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Best Benefit for MED-EL CI Users

Cochlear implants (CIs) are a well-known and accepted treatment method for adults and children with severe to profound sensorineural hearing loss. Advances in technology, increased confidence in experience, and changes in candidacy criteria have made CIs available to a broader population. Due to these technological advances, our expectations of CIs have also changed considerably. In general, users perform well in quiet and have some degree of phone use ability, but have difficulties in noise; more CI users are now able to enjoy music.

What is best benefit?
In general, the improvement in auditory perception following cochlear implantation varies widely from user to user and can range from speech perception to music enjoyment. Nearly all users have some perception of sound; most adults and children can expect open-set speech understanding; and some are able to discriminate pitch and loudness, use the telephone, and enjoy music. Many recipients report that their lives are enriched following implant surgery. The ability to hear raises self-confidence and improves relationships with family, friends, and co-workers, and offers expanded job and social opportunities.

Benefits of a MED‑EL Cochlear Implant may include the ability to:

  • Hear conversation and environmental sounds at comfortable listening levels
  • Detect and identify sounds in the environment, such as the doorbell, car horns, and the telephone
  • Keep their vocal loudness at an appropriate level
  • Understand others more accurately and with less effort
  • Understand speech by listening alone (without lip-reading)
  • Use the telephone
  • Enjoy and appreciate music

What has MED–EL done to achieve best benefit?
Improvements in benefit from the MED-EL MAESTRO™ CI system can also be related to the introduction of the Fine Structure Processing in the OPUS audio processors. The FS4 & FS4p strategies aim at better frequency coding in the low- to mid-frequencies by allowing the neural structures in the inner ear to better phase-lock to the sound signal, as an individual’s normal hearing does in this frequency range.

Demonstrating best benefit with MED-EL

  • 20 children aged less than 36 months and using FSP showed an auditory development that matched that of their hearing peers. This according to results from a LittlEARS Auditory Questionnaire, illustrating a significant benefit for very young children using a MED‑EL for future development of language.1
  • In an assessment of the development of their first 100 words, 76 young children using the MED-EL OPUS 2 audio processor demonstrated rapid development of receptive and expressive vocabulary skills – achieving 100 words within a shorter time frame than infants with normal hearing (n = 63). Children implanted under the age of 18 months required a significantly shorter time to understand and express their first 100 words than those who received a CI later. This again highlights the ability of the MED‑EL cochlear implant system to support and promote the auditory development of early-implanted MED‑EL users.
  • A study concerning eleven children who upgraded from CIS+ to FSP demonstrated that FSP results were significantly better than scores for HDCIS measures, when data was collapsed between groups. Results showed that those children who started out with FSP (as opposed to HDCIS) performed better in the long run.3 It can be expected that this positive benefit with FSP will enhance listening in difficult everyday situations, as well as allow improved music appreciation.
  • MED-EL provides benefit to all cochlear implant users. 60 children who were long-term COMBI 40+ users rated speech and music listening experiences. They significantly preferred listening with FSP for both speech and music tasks.4 
  • MED-EL demonstrates unsurpassed performance in fluctuating speech. OPUS 2 users show a 2 dB advantage in SRT when compared to Harmony users, and a 6–7 dB advantage when compared to Freedom users .5 Furthermore, only the OPUS 2 users show a negative average SRT, i.e. on average, only OPUS 2 users can understand 50% of the speech correctly even when the noise is louder than the speech!
  • MED-EL demonstrates unsurpassed performance in speech discrimination. OPUS 2 users outperformed the users of all other devices (Esprit 3G, Freedom, TEMPO+, Auria and Harmony) in tests both in quiet and in noise.6

  • FSP users reported positive changes in their music listening habits after 3 months of experience with FSP.7 82% of 46 users in an upgrade study reported listening to music every week, if not every day. 91% of subjects reported that, in general, music sounds pleasant with their cochlear implant, 67% reported that music sounded more natural, and 64% reported that it sounded fuller or more resonant. 62% reported that they were better able to recognise familiar melodies; the same number reported improved ability to recognise individual instruments in a known piece of music. Finally, 65% reported improved enjoyment of familiar music and 59% report improved enjoyment of unfamiliar music. These results demonstrate an improvement in music appreciation and enjoyment for users of FSP among recipients of OPUS audio processors.
  1. Sonugler et al. (2009) A comparison of auditory performance of early implanted children and hearing children using the LittlEARS Auditory Questionnaire (LEAQ). Presentation at 12th Symposium on CI in Children, 17–20 June, Seattle, U.S.A. 
  2. Ogut et al. (2009) Comparison of pediatric CI user performance with CIS+, FSP and HDCIS coding strategies acutely and after trial in quiet and noise. Presented at 9th European Symposium on Paediatric CI, 14–17 May, Warsaw, Poland. 
  3. Uruk et al. (2009) First 100 words of Turkish hearing and hearing impaired children. Presented at 9th European Symposium on Paediatric CI, 14–17 May, Warsaw, Poland. 
  4. Lorens et al. (2010) Fine Structure Processing improves speech perception as well as objective and subjective benefits in pediatric MED-EL COMBI 40+ users, IJPORL, 74(12): 1372-1378
  5. Haumann et al. (2010) Speech perception with cochlear implants as measured using a roving-level adaptive test method, ORL, 72: 312-18. 
  6. Brough et al. (2010) Speech discrimination scores using the latest generation of speech processors, CII,11(S2): 119-24.
  7. Müller et al. (submitted) Clinical trial results with the MED‑EL Fine Structure Processing coding strategy in experienced CI users.
© 2020 MED-EL