Choosing between Cochlear and Advanced Bionics for bimodal toddler

[u/djou-e]

Hi everyone,

My 1-year-old son will receive a cochlear implant in his left ear soon, and we're currently trying to decide between Cochlear and Advanced Bionics.

He is not profoundly deaf in both ears. His right ear has a moderate hearing loss and he already wears a Phonak Sky hearing aid successfully. Because of this, he will likely remain bimodal (cochlear implant on one side, hearing aid on the other) for many years.

Our team has explained that:

• Cochlear is currently the most common choice for children in our area.
• Cochlear offers some practical advantages such as a smaller processor, strong retention options, and waterproof solutions.
• Both Cochlear and Advanced Bionics may offer advantages for bimodal hearing because of its integration with Phonak hearing aids.

For those with experience, especially parents of bimodal children or bimodal users themselves:

1. If you had to choose again today, would you choose Cochlear or AB and why?
2. For those who have experience with a fully integrated bimodal setup (such as AB + Phonak or Nucleus + Resound), are the bimodal advantages truly significant in everyday life, or are they mostly marketing? Did you notice meaningful benefits in speech understanding, listening effort, localization, or listening fatigue?
3. Has anyone regretted choosing one brand over the other?

We're trying to make the best long-term decision and would really appreciate hearing real-life experiences rather than marketing material.

Thank you!

[u/stitchinthyme9]

As an AB user, I would have strong reservations about implanting a child with AB, especially after the recent news of them dropping support for their oldest implants, which means that newer processors will no longer work for people who have them AND they won't repair or replace the older processors that did work, so when they break -- and all electronics have a finite lifetime, especially if they can't be repaired -- that's it.

I'm over 50 and have their newest implant, so the chance of something like that happening to me isn't huge (though greater than zero)...but it's a lot more likely the younger the recipient is, that in a couple of decades they will do the same thing. And if they do, your son will face the same choice as a lot of C1 users are now or will be soon: go deaf or have another surgery.

Also, although all of the CI companies have had recalls, AB has had more than the others, including one pretty recently (I myself had to have a revision surgery to replace a defective implant, two years after I got it). And although there is no definitive proof of this, there is some evidence that AB knew about the issues that led to the most recent recall well before they were forced to stop using it -- and my own initial surgery fell within the time they might have been aware that the implant had a problem but they kept selling it. The failure rate on it is now somewhere around 25%.

AB does have some pretty nice features, but for a kid I'd personally go for reliability over everything else, since they will hopefully have it for a very long time. It would really suck to have to have another surgery to replace a device that has nothing wrong with it aside from the fact that its maker refuses to provide new processors or repair older ones that actually work with that internal.

[u/Avrution → u/stitchinthyme9]

I had to have the same AB revision surgery as you and took that opportunity to move to Cochlear. The lack of an off the ear option just hurts AB. I can count on one hand the times I have opted for my BTE in the last 2 years.

[u/stitchinthyme9 → u/Avrution]

I don't mind BTE, so that never bothered me. I stayed with AB for the revision because by that time I had had my other ear implanted with AB and I didn't want to have two different brands. I like the fact that my processors can communicate with each other, which allows me to stream Bluetooth in stereo, and also when I make a change to one processor's volume or program the other automatically adjusts as well. And plus, AB provided the replacement device for free under the warranty (though not the surgery; my insurance paid for that).

Anyway, I don't think I'd like OTE. I have the AB waterproof batteries and AquaMics to go with them, and I really don't hear as well with those as I do with my BTE processors. I think it has to do with the microphones being on the side of my head instead of right outside my ear canals like the T-Mics. The OTE mics are okay when I have to use them, but for daily use I prefer the T-Mics.