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A Cochlear Implant Recipient’s Perspective on RONDO

April 25th, 2013 by | Tags: , , | 6 Comments »

Allison lost her hearing to meningitis when she was 18 months old, and has profound hearing loss. She was implanted in 2001 with a MED-EL cochlear implant.  She currently works for MED-EL as a Patient Support Specialist.  She is married and has three children ages 7, 5, and 3.  She shares her experiences in hearing with MED-EL’s newest sound processor, RONDO.

The design of RONDO was based on the sound processor for Vibrant Soundbridge Middle Ear Implant.

The design of RONDO was based on the sound processor for Vibrant Soundbridge Middle Ear Implant.

Why did MED-EL decide to design an all-in-one headpiece sound processor, RONDO?  

Cochlear implant processors have come a long way, starting first with body-worn designs that used multiple AA batteries, and then moving to ear-level versions that run on hearing aid batteries.  The RONDO represents a new class of CI audio processor:  the Single-Unit Processor.  Our experience with similar processors for our Vibrant Soundbridge Middle Ear Implant informed us that recipients especially appreciate the freedom of a system that isn’t located directly on the ear, and this motivated us to develop a similar design for cochlear implant recipients to enjoy also.


What are the benefits of using an all-in-one headpiece sound processor instead of the behind-the-ear sound processor?   

The RONDO frees up the ear. For those of us who are used to having a hearing aid or a BTE cochlear implant processor, it is a newfound feeling to have nothing on the ear.  It also blends in well with the hair, so it’s very discreet and not as noticeable. And it also is more comfortable for those who wear glasses or other devices around the head/ear, as it’s one less thing hanging on the ear.  There are also no extra cables, which for some people can get in the way.

Also, with the RONDO, MED-EL incorporated the successful MAESTRO software program that is currently available with the OPUS 2 processors, so, for me, the transition was pretty seamless.


What have engineers done differently to be able to build an all-in-one headpiece sound processor?  

The creativity in engineering RONDO is really based on compact use of space.  Building a system where the processor, magnet, electronics, transmission hardware, microphone and batteries all reside in the same housing, while keeping the weight of the processor at a level that could be easily managed using standard magnets was the primary design goal.


Some have expressed concerns in using the phone with RONDO because of the placement of the microphone.  Could you address this situation by explaining how they can still use the phone with RONDO?   

There are two options for using the phone with RONDO.  The listener can just hold the phone up to the ear, in the traditional way, or they can use the built-in telecoil to access the phone signal.  In the traditional setup, the position of the phone may need to be slightly adjusted to account for the location of the RONDO microphone.  In my experience with telephone use, I simply point the RONDO microphone towards my ear (rather than the upwards position) and I am able to hear just fine on the phone.  However, the T-coil is aligned best when the microphone is pointed upright, so if the CI user is a T-coil user, then it may be best to keep it upright to take advantage of the T-coil capabilities.  Either option can work well, and it’s really a matter of individual preference.


Some have expressed concerns that because RONDO as a headpiece is heavier than other headpieces due to including the batteries, computer chip and everything that was on the behind-the-ear sound processor, there might be issues with skin irritation.  Could you explain how RONDO is built to prevent skin irritation?  

The RONDO weighs 18.5 grams (with the batteries).  It is very comfortable and does not feel heavy at all; I forget I have it on.  I have not had any skin irritation issues and in MED-EL’s preliminary experience with the processor there were no reports that this is a problem.  The processor comes with four magnet strengths, ranging from soft, standard, strong and super strong, so the end-user can work with their audiologist to select the magnet strength that is the most comfortable for them.  Like the D coil (and other coils) for the OPUS 2 processor, the RONDO is flat on the side that faces the skin, so it is really no different in terms of skin irritation than more traditional BTE designs.


Cochlear implant recipients are often eager to know what’s in the future for them.  Would you be able to share some insights on what MED-EL hopes to bring to their recipients in the future?

Allison and her family

Allison and her family

MED-EL has a number of hearing implant technologies in development.  Clinical trials are underway in the United States for a device that uses electric-acoustic stimulation to combine a cochlear implant and a hearing aid into one processor. That technology is being researched for people who have significant residual hearing and would not qualify for a cochlear implant today.  The company is also researching new indications for its’ middle ear implant system, the Vibrant Soundbridge, that might allow its use for conductive and mixed hearing loss, in addition to the current approval for moderate-to-severe sensorineural hearing loss.  MED-EL designs all of their technologies as “future compatible,” meaning that, as much as possible, existing users will be able to take advantage of the latest advances as they become available, and I’m excited myself to see what MED-EL comes up with next!




Rich Harder

April 25, 2013 at 5:41 pm

How is the quality of hearing vs CI’s with an external mic? (AB stresses that the microphone in the ear canal enhances sound pickup) Also, are the batteries rechargeable?


Joe Risha

June 19, 2014 at 6:06 pm

Hi Allison. Your blog was great I’ planning on getting a CI with the Rondo in the near future. I read last night in the form of an email from Med-El concerning the new Sonnet Audio Processor. It’s unbelievable. They have also added the Synchrony CI. I believe it’s a BTE style ear piece. The above has been approved in Europe, but not the USA. When time allows, I would like to know with the Rondo how your speech understanding is going. I look forward to your response. With kind regards, Joe Risha, North Carolina.


September 26, 2014 at 9:13 pm

I read with interest on Med-El website
concerning the new Sonnet Audio Processor. It’s unbelievable. They have also added the Synchrony CI. I believe it’s a BTE style ear piece. The above has been approved in Europe, but not the USA so when do you think will happen here in USA? I was born deaf with profound hearing loss in both ears and have worn hearing aid since then. I just can’t wait to be able to hear/understand people better after lipreading all thos years!

KK Leonard

October 16, 2014 at 2:38 pm

My husband’s med el implant was “turned on” this past February…….how long is the average time for him to be able to hear at his best? This is very important to me, we were advised within the first year….now we’re being told 2 years. Never signed up for that Long!! Thanks for you response.

October 20, 2014 at 1:10 pm

Congratulations on beginning this journey! I’m sorry that you feel your CI team did not realistically prepare you for the amount of work involved in learning to hear again with a cochlear implant. It certainly does take time! Whether that’s one year, two years, or more depends on the cochlear implant user and their prior hearing history. Here is a guide to what you might expect: Great Expectations: Progress with a Cochlear Implant. The key will be having good, frequent mapping sessions (it does usually take six months to a year to even get to the optimal map), and lots of practice and aural rehabilitation under the care of a specialist in listening and spoken language.

October 20, 2014 at 1:30 pm

The FDA approval process can be fickle, so it’s really anyone’s guess when the new technology will receive approval for use in the US. If you are currently a hearing aid user but struggling to understand without visual cues, I would encourage you to act now! The technology upgrades are coming and will be available to you in the future. It is not worth waiting for them while you continue to struggle in conversations day to day. For more information, check out this article: Why Wait?