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.
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?
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!