlear has 22, Med-el has 12--what difference would having more or less channels make?
2. Electrode drivers--what are these and same question above--what difference would having more or less make?
3. Max Stimulation rate--assuming faster is better but better how?? Hearing things in real time vs that brain lag with hearing aid where you sometimes don't hear something until after it's been said (if that makes sense).
4. Electrode Array and length--what are these different ones and what difference do they make?
5. IDR---is this basically the opposite of recruitment--meaning I can listen to louder sounds more comfortably
6. Rehab--is there any difference between the various programs that Cochlear or Med-el use
7. If the clinic has no one else using Med-el, would you pick that brand? They audi's have been trained on them, but haven't used them. I'm assuming insertion is the same no matter which brand and the skill of the Dr is what is paramount.
1. The more channels, the more sound resolution/detail or greater possibility for natural quality. However, you have to understand that Cochlear uses 8 channels, one at a time in roving manner, not the entire array. Med El uses 12 and has the technical ability to exceed that. Cochlear does not. Also, the difference in the number of electrodes between the two has to do with controlling channel interaction.
2. Electrode drivers have to do with current sources. Cochlear has one. This means each electrode turns off and on and directs a channel to the same spot in the cochlea. Med El has 12. This means it can turn on all electrodes at once if desired and it has the ability to control the current and exceed the number of channels beyond the number of electrodes. Cochlear will never have more than the 22 fixed channels, Med El can exceed that into the hundreds. Advanced Bionics is the only manufacturer that currently has a strategy that uses this though, resulting in 120 channels. The more channels, the better and more natural the sound quality.
3. Faster is better in the sense of lending the required control for more advanced programming strategies. Cochlear is limited. They market how they did in-house trials of a program that users report hearing up to 161 pitches by firing the electrodes at a rate to result in stimulation between the existing channels, but many miss the fact that it was done on hardware during in-house trials that isn't available commercially using software that isn't available and that the existing electrode does not have the capability or speed to do this.
4. The longer and thinner the electrode array, the better the chance for deeper insertion for lower frequency response. You can only insert an electrode so far due to the size of the cochlea as you go deeper, which is where the low frequencies are. So in general.. Cochlear Implants have a pure tone low frequency limitation that ends at around the equivalent of middle C on a piano. Harmonics can lend the information to the brain to translate what you hear as bass, but it's definitely not the rich, full bass you once knew. It's also worth mentioning that the above mentioned channel steering capabilities can also steer current deeper into the electrode for lower frequencies. Cochlear cannot do this.
5. IDR is the input dynamic ratio. The range of sound you can hear from loud to quiet at once. The best use of this is when listening to music with all of it's complexities and dynamics. Cochlear is limited to 45 db at once. Meaning it will hear a 45 decibel range based on the loudest sound. Med El has a range of 75. You can guess which one is going to sound more natural. Normal hearing is around a 100 db range.
6. Rehab... I think you mean programming strategies. Rehab is what you do after activation, which basically means listening to anything and everything. One of the best forms of rehab for an adult is to listen to audio books. I'd go to work and plug in to my portable CD player (at the time) and listen to audio books and music. It was great for developing passive listening since I'd be focused on another task. Prior to my implant it took too much active concentration to be able to do that without my work suffering.
7. I'd research into all of the major implant manufacturers as well as get a good understanding of my clinic/audie. Are you limited to just that clinic in your area? What type of incision do they use? Are they going to slice open half of your scalp or create a small incision behind the ear that will disappear? Why do they only do Cochlear with no Med El implants? Is it for their convenience? Cochlear has the largest market share due to being around the longest as well as having a slick marketing campaign, but that's a lot like saying Ford is the best way to go because it was first. It may be what you want in the end, but you should be sure of what you are getting.
Would I choose Med El? No. I chose Advanced Bionics. They have the more advanced internal implant with what will be the most advanced external processor coming out this year. Would I choose Med El over Cochlear? Absolutely. It's my hearing. I would want the best possible chance for great sound quality. The doctor is just going to put in your implant. The audiologist is just going to test your speech scores. They aren't concerned with your sound quality. The less they have to do, the better for them.
My original audiologist, who I "fired" after orientation, told me that I would not have music with my implant while passively trying to steer me towards Cochlear. At the time, the programming strategy "Fidelity 120" (which delivers 120 channels of sound for Advanced Bionics users) was due to be released in a couple of months pending FDA approval. She had zero knowledge of it and behaved as if it was just a rumor, meanwhile it was known fact to those who were researching and there was already a program in place to reserve the new BTE required to run the program. This particular audiologist did not last long at my center, thankfully.
. I have a copy of my results. It's pretty interesting and I want to show my family just how bad this is for me.
