As a child, I had allergic reactions to everything and anything that grows under the sun, (i.e., grass and tree pollen, dust, mold, etc.) So I commonly experienced recurrent ear infections. Therefore, I was always given antibiotics or antihistamines, and ironically, it was also said that the medications I was taking affected my hearing loss as well. Either way, I was one of those people that thought hearing-aids were always going to be part of my life. Never imagined that hearing-aids were no longer going to be sufficient for me. Yet, during a hearing evaluation, my audiologist told me I should consider cochlear implants, and I went home feeling overwhelmed. Fast forward to 2011, and after being told I qualified, I started to research more and more about cochlear implants all the while asking questions in social media. It was all a little daunting but having most of my worrisome questions answered by my doctor and by other cochlear recipients slowly gave me confidence to go forward with the process.
In 2012, I decided to get a cochlear implant – and it was a success! Having had such a great experience with my first, I decided to go for my second a year later, becoming bilateral in 2013. At that time, I received the Nucleus 5 processors (for both sides), and I continued enjoying the journey for approximately 8-9 years until it was time to think about an upgrade. Cochlear Americas had just released their newest processor: Kanso 2. So, I knew that all I needed to do to get the upgrade process started was to email or call Cochlear, as they now have a Reimbursement and Insurance Services department to help with the process. Cochlear Americas also takes care of contacting my Audiologist and ENT Surgeon to obtain the letter of medical necessity and other information pertaining to the upgrade. Consequently, I am happy to announce that my upgrade was successfully approved, and that I have had the Kanso 2’s since November 2020.
Key Features of the Kanso 2
Built-in Rechargeable Battery: The rechargeable battery is non-removable, and internally settled (built-in) inside the Kanso 2. This means I do not need to worry about putting on or taking off the rechargeable battery, because the Kanso 2 is a one-piece unit processor. This is also known as an Off-The-Ear (OTE) processor.
Easy on and off functionality: I can turn it on by placing it on my implant and turn it off by taking it off. Or I can tap twice to turn on and tap three times to turn it off while it’s still on my implant.
SmartSound iQ with Scan Technology: The scan technology is automatically listening to the surrounding sounds, and it adapts or changes the settings depending on the environment. There are six scenes in total: Quiet, Speech, Speech in Noise, Noise, Music, and Wind.
Direct connectivity to a smartphone: Connecting to a smartphone (Android or iPhone) to stream and enjoy music, movies, videos, phone calls and video calls.
Nucleus Smart App: The app can help control the sound settings, track hearing data, and battery level. It is free and can be downloaded from the Google Play Store or Apple Store.
Dual microphones: This is important to help filter out background noise and enhance the hearing experience.
Once I received the processors, I called my audiologist to make a mapping appointment. This was necessary because the Kanso 2’s I had received are the latest and newest processors available – and were completely different from the processors that I was using.
In comparison, the Nucleus 5 is a behind the ear (BTE) processor, whereas the Kanso 2 is an off the ear (OTE) processor. This allowed me to free my ear for wearing glasses or sunglasses — and masks which are required now due to the pandemic.
With an Off-the-Ear processor, I won’t need to worry about the coil or the cable, as the Kanso 2 is a one-piece unit. Moreover, the Kanso 2 has a built-in rechargeable battery in it that is non-removable. This means that when I am done for the day, I can simply place my processors in the charger/dryer box and close the lid to allow it to automatically begin charging wirelessly. It takes approximately 3 to 4 hours to charge in full. However, because most of us sleep 6-8 hours at night, it has been said we can leave them safely drying overnight, the technology is smart, and the charger/dryer won’t overcharge the processors.
Once I go about my daily routine, and if I am attending online meetings that day, I know I can use the Mini-Mic 2+ to stream directly into the Kanso 2’s. All I have to do is plug one end of an audio cable into the headset port on my computer, and the other into the Mini Mic 2+. Then I select the audio input on the Mini Mic 2+ by pressing its mode-selector button three times to set it to the music icon. The Mini Mic 2+ streams sound wirelessly to both Kanso 2 processors, and its mic picks up my voice. This, to me, is a game changer! The sound quality is impressive, and I can follow conversations with my colleagues via Zoom. Just to be able to listen and chime in with constructive feedback, is all worth it.
I am also excited to share that working out with my Kanso 2’s has been easier. Plus, I found out that the Kanso 2’s have a water resistance rating of IP68, which means that the sound processor can withstand sweat much more than my Nucleus 5’s did as these had an IP57 rating. I could also get rained on or splashed and not have to worry about damaging my Kanso 2’s. In fact, I have been reading about the IP68 rating, and it has been said that the Kanso 2’s can be submerged underwater (to a maximum depth of 1.5m) for up to thirty minutes without any damage.
After I am done teleworking, I am usually using my iPhone, listening to music, or browsing TED Talks videos to listen to as that is now part of my daily audio rehab. With the iPhone, I don’t need any other intermediary devices, as the Kanso 2’s are able to stream sound directly to my implants. As a matter of fact, this is probably the easiest thing to do, to make calls or receive FaceTime calls from my daughters, because once the iPhone is paired, I really do not need to press any buttons. It just rings and streams without delay.
I can scroll down the timeline in social media and if I click on a video, it will instantly stream the sound to my Kanso 2’s. If I get interrupted with a call or a FaceTime call from my daughter, the call will take over and instantly connect. Then when I hang up, the video that I was watching resumes playing. It surely is as easy as I am making it sound!
The Kanso 2’s can also be used with the Nucleus Smart App, which is a free app that can be downloaded from the Apple Store – or Google Play (for Android). Once downloaded and paired, I can check my settings, such as volume, sensitivity, treble and bass – or I can change programs or leave it on Scan, which is a special program that listens to the surrounding sounds near me, making adjustments depending on whether there is noise or quiet, speech, music or even wind.
There is also a Hearing Tracker feature, which displays Time in Speech (per day) in which I can tell it to “set a goal” depending on the number of hours I wish to achieve and it will highlight the days I have met the goal. The other feature in the Hearing Tracker is the Coil-Offs for tracking the number of times the coil was disconnected from the implant each day.
If I ever misplace my Kanso 2’s, I can tap the “Find my Processor” button to show me the location of my Kanso 2’s to help me find them. So, there are quite a lot of features in the app that are useful. But the feature I use the most is the “status” of the batteries, as the Nucleus Smart App can display the amount of charging power remaining in the rechargeables, and it does so by displaying the percentage. This is a very convenient feature.
I also tested the “Forward Focus” feature, which is also a very effective setting for when I wish to drown out any noise behind me. So, I placed my back behind the TV, which was playing really loudly, and I had told my spouse to read a paragraph or two out of a book I had grabbed. He read out loud and I started to notice that his voice was in focus while the TV noise was reduced to some degree – but noticeable enough for me to enjoy this feature.
Now, in regards to the Kanso 2’s SmartSound iQ with Scan Technology, I was surprised that I didn’t notice much difference. I have tested this program by playing loud music from my Amazon Echo to make the Scan recognize music and change settings, and it certainly did so. Then I would walk away to the dining room and start a conversation with my husband, and the Scan program would automatically change to the Speech setting. All these changes were happening as I expected them to, but in a very subtle and unnoticeable way. In fact, the only way I could tell it was changing was because I was looking at the Nucleus Smart app and watching the changes. Perhaps I should give more time to the Scan feature or bring it to the attention of my Audiologist for enhancement.
Now let me bring up a different aspect about the built-in rechargeables. As mentioned, the rechargeable battery is part of the Kanso 2 — which brought up concerns (to me) about whether or not it would last me all day long. This is because I didn’t want to have to take off my Kanso 2’s in the middle of the day, or during a meeting, or even late at night while watching a movie. The difference is that the Kanso 2 would need to be removed to be charged, and I would be left without sound. However, after doing all the testing, I have come to realize that I am able to wear my processors for 2 days without charging them every single night. That’s how much power there is in the Kanso 2’s (with my Scan and Mapping programs). In the case of a power outage or when going camping, I can use the Portable Charger that was included in the upgrade kit. The portable charger will charge similar to the charger/dryer unit for approximately 3-4 hours, which would give me another 2 days to wear my Kanso 2’s. If, however, I were to go camping for a whole week, or if the power outage were to last much longer, my back up plan is to use my AC outlet portable power station. This can be purchased online and is available at outdoors sporting stores.
Either way, I can tell that the new Kanso 2’s are going to be my new connection to life. I plan to explore the new features and enjoy the new experiences my Kanso 2’s bring me. After all, this is the technology I have always dreamed of having, and I couldn’t feel any more grateful to be able to do so.
About the Author
Iraida Franceschi is a boricua wife, mother of two adult daughters, and one of the five Admins of Cochlear Town USA, a closed-group on Facebook. She mentors and corresponds with other candidates during her spare time.
Globally unique MRI Guarantee: the highest MRI safety with hearing implants from MED-EL
Worry-free, safe magnetic resonance imaging (MRI) with MED-EL cochlear, middle ear or bone conduction implants – now with lifetime guarantee! For immediate access to an MRI examination without surgery, discomfort or hearing downtime.
Innsbruck, 02.02.2021: The innovative design of the implant magnets from MED-EL is completely safe during an MRI examination. As of now, the global innovation leader in hearing solutions is emphasizing this safety with an MRI guarantee that is as yet unmatched. With this, MED-EL is the only manufacturer to accept liability for damage to all cochlear implants that have been produced since 1994, all bone conduction implants and the current generation of middle ear implants during an MRI examination. Users of these MED-EL implants can therefore not only undergo an MRI examination at any time without the need for surgical removal of the magnets* and without pain – they can also do so safely and with no worries.
Three in four people will require an MRI scan in the next ten years**. Whether routine or in an emergency: patients with severe hearing loss may face a challenge if the magnets in their hearing implants are not safe inside the MRI machine. This requires the prior surgical removal of the magnets. Hearing ability is temporarily lost and long-term damage to the implant may occur. If the patient declines surgery, they may suffer from severe pain during the examination coupled with the possible dislocation of the magnet.
The highest MRI safety with MED-EL
Not all implants carry this risk. As a leading manufacturer of implantable hearing solutions, MED-EL has for more than twenty years made a point of only producing implants that offer outstanding MRI safety. To emphasise this requirement, MED-EL offers the unique MRI Guarantee which means no damage to the device during an MRI examination. MED-EL is thereby the only manufacturer to issue its users with a comprehensive global lifetime MRI guarantee.
“The MRI Guarantee ensures more safety, comfort and peace of mind during MRI examinations,” says Alexander Hofer, Corporate Director of Product Management at MED-EL. “We take care of our users for a lifetime and they should have the opportunity to make use of everything modern medicine has to offer. This is especially important when diagnosing serious illnesses such as cancer, tumours, multiple sclerosis or Parkinson’s disease,” stresses Alexander Hofer.
Being able to undergo magnetic resonance imaging immediately can also be crucial in emergencies such as an accident. A further benefit: people with severe hearing loss only have to go without their ability to hear during the MRI examination itself.
Innovative technology excludes complications
The safe and reliable technology from MED-EL ensures that the magnets in place during the magnetic resonance imaging are neither damaged, nor move causing pain. Only the external components, such as the audio processor, must be removed prior to the MRI examination.
“MED-EL has developed its own highly innovative, patented cochlear implant system with state-of-the-art implant magnets and their fixation within the implant. This excludes, for example, a dislocation of the magnet during an MRI scan, which can be very painful for the patient,” says Martin Zimmerling, Head of Implant Development at MED-EL. “With the SYNCHRONY cochlear implants, the magnet can freely rotate and align according to the magnetic field of the MRI scan. With the altered implant design, undesirable forces during the MRI scan and the associated pain for the patient are reliably prevented,” explains Martin Zimmerling. “We are proud not only that the latest generation of our cochlear implants is compatible with MRI machines, but that all cochlear implants produced since 1994 are too, as well as all bone conduction implants and the latest middle ear implant from MED-EL.”
The increasing significance of magnetic resonance imaging makes it clear how important it is to provide people with severe hearing loss access to this gentle and high-resolution imaging process. MED-EL rises to this responsibility and provides extra security and comfort for all users with the MRI Guarantee.
*So as to avoid imaging difficulties in the immediate vicinity of the implant, it may be advisable to remove the magnets.
**Source: OECD. Magnetic resonance imaging exams 2016–2019.
Editor’s note: Current implants from Advanced Bionics, Cochlear, and MED-EL are all tolerant of 1.5T and 3.0T MRIs with the magnet in place. Also, Advanced Bionics’ previous implant, the HiRes 90k Ultra, is tolerant of 1.5T MRIs with the magnet in place.
Startup company Xander is developing a clear augmented-reality display that clips onto your eyeglass frames. It performs live transcription so that you can read what people are saying.
They are participating in the IGNITE medical device competition. Watch the video (at the bottom of the screen – the entries are organized alphabetically) and vote for Xander if you think it is a great idea! The video isn’t captioned, but all the information is provided in text on the slides.
Advanced Bionics has received FDA approval for three new processors, the Naida CI M30, Naida CI M90, and Sky CI M90. Many new accessories also received approval, including slim headpieces and a waterproof battery.
Bluetooth classic means that media can be streamed in true stereo from any modern cell phone. Hands-free phone calls use the processor mics so you can keep your phone in your bag or pocket.
Stay tuned for more information!
Inaugural Hearing Health & Technology Matters Awards Recognize SYNCHRONY Cochlear Implant System, BONEBRIDGE Bone Conduction Implant and AudioKey App for Innovation Excellence
DURHAM, NC – October 19, 2020 – MED-EL announced today that it has been named Innovator of the Year by the first-ever Hearing Health & Technology Matters (HHTM) Innovator Awards™. The announcement was made at the virtual Academy of Doctors of Audiology meeting, AuDacity 2020
MED-EL placed in each category that it entered:
- The SYNCHRONY Cochlear Implant (CI) System, was awarded 1st place (Gold) in the Auditory Implant Category. The industry-leading innovation of a diametrically-opposed magnet shattered traditional CI design features and – for the first time – enabled safe MRI with the internal magnet left in place by following simple scanning instructions that are easy for any MRI facility. The SYNCHRONY CI System was the first, and remains the only, cochlear implant system in the United States to receive U.S. Food and Drug Administration (FDA) approval for a single-sided deafness (SSD) indication, filling a major unmet need in the hearing loss community. The SYNCHRONY CI System now features the latest FDA approved off-the-ear audio processor, the RONDO 3.
- The BONEBRIDGE Bone Conduction Implant, was awarded 3rd place (Bronze) in the same Auditory Implant Category. The introduction of BONEBRIDGE meant that for the first time, bone conduction implant candidates could choose a system that offered a powerful combination of intact skin, enhanced wearing comfort and direct stimulation of the bone. As a result, BONEBRIDGE is widely considered a breakthrough in bone conduction technology and it aligns with the MED-EL mission to gently restore hearing with intact-skin hearing implants that enhance communication and quality of life.
- The AudioKey App, was awarded 2nd place (Silver) in the Assistive Technology & Software Category. AudioKey is the only cochlear implant app that allows a parent to pair multiple user’s audio processors with their phone, which is ideal in families with more than one MED-EL cochlear implant recipient.
“The Innovator of the Year award is an exciting accolade, as innovation is a part of our DNA. While we are driven by research and development, MED-EL is so much more than a single implant, processor or technology. We are hundreds of thousands of lives that have been changed as a result of the pursuit of ideas that were once thought to be impossible,” said Raymond Gamble, President & CEO, MED-EL North America. “It’s gratifying to be recognized for our pioneering vision and dedication to fulfilling our mission.”
“It is exciting to recognize and honor companies who invest in innovation to improve the lives of people with hearing loss. We are thrilled to name MED-EL as our first-ever Innovator of the Year based on their industry leadership and innovative spirit,” said Kevin Liebe, AuD, HHTM President and CEO.
Through the annual awards program, HHTM recognizes technological innovation and achievement in the hearing industry. This year’s awards program saw dozens of innovative technologies, submitted from companies across the globe.
About the Hearing Technology Innovator Awards
The Hearing Technology Innovator Awards™ is an international awards program designed to recognize and celebrate innovation within the hearing industry. Learn more here.
About Hearing Health & Technology Matters
Hearing Health & Technology Matters (HHTM) is an organization dedicated to bridging the knowledge gaps in treating hearing loss. Readers and contributors are drawn from many sectors of the hearing field, including practitioners, researchers, manufacturers, educators, and, importantly, consumers with hearing loss and those who love them. By involving all these groups, we hope to bridge the gaps in knowledge that so often divide them. To learn more, visit HearingHealthMatters.org.
MED-EL Medical Electronics, a leader in implantable hearing solutions, is driven by a mission to overcome hearing loss as a barrier to communication. The Austrian-based, privately owned business was co-founded by industry pioneers Ingeborg and Erwin Hochmair, whose ground-breaking research led to the development of the world’s first micro-electronic multi-channel cochlear implant (CI), which was successfully implanted in 1977 and was the basis for what is known as the modern CI today. This laid the foundation for the successful growth of the company in 1990, when they hired their first employees. To date, MED-EL has grown to more than 2,200 employees from around 75 nations and has 30 locations worldwide.
The company offers the widest range of implantable and non-implantable solutions to treat all types of hearing loss, enabling people in 124 countries to enjoy the gift of hearing with the help of a MED-EL device. MED-EL’s global portfolio of hearing solutions includes cochlear implant systems, a combined Electric Acoustic Stimulation hearing implant system, and bone conduction devices. www.medel.com
The MED-EL RONDO 3 processor has received FDA approval. This means that the company is allowed to market the processor in the United States. Look for clinical availability soon!
Exciting news is on the way from Advanced Bionics, Cochlear, and MED-EL! AB and MED-EL are on the verge of introducing new processors, and Cochlear is making the Nucleus 7 and Kanso 2 processors available to N22 recipients.
The United States Federal Communications Commission has approved the radio-frequency components of a new family of processors from Advanced Bionics. According to the report, there will be three versions, presumably offered in different markets around the world, and with different feature sets. The three processors are identified as Naída CI M30, Naída CI M60, and Sky CI M90. The accented character isn’t in the FCC documentation, but the assumption is that it will mirror the current family of processors.
More information is sure to be coming from Advanced Bionics. But based on sister company Phonak’s Marvel line of hearing aids, the M series will likely include direct wireless streaming from both Android and iPhones. And it appears they will be somewhat smaller than the current Q series processors.
The Nucleus 7 processor and the Kanso 2 processor have received FDA approval for N22 recipients. This FDA approval paves the way for the company to make the processors available to N22 recipients. Cochlear continues to support its legacy users by making the latest technology available to the greatest extent possible.
The new RONDO 3 has its own page on the MED-EL web site! The processor has a high-tech look with its array of holes. And it introduces a second microphone so that it can focus on sounds coming from directly in front, which is helpful in noisy situations. The rechargeable battery life is up to 24 hours, while that of its predecessor was up to 18 hours.
Wireless streaming is accomplished with an intermediary device, the AudioLink.
While MED-EL claims that the Rondo 3 is compatible with all hearing aids, the only compatibility is that you can wear any hearing aid on one side, and the RONDO 3 on the other side. There is no provision for the RONDO 3 and any hearing aid to stream from one side to the other, to work in concert on noise reduction strategies, or to stream to both side simultaneously, unless the RONDO 3 has a telecoil.
A study from Ann & Robert H. Lurie Children’s Hospital of Chicago found that children with a MED-EL SYNCHRONY cochlear implant device can undergo MRI safely, with no discomfort and reduced need for sedation or anesthesia. Findings were published in the peer-reviewed journal Laryngoscope.
The study only included subjects with the MED-EL SYNCHRONY implant, which has a rotating magnet that aligns with the MRI magnetic field. The HiRes Ultra 3D implant from Advanced Bionics has magnets that rotate in multiple axes, so the head can be in any orientation. The Nucleus 7 implant from Cochlear has a rotating magnet for MRI compatibility as well.
I have a CI and my wife is normal hearing. A week ago we saw the stage production of Hamilton in San Francisco. The play has a lot of fast dialog, jazz, hip hop, and rap singing. Prior to our performance date, the theater announced availability of a new app for smart phones and tablets called GalaPro. You download the app from your App Store prior to going to the theater. Once in the theater, you put your device on airplane mode (so as not to make noise during the performance), connect to the theater’s Wi-Fi, and launch the app. “Real time” captions appeared on our devices, in sync with what was happening on stage. The captions are a dark red font on a black background, so it doesn’t distract others. But it’s easily readable. When I looked over at my wife’s phone, I could hardly tell she was looking at captions. The performance was SO much more enjoyable for both of us.
How does it work? It’s not 100% clear. The GalaPro web site says that it uses real time speech recognition and can translate to any target language in real time. Our assumption is that the captions (which were perfect) have been created ahead of time, and someone is either “backstage” or “listening in” and paging through them in time with what’s happening on stage. The captions also had the name of the person speaking or singing – which would not happen if it was pure speech recognition.
On occasion the captions would lag or get ahead as if someone backstage was hitting “next page” while distracted looking at Facebook. Theater captions are currently only available for certain cities and certain shows (New York, Washington DC, San Francisco, Berkeley, Costa Mesa, Pittsburgh, Melbourne, Buffalo, London, Sarasota are cities currently listed).
The GalaPro website says that they are also in the process of bringing this to movie theaters so you’d use your smart phone or tablet to get captions instead of using the clumsy (but appreciated) devices that sit in your cup holder – and that you will be able to walk into a comedy improv (where the dialog is unpredictable) and get real time captions. They may not be there yet.
GalaPro was a great experience for us. We’ll be watching to see if GalaPro becomes more widely available and usable for different types of productions.
About the Authors
Suzy & Mike live an hour north of San Francisco. Mike is a retired telecommunications engineer from Hewlett Packard. He is an adjunct professor at Arizona State University in the Speech and Hearing Sciences, and works with both the ASU and UCSF CI teams trying to improve low frequencies and music for CIs using his hand-built speech processor.
Advanced Bionics has sent a letter to some recipients of the HiRes Ultra / HiRes Ultra 3D noting that some of these devices may have an issue with the electrode array that could adversely affect the performance of the device. The text of the letter is available here.
Implants that may be affected have been recalled, and the current version available today has resolved the issue. The company says that about 0.5% of recipients of the affected devices have had revision surgery.
To assess the significance of the issue, refer to our analysis of the FDA Manufacturer and User facility Device Experience database. A constant failure rate for a given manufacturer should show a curve that rises with the number of implants in the field. Over the past several years, all three major CI manufacturers show relatively flat numbers of incidents. As cochlear implants have enjoyed healthy growth in this time frame, the implication is that reliability has been improving steadily.
The Advanced Bionics chart shows a spike in the middle of 2019, which may be related to the recall. After the middle of 2019, the incident rate seems to have returned to preceding trend. Prior recalls (from any manufacturer) are visible on the charts.
There does seem to be a recent increase in reported events for Cochlear towards the end of 2019 beyond what a trendline would indicate. Hopefully this is just an anomaly, and not related to any reliability issue. The MED-EL curve appears to be decreasing, which would indicate improved reliability, particularly in a growing market.