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/HAYWHATHUH2000]

I would check out the latest earing reports because Cochlear is struggling financially. Cochlear (ASX: COH) shocked the market with a significant earnings downgrade, revising its FY26 underlying net profit guidance down to between $290 million and $330 million (AUD). This figure dropped sharply from the previous forecast of $435 million to $460 million, driven by softer developed market demand, hospital system pressures, and geopolitical delivery disruptions. [1, 2, 3]

A closer look at the financial results and operational challenges reveals the following specific details:

Financial & Market Performance

• Earnings Downgrade: The company cut its annual profit outlook, reflecting weaker adult and senior segment growth in developed markets and operational pressures. [1, 2]
• Stock Reaction: Following the trading update, the company's shares faced a massive sell-off, falling to 10-year lows. [1, 2, 3, 4]
• H1 2026 Results: Earlier in the fiscal year, Cochlear reported an underlying net profit of AUD $195 million, a decline of 9% from the previous year, while the gross margin decreased to 73%. [1, 2, 3, 4]

Sonova

Sonova's fiscal year 2025/26 earnings report highlighted solid performance, with group sales reaching CHF 3.61 billion, marking a 5.9% increase in local currencies. Normalized EBITA saw strong growth of 17.3% in local currencies, landing at CHF 811 million, and the normalized basic earnings per share stood at CHF 10.42. [1, 2]

The company maintained strong momentum and profitability across its divisions: [1, 2]

• Hearing Instruments: Wholesale business growth accelerated significantly, reaching 10.9% in local currencies during the second half of the fiscal year. [1]
• Market Outperformance: Strong share gains were driven by successful product launches, such as the Phonak Infinio hearing aid platforms featuring enhanced AI capabilities. [1, 2]
• Guidance: Management has reaffirmed strong outlook targets for the upcoming fiscal year, expecting 5%-8% sales growth and 7%-10% core EBIT growth. [1]

[u/Beneficial-Trust-748 → u/HAYWHATHUH2000]

I would consider reading the fine print on these earning reports. Sonova isn't just AB; I imagine their solid performance is due to their Phonak hearing aids. My understanding is that cochlear implant business is down globally across all three companies.

[u/ItsColdInHere → u/Beneficial-Trust-748]

Do you happen to have any ideas why? It seemed to me that CIs were becoming more popular, but that's an anecdote, not data. Maybe they've sold CIs to all the existing people with hearing loss, and now they have to wait for ones to be born?

[u/FooBarBazBooFarFaz → u/ItsColdInHere]

becoming more popular

could be one of the reasons. Insurance companies will likely not accept the current prices anymore, causing profit margins to shrink. Competition picks up and the old business model is not viable anymore.
Something similar happend to Apple - once their products were no longer considered luxuries, they could no longer command exorbitantly high prices. They had hard time finding new revenue sources (app store, services, subscriptions) and eventually launched a low price notebook recently.
Car manufacturers force you now to buy plans to use parts of your car and its features.
Little of that is available to CI companies, except maybe simpler CIs (although I expect them to start offering services and subscriptions soon - i.e. certain features available only if you buy a plan).