Med-El's Maestro
AB's Harmony
Cochlear's Nucleus 5
Many people I have talked to about these note that the most important part to pay attention to is the internal processor because you "marry it and the company." The internal processor is the piece that will go inside my cochlea and be implanted in the base of my skull, with a magnet embedded. The images you see above are the external processors that go behind the ear and attach to the magnet. The reason you marry the company though is because the surgeon will typically never go back inside the ear and upgrade the internal piece, except maybe, very rarely, or if it needs to be taken out due to complications. But the external processors can be upgraded as newer models are released.
Externally, the biggest difference between the 3 is that the Nucleus is the smallest one yet, but comes with a remote, of a sort, to change settings. The Med-El is pretty typical in size and there's nothing fancy to it, but it has the option for 3 different kind of cochlea implant stems and also comes with a remote. The Harmony is the biggest in size, unfortunately, but does not come with a remote... it has sensors to switch settings on its own. As far as the important things go, like pitch potential, temporal and spectral resolutions, decibel range, this chart is the best thing I can find to summarize the difference between the Nucleus and Harmony. The Maestro is kinda in between the two of them.
Which one did I choose? The Harmony. That chart was the reason why. It has a wider range of potential sounds than the other two have and that's ideally, what I want, as I don't want to be able to just hear people and converse better, but I want to be able to hear as close to normal as possible. I know I won't hear "normal" whatsoever, ever again, but it gives more benefits for the possibility of hearing more than the other two provide. With that said, I can't even process why people pick the Nucleus... it's like picking glasses that see 25/20 instead of 20/20, or 15/20. I know this processor I'm choosing is on the big side, but there's a good chance a smaller version will be released in the next 5 years, probably.
Any questions?
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If I got implanted now rather than 10 years ago, I would have probably chosen the Harmony by AB. But back then, it's what my parents thought was best.
ReplyDeletePart of what factors in for many people is the reliability issue -- no one wants to go through reimplantation after only a year or two. When we chose Cochlear's product a couple of years ago, AB was in the midst of the 2nd of two big recent recalls in which the implants were faulty and many had to be explanted at our local hospital. We were facing some serious concerns of our own about this, as well as from several surgeons who were pretty outraged by the device failures and higher incidence of infection. I do think those failures were a serious wake up call and that todays' recipients are not putting themselves in any undo danger, but at the time, things were a little dicey. There are charts like those you showed (and I've read several other great studies) that make me drool over the AB device, but the Cochlear product also has some significant strengths over the AB device that may tip the balance for some people, especially those with prelingually deaf children. Honestly, I think we'd be thrilled with any of the 3, in fact, I wish we could have had one of each (well, obviously, only 2 would be possible :) ) but we're extremely happy with the N5.
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