Tuesday, June 1, 2010

Advanced Bionics

The decision to get a CI is only the beginning. I stumbled into the whole process only vaguely aware of the choices that would be involved, the decisions and commitments I would have to make along the way. My first obstacle, once I had been evaluated and deemed a good candidate, was to decide what kind of CI to get.

There are three companies that manufacture CI devices - Advanced Bionics, Med-El, and Cochlear - and all three have their subtle differences. When I first went through the choices with my audiologist, she told me that all three devices had similar performance results, so there was really no going wrong. Essentially, she was telling me, in the long run it didn't matter.

This insight was echoed by the other professionals I talked to. My future surgeon told me that, when he and his other implant specialist friends convene for lunch, they debate about which device each of them prefers. There is almost never a consensus. "Each doctor has his own preference," he told me. "It's like talking about cars. Some people love their Ford, while others would prefer to drive a BMW or a Lexus." Again, he was saying, it didn't matter. I wanted to throw up my hands - I might as well pluck a name out of a hat.

Wait a minute, though. This is a huge decision that will affect the rest of my life, the way I hear - and I'm going to take it so lightly? Even the car analogy, upon closer scrutiny, breaks down. While some people are die-hard Ford supporters, I think it's true that a Lexus is a higher-quality car. Sure, all these car models have four wheels, an engine, and will get you where you want to go, but that does not mean they are the same. Preference and subjectivity may be part of the decision to get a CI, but I did not believe that all the CI devices were inherently created equal. My parents didn't, either. Which one provided the best technological platform, the best features, the best innovative potential? We set aside the noncommittal advice of the doctors and set out to do our own research.

Quickly, we found that it was almost no use to research directly from the companies themselves. All are subject to marketing techniques, and all have detailed statistics showing why their device's performance is better than the other two. In addition, talking to company reps was inherently biased. We began to search for more fundamental comparisions between the three.

Here is a general recap:

Cochlear. By far the "name brand" on the market. Has been around the longest, since the 1980s when the cochlear implant first came into prominence. Because of this, has by far the best publicity, the best advertising (involving beaming little kids running around with their parents looking on proudly), and the most users. The friends I have who do wear CIs all have Cochlear. The inner implant has a removable magnet, in case there's ever an emergency requiring removal for a MRI (scary possibility, but necessary to consider). However, the technology of the internal processor is lagging behind the other two companies. Cochlear has just come out with a new Nucleus 5 device, but this appears to "max out" the potential of the implant for any future upgrades. Admittedly, I found this device the most attractive. The new Nucleus 5 device has gorgeous aesthetics, compared with the other two - a sleek, slim external processor looking something like a cross between a Bluetooth device and some hip new Apple technology. The hand-held remote that controls its programs looks a lot like an iPod. Sexy!

Med-El. The second most used brand after Cochlear, and it has more removable/rechargeable battery options. The external processor was much less attractive, though - blocky and unwieldy, and looked as if it were made of a cheaper-quality plastic. Better performance electronically, perhaps, but the magnet on the inner implant is not removable. We didn't pay much attention to this one, to be honest.

Advanced Bionics. The largest (and, ahem, ugliest) processor of all, I must say. The first time I saw the external BTE, I thought, "Ugh, it looks just like a brick." But AB is a newer company, and has a more forward-thinking technological platform. The inner magnet, like Cochlear, is removable. The inner array has the best electronics, and the BTE has a patented T-mic microphone that gathers sound from the ear canal itself (where the pinna of the ear naturally collects sound waves), rather than elsewhere. The processor also has a set of new programs targeted toward making it easier to hear in noise and to appreciate music. Plus the company, from talking to reps, seems to have the most vision for future innovation.

In describing the three different brands, I think I have made it generally clear why I settled on AB for my cochlear implant. I will not explain all of the pros and cons of the different companies here; there are plenty of better-versed people and websites out there for that, and my overall impressions are enough. I am especially indebted to Tina's intensive research on the different CI brands at http://funnyoldlife.wordpress.com/cochlear-implants/choosing-a-brand.

I feel confident that I have settled on the best implant for me, and hopefully AB's future technological improvements will make the device more attractive to wear. To close, here is a more detailed picture I found of what the implant will look like, inside and outside:

Above is the internal processor (and its comparative size), below is the external BTE and magnet. Kind of scary, huh? You can see why the first CI researchers gathered criticism for "unethical" experimentation with humans...

But yet - it's amazing to look at and to ponder. The marvels of science.

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