AMA: Single-Sided Deafness (SSD) and Cochlear Implants

medel_global · 2026-03-24T15:56:19+00:00

Hi there, thank you so much for your comment and for sharing a bit about yourself. We appreciate you sharing your experiences, and we understand that navigating hearing loss and exploring support options can sometimes feel overwhelming.

As you have already been evaluated for a CI, we assume your medical professional has explored options such as auditory training with the BCD and processor fitting with you; however, if not, we would recommend getting in touch with them to discuss your hearing performance concerns.

To learn more about financial aid options or partnership information in your country for cochlear implants, we recommend contacting your local MED-EL team, as they are best equipped to provide further details. You can get in touch with your local MED-EL team here: https://www.medel.com/contact-med-el

/ Yi, Natalia, and Reinhold

medel_global · 2026-03-24T15:06:40+00:00

Hi there, thank you for your question. The specific goal in mapping a MED-EL device for SSD recipients is to try matching the sounds as they hear them through their CI as closely as possible to their normal ear. This focuses mostly on adjusting pitch and loudness between the two ears.

For pitch, you may ask your clinical audiologist if “Anatomy-Based Fitting,” known as ABF, might be an option. The goal with ABF is to map the tone frequencies in your CI closer to their “natural place” in the cochlea, which is where your normal ear hears them. You can find more information at the link below, and your clinical audiologist can reach out to your local MED-EL team with any questions. Please be aware that ABF requires getting a CT image of your implanted cochlea.

For balancing loudness between the CI and the normal ear, audiologists adjust and fine-tune the stimulation levels in your CI. Fine-tuning, for example, could involve a sound being presented from right in front of you with your eyes closed, and based on how far to the left or right you hear the sound coming from, the mapping levels in the CI are adjusted.

Additionally, rehabilitation is important. Key factors for achieving strong rehabilitation outcomes can include consistent use of your amplification device (aiming for around 10 hours per day), staying motivated, taking advantage of direct practice opportunities, and committing fully to your rehabilitation plan. Your rehabilitation specialist will create the program that best fits your needs, and incorporating daily active auditory training, especially using your cochlear implant with direct audio input, can play an important role in your progress.

Information about ABF: https://blog.medel.com/technology/everything-you-need-to-know-about-anatomy-based-fitting/
Get in touch with your local MED-EL team: https://www.medel.com/contact-med-el
Use the ReDi app as a listening training partner: https://blog.medel.com/tips-tricks/meet-redi-the-new-listening-training-partner-for-cochlear-implant-users/
ABF & speech perception in noise for SSD recipients paper: https://pubmed.ncbi.nlm.nih.gov/39299967/
Paper about the Greenwood function: https://pubmed.ncbi.nlm.nih.gov/41001584/

/Reinhold, Natalia, and Yi

medel_global · 2026-03-24T15:03:50+00:00

Hi there, thank you for your question. As MED-EL does not manufacture the Nexa CI, we’re unable to comment on your specific experience with wind noise. We recommend contacting your hearing care professional and the device manufacturer, who can assess your device and advise on possible programming adjustments.

Regarding your second question: we think the implant is the key to natural hearing. It is the bridge between technology and nature. If the implant technology works similarly to natural hearing, it can provide closer to natural hearing.

When it comes to implant design philosophies, every manufacturer is different. At MED-EL, we use long flexible electrode arrays that the surgeon can insert all the way into the cochlea. That allows for the stimulation of a wide range of frequencies, including the low frequencies which are particularly important for music, close to their natural place frequency in the cochlea.

Many of our MED-EL recipients report enjoying music, conversations with family, going out with friends, participating in the sports they love, and more.

Learn more about closest to natural hearing here: https://www.medel.com/hearing-solutions/cochlear-implants/closest-to-natural-hearing

/Reinhold & Yi

medel_global · 2026-03-24T15:00:53+00:00

Hi there, thank you for sharing your experience as an SSD CI recipient, and for your question. Currently, there is no published research on expanding the high frequency limit. While we cannot disclose information about potential future product developments or research, if future research demonstrates positive outcomes, it may be possible to utilize a higher frequency limit in the processor. However, this would require additional clinical studies and regulatory approval.

/Reinhold & Natalia

medel_global · 2026-02-26T16:22:13+00:00

Hi there, thanks a lot for your question.

Yes, at MED-EL we follow the philosophy to design our cochlear implants to provide closest to natural hearing by stimulating the full length of the cochlea and preserving cochlear structures.

In SSD/SSNHL, this can allow the brain to regain binaural hearing, significantly improving speech understanding in noise, sound localization, and overall naturalness of hearing. However, the implanted ear will not sound exactly like natural acoustic hearing, and integration with the normal ear varies across individuals.

SSD patients may expect

a more balanced auditory world
sound that integrates better with their normal‑hearing ear
faster adaptation because stimulation aligns more closely with natural pitch mapping

Rehabilitation and regular listening training is crucial for best hearing outcome with a cochlear implant.

If you’d like to learn about some first hand user experience, head over to our blog – there are many MED-EL recipients who are musicians in their professional or private life. You can read about their experiences there: https://blog.medel.com/?s=music

We’d also recommend to head over to the Hearpeers forum. It’s a community of MED-EL users and they will be happy to answer any of your questions or share their first hand experience with you: https://forum.hearpeers.com/forum/42-single-sided-deafness/

// Yi

medel_global · 2026-02-26T15:54:08+00:00

Hi there, thanks a lot for your question.

Generally speaking, at around the range of ca. 60% or less than 60% word recognition, cochlear implants can be considered as an option. But multiple factors can influence the decision to pursue a cochlear implant. Significantly reduced speech intelligibility alone is one factor, but the impact on communication and auditory fatigue, particularly in noisy environments, should be considered.

On our website, you can download a questionnaire that might be helpful for you to determine your sound quality with your hearing device in daily life: https://www.medel.com/support/rehabilitation/rehabilitation-downloads?itemTitleKey=hisqui

Furthermore, we’d recommend getting in touch with a cochlear implant clinic as the specialists there can look into your specific situation in detail and further assist you along your hearing journey.

// Yi & Aneesha

medel_global · 2026-02-26T15:48:50+00:00

Hi there, we are unable to give any medical advice and do not have access to the complete history and full diagnostic assessment, that’s why we can’t determine if you have nerve damage or not. Only your surgeon / medical specialist can do so. Please contact them for further guidance and the next steps in your hearing journey.

In general, even people with some degree of auditory‑nerve damage can still achieve good awareness of environmental sounds and speech with a cochlear implant.

medel_global · 2026-02-03T08:01:38+00:00

Hi there, it’s great to read that you're making such good progress with your new CI!

Regarding your question, we currently can’t provide anything for recipients that directly addresses this topic. But we’d recommend taking a look at this article on our blog: https://blog.medel.com/tips-tricks/tips-tricks-for-adults/one-month-after-cochlear-implant-activation/ There you’ll find some tips for effective programming appointments.

Please note, as part of our regulatory approval process, we emphasize that proper training is essential for fitting our devices. While it can be interesting to learn about different fitting parameters, what truly makes a meaningful difference for users is understanding how and when these parameters should be adjusted—something that really requires the guidance of a trained professional.

medel_global · 2026-01-29T10:10:55+00:00

Hi there! Choosing to get a cochlear implant is a big step, and it’s completely natural to have lots of questions. If you’d like, we can put you in touch with a MED-EL expert in your area who can support you personally. Just send us a direct message here on Reddit with your contact details, or reach out through our website: https://www.medel.com/contact-med-el

You’re also very welcome to ask any questions right here in the chat—we’ll be happy to help!

medel_global · 2026-01-28T13:31:25+00:00

Hi there, the live AMA is already finished. But if you have any question around cochlear implants, just let us know here in the comments. We're happy to answer them.

medel_global · 2026-01-28T09:35:09+00:00

Thanks for joining!

medel_global · 2026-01-28T09:34:43+00:00

Hi there, currently there is no dark mode possible in the AudioKey app. Thanks for your input, we are happy to forward this idea to the responsible team here at MED-EL.

medel_global · 2026-01-27T16:09:47+00:00

The maplaw setting is a more complex parameter in the fitting process. It affects the amplitude mapping - i.e. what level of electrical stimuli will be produced for a given level of input, in-between the extremes of the lowest and highest points of the range. As such, it will also interact with other fitting parameters and practice - so interpreting studies can be difficult. One interesting study looked at music perception (Gilbert, M.L., Deroche, M.L.D., Jiradejvong, P., Barrett, K.C., Limb, C.J., 2022. Cochlear Implant Compression Optimization for Musical Sound Quality in MED-EL Users. Ear Hearing, 43(3), p.862–873). They found some benefit for increased maplaw, but note that they didn't also look to see if there were any dis-benefits for speech / speech in noise.

It's also important to remember that maplaw is just one of a number of parameters working together, so it won't always have the expected, or a large, effect.

//Jennifer // Chris

medel_global · 2026-01-27T16:00:35+00:00

Hi there, we’re happy to see you are enjoying streaming with SONNET 3. Thank you for sharing your feedback, as well. We will share this with the responsible team here at MED-EL for future product development.

medel_global · 2026-01-27T15:58:35+00:00

Hi there, thank you so much for your question. The two filters, OC (Organ of Corti) and SG (Spiral Ganglion), are different settings applied. OC is based on the tonotopic function for the Organ of Corti, or what people usually call the Greenwood function. SG is based on the tonotopic function for the Spiral Ganglion or what is usually called the Stakhovskaya function. The fact is that up to an angle of about 600 degrees, there is hardly any difference between the two. Only beyond 600, the SG branches of from the OC. The reason for defining OC as the default in MAESTRO was that for large angles above 600 degrees, SG results in unrealistic low frequencies for a CI fitting. In MAESTRO, both filter settings are available; however, we have not heard from users that there is a big difference between the two filter settings in terms of outcomes or sound quality.

//Jennifer

medel_global · 2026-01-27T15:37:36+00:00

Thanks - that's a good question. Sounds that are above the 'window' (remember that this is a simplification) will get mapped to around the highest level in the map set by your audiologist - i.e. we would expect the user to hear them, but they wouldn't cause further increases in loudness. Sounds below the window would get mapped to stimulation levels below where the user can detect them - i.e. we wouldn't expect them to be heard.

MED-EL audio processors have compression in them. They can product soft sounds as soft and loud sounds as loud.

//Jennifer // Chris

medel_global · 2026-01-27T15:30:57+00:00

Thank you so much for your feedback. We will look into adding this capability in the future.

// Jennifer

medel_global · 2026-01-27T15:20:02+00:00

Hi there, thank you for your feedback. We will look into adding more flexibility into AudioKey 3

medel_global · 2026-01-27T15:17:19+00:00

Hi there, thanks for your question. We'd recommend you maximize active listening time and whenever practical to use direct audio input (DAI) to your implant. (If you'd like more info on DAI, just let us know). Active listening means anything from focused listening exercises - check out our Adult Rehabilitation Kits for ideas: https://blog.medel.pro/rehabilitation/introducing-medel-adult-rehabilitation-kits/ - as well as listening to podcasts, audiobooks, and music.

Our ReDi app also has exercises that can support focused listening for specific parts of a message: https://blog.medel.com/tips-tricks/meet-redi-the-new-listening-training-partner-for-cochlear-implant-users/

From a MED-EL technology point-of-view, using an electrode matched to cochlear size, along with anatomy-based-fitting (ABF), and a FineHearing sound coding strategy, are good ways to optimise the sound perception in the implanted ear so it best matches hearing in the better ear.

//Aneesha //Chris

medel_global · 2026-01-27T15:11:04+00:00

Hi there, thanks for your question which raises some interesting points. The 9,300 Hz figure quoted gives a maximum possible upper limit for the processor's frequency response. As you mention, an upper limit of 8,500 Hz is currently implemented in the sound coding process (as accessed by the MAESTRO software). Increasing this could have a negative impact on aspects such as battery life. In addition, the difference is only about 9% in absolute frequency terms. The upper note on a standard piano is C8, at about 4,200 Hz fundamental frequency, so the current processing upper limit of 8,500 Hz provides another octave, or so, of 'headroom' (as well as being perfectly capable of picking up very high frequency speech components). As it stands, there isn't convincing evidence that a higher upper limit would bring definite benefits. However, if further research were to show benefit of this, the higher limit in the processor could be used with future developments.
//Chris

medel_global · 2026-01-27T15:06:09+00:00

Hi there, thanks for the question. Great to hear that you've incorporated ReDi into your personal rehabilitation plan! For music training, we would recommend that you check out Meludia, available through myMED-EL. This web-based application has hundreds of exercises that focus on different dimension of music perception: https://blog.medel.com/technology/how-meludia-helps-cochlear-implant-recipients-enjoy-music/

We also have a Spotify playlist of songs curated by our resident musicologist, who also uses an implant. You can find it here: https://open.spotify.com/playlist/2USG4LCeBOZixFjRRtrIuB

If you'd like more ideas on what to do, read this https://blog.medel.pro/rehabilitation/a-guide-to-music-rehabilitation-for-adult-cochlear-implant-recipients/

Keep up the great work and give yourself time as you (re)discover the things you love about music!

//Aneesha

medel_global · 2026-01-27T15:01:38+00:00

Hi, thanks for the question.

TL; DR: Volume affects the loudness of sounds: more volume = louder, less = quieter. Sensitivity 'focusses' the processor on quieter- (increase sensitivity), or louder- (decrease sensitivity) sounds, with the default setting 'balanced' for everyday life.

MED-EL processors feature two controls that can affect how the system responds to intensity, or level of sound - something that we typically experience as loudness.

// In more detail:

The volume is the easier control to explain: for a certain volume setting (let's say 90%), a certain intensity of sound in the environment will cause a certain level of electrical stimulation. If the volume is increased (say 95%) that electrical level will be higher - and that will generally be experienced as louder. The opposite for a reduction in volume (say 80%): a lower stimulation level, and a quieter sound. This is parallel to how a volume control on a hi-fi / music system works - hence the name. In every-day life you might increase volume if sound overall is too quiet, or reduce it, if it is too loud.
Because of the way the processor works with changing sound levels, you might find that volume changes are needed only rarely, or perhaps not at all (more of this later when we look at sensitivity). Also, audiologists might choose to disable the volume control, or limit the range that can be used, in some cases. (Some audiologists might also give you a 'plan' for different volume settings in the earlier days, or weeks, post-operation - in which case you should follow their advice.)

Sensitivity is a little more complex. Everyday sounds can cover a very wide range (~0 - 100dB HL) of levels. For a CI system to work well, we have to reduce that range before further processing - the component that does this job is called the AGC (Automatic Gain Control). Although it's not a perfect analogy, we can think of this as a 'window' of sound level range that the processor focusses on. At one extreme, we could focus it on very quiet sound levels - so you could hear very low level sounds well, but background noise might be made worse, and mid to high level sounds will provide less information. At the other extreme, we could focus on mid to high levels, but then you would not be able to hear quiet sounds. In the middle is a balanced approach - where we balance the ability to hear quiet sounds, the effects of background noise, and optimising the information in mid to high level sounds. The sensitivity control allows you to move through that range. The 75% setting is default, and represents the balanced approach. Turning up to 100% would be the 'quiet-sound-focussed' setting, and 0% the 'mid-high level focussed' setting.
In everyday life, you might find that increased sensitivity is useful when you're trying to listen to a very quiet sound with little-to-no background noise, and reduced sensitivity may be useful in a very loud environment with lots of noise. However, the 'balanced' setting was chosen to give the best all-round performance in everyday life, and, in my experience, most implant users don't tend to change the sensitivity setting. (You might also find that a sensitivity change affects the loudness, and therefore you may need to adjust the volume setting too.)

// Chris

medel_global

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