Cochlear Kanso 2 Processor Review

Iraida Franceschi

Cochlear Kanso 2

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.

Now you see it – now you don’t!

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. 

My Kanso 2s with safety line hair clips

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.

The Mini Mic 2+, ready to stream from my computer

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!

Nucleus Smart App screen shot

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.

Selecting Scan and Forward Focus

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.

Cochlear Kanso Review

My Kanso Story

by Roger Smith

Hearing loss is something I’ve dealt with for over 40 years. I was first diagnosed at age five and my hearing declined for the next 20 odd years. Choosing the right hearing aid and ultimately the right cochlear implant can be a challenge. Lucky for me, my brother, four years older, has the same history of hearing loss, and I usually had him to rely on for feedback about new technology or functionality. Now, I’m in a position to provide some insights into the new Kanso Sound Processor from Cochlear!

A little bit about myself, I work for Cochlear in Sydney and help develop and market new processors and accessories. I love my job because I get to work with and learn from our customers and help make sure the new products best meet our customer needs. I’m doing this for me, my brother, my son and all of you, and I truly love it.

In my role, I had the opportunity to be part of first clinical trial for Kanso, where I tested the device for more than six months in Sydney, Australia.

One thing we’ve learned over the years is that everyone is different and what is best for one person might not be best for another.

Kanso has been developed for people who are looking for a sound processor that is discreet, smart and simple.

Kanso is for people who might be a bit self-conscious about wearing a processor, who want something to ‘set and forget,’ or who just don’t want anything on their ear, all while still receiving great hearing performance.

So here’s what I can tell you from my experience about hearing performance with Kanso.

As a recipient and customer myself, I really focus on hearing performance. I want to be able to hear my best in every situation. Whether it’s social or at work, I don’t want to miss out on anything.

So when I was asked to trial Kanso, I must admit, I was a little sceptical. Would this new processor allow me to hear as well as with my Nucleus 6® Sound Processor? I put it to the test.

I went to the noisy café and the windy beach, I listened to music and watched TV, attended lectures and conferences, and in every situation I switched back and forth between Nucleus 6 and Kanso.

I can honestly say I could not tell the difference. I felt like with Kanso I was hearing just as well as with Nucleus 6 and maybe, more importantly, my family couldn’t tell the difference either. My wife, who’s able to tell better than me when it’s time to change my microphone covers, didn’t even notice I had a new processor for three weeks!

Kanso has the same performance technology as Nucleus 6 (SmartSound® iQ), which includes SCAN*. SCAN is an automatic environment classifier that constantly scans the environment you’re in and changes the processor settings to make sure you’re in the right setting at the right time. It’s all I ever use with Nucleus 6 or Kanso.

Kanso also offers all the same True Wireless connectivity options as the Nucleus 6, which is very important to me. I use my Phone Clip, Mini Microphone and TV Streamer on an almost daily basis. Being able to stream directly to my processor in certain situations is a huge advantage for people with Cochlear implants.

I feel sometimes like I’ve gone from being the person in the room with a disadvantage to being the only one in the room with a real advantage.

* SNR-WR, WNR and SCAN are approved for use with any recipient ages 6 years and older, who is able to: 1) complete objective speech perception testing in quiet and in noise in order to determine and document performance: and 2) report a preference for different program settings.

What is Kanso?

Kanso is an integrated sound processor for a cochlear implant that has the processing unit (read: brains of the computer), the battery, and the coil all in one unit.  

The Kanso processor

The Kanso processor

It must be worn directly over the implant, so there are no cables to fiddle with and no earhook as it sits behind or above the ear.

To break it down further:

Processing Unit

This is the part that does the hard work. It gathers the sound through the dual microphones and processes the input, filtering out background noise and sounds that you don’t want to hear based on your situation. Kanso comes with the same industry leading sound processing capabilities as the Nucleus® 6 processor with SmartSound™ iQ.

Kanso also has SCAN* technology, which means the processor can analyze the environment you’re in and put your processor in the right program, no matter what the situation.

Processor Button

Kanso has only one button to control functionality of the processor. This was done to simplify the user interface and make it even easier to use. You can control on/off, programs and streaming accessories with this one button. For those who want even more control, Kanso is compatible with the Cochlear Remote Control and Remote Assistant.


The microphones are where the sound comes into the processing unit. Kanso has two microphones. This is very important for background noise management because the processor can analyze the sound from the two microphones and determine which sounds came from behind. This ‘beamforming’ means you can hear better in noisy situations.


The coil is the part that communicates with the internal implant. It sends the ‘sound’ to the implant. Kanso has the coil built in so there is no coil cable to deal with.


You use Kanso with zinc-air disposable batteries. Rechargeable batteries would mean a bigger and heavier processor, which is not something customers wanted. With two zinc-air batteries, Kanso is designed to deliver the same battery life as Nucleus 6.


Kanso comes with retention accessories like the nearly invisible safety line for everyday use and the headband for more vigorous activities.

True Wireless

Kanso is fully compatible with the Cochlear True Wireless™ devices – Mini Microphones, Phone Clip and TV Streamer – so you get even greater performance in challenging situations and the convenience of no wires.

Real Life Experience

By now you’re probably thinking ‘great, so you can hear well but how well does it stay on? Is it really discreet? What about swimming and sports?’

Here’s how I answer these questions after six months of experience with Kanso:

What’s retention really like? Does it fall off?

Straight away, people ask me about the retention of Kanso. Does it fall off? No. I’ve never had a situation where the Kanso just fell off my head.

I use the same magnet strength (2) as with my behind-the-ear (BTE) sound processor and didn’t have any problems with Kanso falling off.

Did I accidentally knock it off? Yes. I had to break a few habits. With a BTE, if I had an itch, I could just flick the coil off and scratch and the BTE would keep everything on my ear. With Kanso, I had to remember to hold the processor while I scratched. This took me a week or two to change.

I also had to be a bit more careful changing a shirt or putting on a hat, but this was not a big deal to me. When wearing a hat, I did have to loosen the band a bit, but it didn’t seem to impact my hearing when I had the hat on.

Kanso comes with a clear safety line (like a fishing line) that you can attach to your hair with a clip or another, longer line that you can clip to your shirt. I used the short one in my hair, and I must say I was really hesitant to wear a hair clip, but it was pretty much invisible and surprisingly easy to use. Clip it in in the morning and pop it off at night – too easy!

Kanso with Safety Line and Clip

Kanso with Safety Line and Clip

How’s the battery life?

Battery life with two disposable zinc air batteries was the same for me (around 62 hours because I’m a low power user).

How simple is Kanso to use?

As simple as I found my Nucleus 6 to be, Kanso was just a little bit simpler. I use a hearing aid mould with my BTE for retention, and with Kanso, I didn’t have to spend a few seconds each day putting the earmould in and positioning the coil. And having only one button and SCAN* means Kanso is truly a ‘set and forget’ processor.

Can I use Kanso in water?

Kanso comes with a waterproof accessory that covers the processor and allows you to swim, snorkel, exercise and more.

Aqua+ with Kanso inside

Aqua+ with Kanso inside

I found the hearing performance when using the Aqua+ to be slightly less, but I could still understand, communicate and have fun with my kids and hear safety alarms or whistles.

If you’re doing anything besides just relaxing in the water, you’ll need to use something to keep the Kanso in the Aqua+ on your head. I used a neoprene swim cap (Nammu), but there are lots of options out there, and the Aqua+ has notches for goggle straps if you prefer that. A small price to be able to hear in the water!

How discreet is Kanso?

I’m not really too worried about people seeing my processor since I’ve been wearing something on my ears for 35 years. But if I was concerned about it, Kanso would be perfect for me. I have shorter style hair and Kanso is nearly invisible when I put it on.

Kanso with safety line attached

Kanso with safety line attached

Can I wear a hat or helmet?

As with any implant and processor combination, implant location on your head plays a role in how well (or not) hats and helmets fit. My implant is located just above and behind my ear – right on the ‘hat line.’ I find that I can still wear my hats and my bike helmet but with the hats, I need to loosen a little bit or there is a little too much pressure. This only bothers me in the wind as a loose hat comes off easier.

Is Kanso right for me?

This is the one question I can’t answer. Only you and your hearing health professional(s) can decide what is best for you

Personally, I would be very happy with either Kanso or Nucleus 6. I’m not worried about discretion, and I get great hearing performance and connectivity with both.

Kanso and Nucleus 6

Here is a comparison summary of Nucleus 6 and Kanso:


  • 2 microphones and SmartSound iQ and SCAN
  • True Wireless compatible
  • Aqua+ for complete waterproofing
  • Dust and splash proof
  • CR230 Remote Assistant and CR210 Remote control compatible

Nucleus 6:

  • Offers Hybrid™ Hearing with acoustic component attached
  • Can use disposable or rechargeable batteries
  • Telecoil optimised for phone use
  • Compatible with all Nucleus implant types


  • No acoustic component
  • Disposable batteries only
  • Nothing on the ear
  • Telecoil optimised for room loops

Some considerations when choosing between Nucleus 6 and Kanso:

  • Since Kanso is not worn on the ear, people with glasses might find Kanso works better, especially if you have thick temple pieces on your glasses.
  • While both processors are compatible with the Phone Clip, the Nucleus 6 processor telecoil is optimised for phone use. I used Kanso with the mics alone on the phone for quick conversations with family and friends but much preferred the Phone Clip for long calls or calls for work.
  • Consider battery type and how important that is to you.
  • If you wear hats a lot, consider taking one to your audiologist appointment to try on with Kanso because it slightly thicker than the Nucleus 6 coil. While I could still wear hats, I needed to adjust them slightly

Talk with your  hearing health professional and be honest about what you hope to achieve with your processor. I hope hearing about my experience has proven helpful if you’re thinking about Kanso. Good luck with your hearing journey!

Kanso User Guide

About the Author

roger-head-shotRoger Smith, MSPT has been working in the field of healthcare for over 18 years. He is currently a Global Product Manager with Cochlear Ltd., spending the past 5 years in Sound Processors and Connectivity. As an employee and an active volunteer, Roger draws on his unique experience as a cochlear implant recipient to help improve the lives of those with hearing loss.

From N5 to N6: Initial Impressions

From N5 to N6: Initial Impressions

A review of the Cochlear Nucleus 6

CP910 inside

Model reviewed: CP910

To go from significant hearing loss to being able to hear significantly within the space of four weeks – the usual period between a cochlear implant operation and activation with the processor – is a life-changing experience for many. To then go from activation with one device to an upgrade to the latest processor for that device within three weeks was an equally life-changing moment for one London recipient.

TB is an adult cochlear implant user who received her first processor, a Cochlear Nucleus 5 (N5) in summer 2013. Three weeks after activation, she was upgraded to the Cochlear Nucleus 6 (N6) and the article below brings together her experiences since activation with those of a long-term user of the N5 who has not yet upgraded to the N6, to allow comparison of the models for the purposes of this review.

Both users are broadly similar in background and experience, being profoundly deaf from birth or infancy, and having grown up in mainstream education with good speech and lipreading skills. Both were motivated to obtain their cochlear implants through finding it increasingly difficult and demanding to keep up lipreading skills in their day-to-day lives. TB recalls “falling asleep through exhaustion” at the end of the day, while SC, a lifelong lipreader, found that she was forced to put in more and more effort to achieve the same results as she had had in her teens.

Distilling experiences between users of the N5 and the N6 with similar backgrounds provides a comparable benchmark between users, their expectations, and their experiences between two different models of the same brand of cochlear implant speech processor.

User experiences compared:

Both users found activation with the N5 an overwhelming experience, one that is common to many cochlear implant activations, regardless of brand or hearing history: it is in part attributable to the sudden access to a wider range of sounds than hitherto, rather than to the specific implant itself. Their reactions were surprisingly similar: “I hated it and thought to myself, what had I done?” (TB) and “So this is how hearing people hear, my goodness, I don’t know if I want to be part of this world!” (SC) Both adapted remarkably quickly to being able to hear again, and it appears that for TB access to the N6 has accelerated this process of adaptation.

TB exchanged her N5 for an N6 three weeks after activation, and reported an immediate positive response to the change in processor that seems to go beyond the changes expected at the key stage of mapping 1 month post-activation. (For comparison, at 1 month SC was given the basic map that she still uses for everyday purposes.) In particular TB reported that the automatic scanning of environmental sound as part of the N6’s new processing strategy (which is described in more detail below) significantly reduced the noise levels of a busy London street. Prior to this point she felt that she had been struggling with ‘loud noise syndrome’ in which she felt that her voice rose above the surrounding noise level, and the impact of the new strategy returned her voice to normal levels, much to her relief, as she was no longer straining to hear herself.

Description and technical features of N5 CP810 for comparison:

CP810The N5 CP810 sound processor has dual microphones alternating with dual control buttons across the top of the processor, with an accessory port hidden under a flap. The size of the processor can be modified to suit the user through battery choice, with three interchangeable battery options: a standard sized battery cage holding two cochlear-implant specific disposable batteries, and rechargeable lithium-ion batteries offered in two sizes: standard and compact.

CR110It is accompanied by the CR110 remote assistant in white with a large user-friendly central button, allowing the user to cycle between programmes remotely rather than through the buttons on the processor itself. SC found this useful in toggling between programmes in the early days of activation, rather than using the buttons on the processor. It also permits individual settings of volume and sensitivity across all four available programmes: Everyday, Noise, Focus, and Music, which in the CP810 can be loaded individually or collectively with the proprietary SmartSound strategy. Everyday and Music are self-explanatory; Noise is intended to reduce the discomfort of surrounding noise, while Focus is intended to enhance speech discernment in noise.

The remote assistant also allows a certain amount of troubleshooting via simple yes/no choice options to identify typical issues, reassuring for users (and which SC has only ever used twice in 3.5 years to solve simple issues).

Programming is flexible, with the capacity to have four programmes based on the same map or to tailor the programmes according to user preference.  For example, the Noise and Focus programmes can be discarded if preferred and replaced with Everyday and Music programmes based on a second map, thus having a choice of two Everyday and two Music programmes for different listening situations.

Description and technical features of the new N6 CP910 and CP920 models:

Physical features:

Cochlear CP910 CP920In appearance, the N6 is very similar to its predecessor, with some minor modifications that result in increased comfort. The controls and microphone covers are also similarly disposed alternately across the top of the processor, with greater ease of use in the control buttons. There are two models, the CP910 and CP920: the difference between the two models is that the CP910 offers an accessory hatch similar to the N5 for direct input of cables from audio accessories such as mp3 players, etc., while the CP920 does not, leading to a size reduction in the CP920.

Like the previous generation N5 processor, the N6 CP910 and 920 are both powered by a rechargeable lithium-ion battery or disposable battery unit taking 2 cochlear implant-specific batteries. Both compact and standard size rechargeable batteries are available in the UK.[1] The compact batteries of the N6 and N5 differ very slightly in profile, the N6 having straight edges rather than being slightly rounded, shaving off a fraction of the size, up to 2mm in height.[2] However, the batteries of the two are interchangeable using the same snap-on/off mechanism, which is good news for those wanting to upgrade and having significant life remaining in their existing N5 batteries. It is also good news from an ecological standpoint.

The choice of a CP920 without an accessory hatch and powered by fractionally more compact batteries therefore reduces model size compared with the N5 CP810 in two dimensions, which is immediately apparent to the wearer. Most implant recipients will previously have worn hearing aids, which are nowadays extremely small: while cochlear implants do not currently match the small size of the latest hearing aids, the market as a whole is tending towards miniaturization of the external package. These changes, though cosmetic, represent a positive step forward in that direction for Cochlear and would be an attractive option for adults with small ears and for children. User comfort is an important consideration in encouraging implantees to wear their processors during waking hours to obtain maximum benefit.

Processing strategies and remote assistant:

The processing strategies have been refined with a wider suite of programmes for different hearing and listening situations to suit the user, although the processor still has a capacity of four programme slots.[3] The proprietary SmartSound iQ can be used as a programme in its own right, automatically scanning the ambient noise environment and responding with an appropriate selection out of six rather than four possibilities. This takes it beyond the previous generation SmartSound strategy on the N5, which could be layered across one or more programme slots to enhance that particular programme, but could not change the programme itself to suit the environment.

The original four programmes appear to have been retained as part of the choice for the user, two of which have been renamed to reflect the role they play more accurately: they are: Speech (Everyday); Noise; Speech in Noise (Focus); and Music. They are joined by Quiet, in which soft sounds are highlighted, and Wind, suppressing ambient wind noise, and the Smartsound iQ programme will select from all of these within its own programme slot. Each of these choices is available as a programme in its own right on the other slots.

Remote+Assistant+Front+Back+LargeThe CR230 remote assistant delivers the same programme selection and troubleshooting options as the former N5 model with a similar user-friendly large button, although it has been restyled and is much more mobile-phone like in appearance than the white N5 remote, and has a USB port for future data exchange capabilities.[4] The smaller CR210 remote control allows simpler adjustments to be made and could be useful for children or the elderly.

Data Logging:  

In tandem with the upgrade to automatic scanning, the N6 processor also differs from the N5 in that it also offers a data logging capability.[5] This can: show how long the processor is in use on a daily basis; identify to the audiologist which programmes the user prefers; and demonstrate noise levels of exposure, permitting the programmes to be tailored more specifically to user needs, again a refinement which reflects a wider trend in the cochlear implant world.[6]  These are lifestyle options and it is easy to envisage that someone who lives an outdoor lifestyle will, for example, appreciate the benefits of enhancing their maps to minimise wind noise.

For example, the Quiet programme was a good choice for TB in her earlier maps as she adjusted to learning to hear again, but this has now been discarded in favour of enhanced remaps on the ‘scan’, speech and music slots, with the standard industry ‘good practice’ of saving a previous favourite, in this case an earlier map on her previous ‘scan’ programme, as a fall-back. The ‘scan’ programme is currently the programme which TB uses 90% of the time and she reports that her most recent map has “given me a boost to the noise levels, rather than set the electrodes individually.”

The ability to respond to the ambient sound environment in several different ways has enhanced the ‘new user’ experience for TB, who has only been activated for a few months. Her sound environment has altered radically from that initially rather unpromising start, so much so that she “finds the sound of light wind really rather relaxing.” That, in the end, is what it is all about: discovering the world of sound, all the myriad little things that hearing people ignore or take for granted.

*One final aspect of the N6 cannot yet be reviewed – the advertised wireless capability which remains in development and is not yet available. It is understood that it will become available to current and new users via a software upgrade. Hence the title of this review: From N5 to N6, Initial Impressions to allow for a follow-up review.

With many thanks to TB for her willingness to share her new user experiences and compare and contrast the N5 with the N6, and to Howard Samuels for his support and suggestions.

Tamara Bunting is a researcher with a leading medical charity in London, UK.

SerenaSerena Cant is a researcher in one of the main UK heritage organisations, and blogs regularly on her experiences of her cochlear implant, together with arts reviews and musings on being deaf, at

[1] Not yet approved by the FDA in the US at the time of writing. Cochlear: Options to suit your lifestyle

[2] Measurements in two dimensions taken and cross-checked by TB and SC, October 2013.

[3] Cochlear: SmartSound iQ and as reported by TB, October 2013.

[5] Cochlear: Nucleus 6 Canadian Announcement with mention of datalogging capability and audiological session, TB, October 2013

[6] Personalizing maps even for long-term implant patients, has been a focus of recent research: for example, the recent Vanderbilt study.


by Joe Duarte


RONDO is the world’s first single-unit processor for cochlear implants.

Initial impressions

RONDO is a single-unit “button processor” compared to a BTE that has a separate coil. Because my hair is short, the RONDO is more noticeable than the OPUS 2. People have asked me more questions about the RONDO in just a few weeks compared to the OPUS 2 in a year. For some reason, people are more fascinated with the RONDO and seem more comfortable asking about it.  I’m social by nature and have had great conversations with people who have approached me to ask about the “thing on my head.” This could be a minus for some people who don’t like to be noticed or are more introverted.  I believe that it appeals to some people with longer hair because it’s more discreet.  I personally never cared if people looked or not. I just love the convenience of the RONDO on my head instead of behind the ear like a BTE.  And, it’s much easier for me to wear glasses, especially thick sunglasses!

The device is so easy to use… just turn it on and plop it on your head. The only “hassle” is having to change the batteries once every 4 or 5 days depending on how long your day is. For me, this is an advantage compared to having to replace rechargeable batteries daily for the OPUS 2.  I put the CI on first thing in the morning and it only leaves my head before I hit the pillow at night. Everything about the device is neat. It is just a small “puck” on your head. The only negative that I have noticed so far is that when I have to replace the batteries I have to stop whatever I am doing and find a table to replace them.

Tour of the RONDO

RONDO tour guide

The microphone is at one end of the processor and has a protective cover over it. To each side of the microphone are LED’s that will flash to indicate different things about the CI. It will flash continuously, for example, if the battery dies. When it is powered on it will flash a number of times to indicate which program it is using. It will also flash anytime some action is taken with the remote.  It is important to note that this light activity can be “turned off” if the user does not want them to flash.

The RONDO has very small holes for a tether to clip the device to your hair or clothing, which I don’t use. It has a switch to turn the unit “on” and “off” which is also used to unlock the case to replace the batteries. Very easy and convenient switch the way it was designed.

Size of the RONDO

RONDO dimensionsIt is hard to compare RONDO with OPUS 2 as far as sizes are concerned because of their different form factors. I can’t hide it with my thin hair.  I think people with longer hair are able to cover it.  The color options are close to typical hair colors.  But, this doesn’t really make a difference if you are bald or wear your hair very short.

The processor is somewhat thick, but it is not that bad in my opinion. The D-coil is surely much thinner!  I use hard hats from time to time at work and even though I have worn the hard hat with the RONDO, I prefer not to. I plan to switch to the OPUS 2 when I am on the field all day working with a hard hat. If I am going to use the hard hat just for a quick site inspection then I don’t bother switching processors.


The RONDO uses disposable batteries only — three 675 size and I get more than 60 hours on them.  The OPUS 2 has both disposable or rechargeable options available.  I use the rechargeable battery pack with the OPUS 2.

I have only used rechargeable batteries with the OPUS 2 and I get 12 hours on the dot with each processor. I have not used disposables for a long time but I remember they lasted 3 days with the same 3 batteries as the RONDO. But that was before the D coil was available for the OPUS 2, and the D coil improves battery life by up to 50%. So the same batteries last longer with the RONDO than they did for me with in the OPUS 2, as expected.

The batteries are easy to replace by using the magnet to take them out of the sockets. After replacing them a few times, I’ve gotten better at it over time and now after several weeks with practice I can replace them rather swiftly.

When you change the batteries, RONDO retains the program and settings. This is a tremendous advantage! I typically don’t change programs very often.  However if I had the unit on Telecoil, switching the unit off and on brings it back to microphone mode (turns off T-coil function).

Mini Battery Pack with AAA Battery

Mini Battery Pack with AAA Battery

The Mini Battery Pack, which I use for Direct Audio Input, takes a single AAA battery.  It can also use a rechargeable battery (AAA or DaCapo Power Pak). The Mini Battery Pack for RONDO is slightly different than the Mini Battery Pack for OPUS 2, as a different connection is needed on the processor side.

Sound Quality

The mic is obviously in a different location than the OPUS 2 mic. Sound quality is almost the same for me. The differences are slight as far as I can tell. The RONDO appears to provide a somewhat more “normalized” sound. I prefer the RONDO sound a little better in quiet environments due to the way the microphone is positioned. I do a bit better in restaurants and at parties with the OPUS 2 compared to the RONDO. This minor decrease is somewhat compensated by the tremendous convenience and dramatic improvement in comfort that the RONDO provides. I’ve also noticed that for me, the RONDO seems to pick up a little more wind noise than the OPUS 2.


RONDO, FineTuner, and OPUS 2XS

RONDO, FineTuner, and OPUS 2XS

The FineTuner remote control has the same functionality as with the OPUS 2 – you can use the same remote with either processor. I use the remote mostly for T-Coil activation or to evaluate new programs or strategies. 

One remote controls both RONDOs for bilateral users. That is a terrific thing for me. I love the convenience. I also like the way the remote is designed with its buttons because I can switch just about anything in the dark and inside my pockets without looking at it. Very intuitive!

Keeping the processor on

I use the same magnet (standard) that I used for the OPUS 2. And I can run with it without a problem.  There are four strengths – soft, standard, strong and super-strong.  The processor stays on very well. It only comes off when I swipe it accidentally.

It comes with a retaining tether, but I don’t use it.

Comparison with OPUS 2

RONDO and OPUS 2 are identical in the functional sense, with the exception of one significant difference… the Telecoil orientation is critical for good reception, so if the RONDO is not in its proper orientation adjustments may be needed. I often have to tweak the orientation of the OPUS 2 to make sure it is perpendicular to the loop plane to get the maximum sensitivity possible. The RONDO can shift a little on your head and may not be in the optimal Telecoil angle. The same programs that were on the OPUS are used on the RONDO. There is no difference and maps work equally well for both the OPUS 2 and the RONDO. Like the OPUS 2, the RONDO has four program slots.

Also, I prefer to wear my RONDOs with the microphones pointed slightly differently than the normal operation, so when I use a hearing loop or neckloop, I have to make a quick adjustment. I have gotten used to do that so much that is now becoming an automatic thing for me.

With the telephone, I have developed a technique where I use two of my fingers to position the RONDO in an ideal position relative to the phone for maximum pick-up.  In the beginning, this was hard because the processor is on your head and not behind your ear. It took some getting used to. This is now automatic for me as well. I don’t use the Telecoil with the phone, just the microphone. It does look a little odd holding the phone to your head instead of your ears, but I do it all the time and I haven’t noticed any strange looks – yet!

People can still hear me well when I use the cellphone even with the phone’s microphone further away from my mouth.


To use the telecoil, activation is via remote only. To deactivate it you can either press a button on the remote control or if the remote is not handy, you can just switch the RONDO “off” and “on” and the Telecoil will go off automatically.

Direct Audio Input

Head - DAI Rondo

I use this all the time when I am travelling, in the airport lounges and on the plane. The RONDO has a special accessory that replaces the battery platform. This Direct Audio Input accessory has a cable attached to it. Then this cable connects to another small accessory called a Mini Battery Pack. This “pack” unit has a jack that allows me to plug another cable that then connects to just about any audio jack out there;  iPad, iPhone, laptop, plane audio jack, etc.

My bilateral DAI travel kit

My bilateral DAI travel kit

You can also connect an FM receiver via the mini battery pack. I just carry this same kit with me if I go to a theater or a movie and want to capture the best sound possible.  Loops don’t come anywhere close in terms of Hi-Fi listening.  However, if a facility has a hearing loop then I don’t bother with the kit.

Everything ready for bilateral DAI.  The audio cable has Euro connectors - the same ones that FM receivers use.

Everything ready for bilateral DAI. The audio cable has Euro connectors – the same ones that FM receivers use.

On the plane with my gear!

On the plane with my gear!

Warnings and indicators

There is a warning beep when the batteries are running low that lasts a minute or two to warn the person to replace them. This can be deactivated in your program, for instance if the listener is a child.

The lights flash for different programs and also for low battery, dead battery, etc.  I had my “lights” turned off to avoid distracting people when the battery is about to die.  When I turn on the processor the lights flash to tell me it is operational and which program it is in.

Unless you ask the audiologist to turn the lights off, they will show parents different statuses… when changing programs, changing volume or sensitivity, etc… basically, each time a remote key is pressed the light flashes to confirm the change. Also, when the battery dies, the light flashes continuously.


I was in the field all day using a hard hat with the OPUS 2 and I noticed that I had gotten so used to the RONDO sound quality that I instantly noticed that do have a preference to the RONDO quality.  Music does sound a little better with the RONDOs for me personally. It only confirmed my earlier assessment that the RONDO provides a more “normalized” sound quality. Switching back to the ROINDO came as a mild relief. Nothing dramatic but it is “somewhat different” as far as my personal experience is concerned.

I will use the RONDO probably 99% of the time. Comfort is the primary reason. I will use OPUS 2 with hard hats and for very active sports like soccer. When I go to my fitness club, I use the RONDO because I can jog and run and do all of my workouts without a problem. In fact, I find that I don’t have any sweat issues with the RONDO. I think the reason is because my hair is very short and the sweat never reaches the top surface of the processor. It seems to slide around the base. I used to have more problems with the OPUS 2 because the microphone would get wet and the sweat could easily find a way into the processor. That has not been the case with the RONDO so far. I am not sure if I will have issues when my hair gets longer and it starts covering the RONDO.

As an adult, I love the comfort and convenience of the RONDO!

Where the RONDOs came from

Joe and other members of MED-EL’s Patient Support Team (PST) received RONDOs from MED-EL to try out.  Joe decided to keep his, and worked through MED-EL’s exchange program to keep them.  If you have OPUS 2 processors, you may be eligible for an exchange, but the details depend on the age of your OPUS 2, if it has been opened, etc.  In some cases, it’s a simple exchange, in others there is a cost involved. If you are interested in an exchange, please contact MED-EL.

About the author 

Joe DuarteJoe Duarte has had hearing loss for most of his life of unknown causes.  He began wearing hearing aids when he was four years old, and now has bilateral cochlear implants from MED-EL.  Joe engineers and sells hearing accessibility solutions through his company, Duartek.

Joe is a member of MED-EL’s Patient Support Team (PST).  PST members include people who wear MED-EL hearing implants, their spouses, and parents of children with MED-EL implants.  They are a volunteer resource for people considering an implant and who are interested in learning more from actual users with real-life experiences.

App Review: Rehabilitation Game

Tina Childress, Audiologist

Tina Childress

Rehabilitation Game, Neurelec

For iPad, iPhone

Rehabilitation Game by Neurelec is a great FREE app and was developed to work on auditory skills in either French or English, in either Adult mode or Child mode (they use the same stimuli but the interface is a little different) and at different levels that get progressively more difficult.

You will be working on the following skills:
1.   Detection  – tap on the screen when you hear the stimulus
2.   Discrimination – tap on the screen when you hear the stimulus that is different…this one was HARD and towards the end, even if you are in English mode, I noticed some stimuli with funny looking accents. 🙂  Methinks there is a bug.
3.   Identification – tap on the item that you hear…this is across a variety of environments like a bathroom, kitchen, backyard, on a street

One feature that I always appreciate is that it will keep track of your progress over time.

Happy Hearing!
Tina Childress, M.A., CCC-A
Educational Audiologist, late-deafened adult, bilateral cochlear implant recipient, techno-geek


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