My Cochlear Implant Story: Part 8 – Choosing an Audio Processor

Deciding which audio processor to choose has been a tricky part of my cochlear implant journey. In a nutshell, a cochlear implant processor is the external component of a cochlear implant system. It captures sounds from the environment, converts them into digital signals, and sends these signals to the internal implant. The internal implant then stimulates the auditory nerve, creating the sensation of hearing. Your choice of processor depends on the brand of your implant, and in my case, that’s Med-El. Ahead of my audiologist appointment to discuss options, I did my own research to make sure I was well-prepared.

Understanding the Different Processor Styles

With Med-El, I had two main styles of processors to choose from:

1. The Med-El Sonnet Processor
   • Style: Worn behind the ear, similar to a hearing aid.
   • Design: Consists of a small unit that fits comfortably behind the ear with a cable that connects to the transmitter/magnet (to send signals to the internal implant).
   • Latest Version: The Sonnet 3.
2. The Med-El Rondo Processor
   • Style: An all-in-one, single-unit processor worn on the head, just behind the ear.
   • Latest Version: The Rondo 3.

When I started researching, the Sonnet 3 had just become available in Spain, but I don’t think it was FDA-approved in the U.S. yet. Meanwhile, the Rondo 3 had been on the market for four years. Unlike some people, who are lucky enough to receive both styles, I could only choose one—so I wanted to make the right decision.

What Mattered Most to Me

The main things I was looking for in a processor were comfort, ease of use, and sound quality.  Since I wear glasses a lot—reading glasses for computer work and sunglasses for the bright Spanish sun—I needed something that would be comfortable to wear. 

Streaming audio from my phone for aural rehabilitation (activities to help improve my ability to understand and process sounds through the implant) was non-negotiable. However, I didn’t want to sacrifice overall audio quality or find myself stuck with outdated technology.

Researching My Options

The Spanish healthcare system provided my implant, so I wasn’t sure which generation of technology I’d be offered. I prepared myself for the possibility of older models but researched all available options to make an informed decision no matter what.

As part of my research, I explored Med-El’s website and joined the Med-El Hearpeers online community forum. Regarding the latest versions of each processor, I discovered the following:

Hmm, The Sonnet 3 offers direct streaming but relies on batteries, which I’m not a fan of since it means constantly changing them. On the other hand, the Rondo 3 doesn’t have direct streaming, but it does feature wireless charging.

Consulting with an Audiologist Friend

A friend of mine who is an audiologist whose husband has experience with Rondo 2 and Sonnet 2 talked me through the various parts, functionality, streaming capabilities, and charging/battery life options of each device, and also shared information with me about the newest Med-El Processors and relevant accessories, such as those used for streaming.

Real-Life Insights

To dig deeper, I connected with friends and colleagues who had experience with these processors. Many of them used both styles and shared their insights.

Most people who were glasses wearers commented that they didn’t find that glasses were a problem with a behind-the-ear device—some of these people were used to wearing hearing aids behind the ear before getting a cochlear implant.  

One person I spoke with shared that they use both types interchangeably and find the sound quality to be the same. In contrast, others preferred a behind-the-ear device, as they were accustomed to the feel of it from years of wearing behind-the-ear hearing aids.

Another person told me that they only use their Rondo because they dislike the sensation of having something behind their ear. “It’s highly personal,” one contact told me, which confirmed what I had already been sensing.

Preparing for the Audiologist Appointment

Consulting with the Audiologist

Three weeks after my surgery, I met with my audiologist who will program my implant, to review the options. He brought brochures for the Rondo 2, Sonnet 2, and Rondo 3 and explained that the Sonnet 3 was also available, even though he didn’t yet have a brochure for it. He also had a dummy-style Sonnet and Rondo, so I could try them on for size and fit. 

Weighing the Costs and Technology Options

To my surprise, I had access to the latest technology, but there was a catch: the Sonnet 3 and Rondo 3 required an out-of-pocket cost, while older models like the Rondo 2 and Sonnet 2 were fully covered by the Spanish healthcare system. The cost of the newer models was about the same as what I would pay for a standard hearing aid.

I was concerned that choosing the older technology would leave me with outdated equipment in 7 years (the typical lifespan of the processors, according to the specialist). For this reason, I ruled out the Rondo 2, which lacked the streaming capability essential for my rehabilitation, as well as the Sonnet 2.

First Impressions: Sonnet 3

I was excited that the Sonnet 3 was available to me! However, when I tried on the dummy Sonnet processor, I found it a bit uncomfortable, and I wasn’t sure how well I would adjust to the behind-the-ear design. It felt bulky and awkward, especially with my glasses. Is this something I would get used to? I wondered.

First Impressions: Rondo 3

I then tried the dummy Rondo processor, which felt much more comfortable, even though there was still swelling in the area where the magnet attached. I was able to put on my glasses easily, without worrying about accidentally knocking the processor off.

Influence of Social Media

I had always assumed I would choose a behind-the-ear device, but the Rondo felt more comfortable. Many people I follow on social media use a behind-the-ear option, though I know that shouldn’t influence my decision. I’m not sure why I started fixating on this, but I found myself wondering—What, if anything, would I be missing out on by choosing an on-the-head device over a behind-the-ear one?

Managing Expectations for Activation

As always, the audiologist made sure my expectations for activation and the experience of hearing through the implant were realistic. He reminded me that my strong right ear could make rehabilitation more challenging. Even if I block my hearing ear, I’ll still pick up environmental sounds, making it harder to focus entirely on my implanted ear—a point that’s been emphasized in every appointment. This is why being able to stream audio is so important for my aural rehabilitation. 

He also noted that since my hearing loss occurred eight years ago, adapting might be difficult. With zero word recognition even at full volume, my right ear hasn’t been “hearing” for eight years, which could impact how well I adjust to the bionic ear. This, too, is a point that’s been consistently emphasized in every consultation. Even with these factors, I remained optimistic about a positive outcome.

Next, I needed to call Med-El to confirm my choice of processor.

A Conversation with Med-El

Three days following my consultation with the audiologist, I spoke on the phone with a Med-El representative. I was able to speak to someone in English, which was super helpful. 

Audio Quality Concerns

I asked her my question: What will I be missing out on in terms of audio quality by wearing something that isn’t behind the ear? She assured me that the technology in both the Sonnet 3 and the Rondo 3 is excellent, with users satisfied with both devices. The main difference is personal preference of style and features. This was backed up by my previous conversations with Med-El users of the 2 types of processors. 

I thought back to sitting in the audiologist’s chair and the uncertainty about the feeling of the behind-the-ear dummy Sonnet processor and my glasses behind my ears. Maybe I would get used to this, but I didn’t have the luxury of being able to ‘try before I buy’. All I have to go on is how the processors felt during my consultation with the audiologist. 

AudioLink or AudioStream: What Do I Need for Rondo 3 Smartphone Streaming?

I then asked if I would need the AudioLink device to connect my phone to the Rondo 3 processor for rehabilitation through apps or streaming music. She said, it wasn’t necessary for this, and that I would just need to connect the AudioStream adapter (a small wireless pendrive-like device that slots into the Rondo 3), that comes in the activation kit. The AudioStream is compatible with iOS and Android devices that support Made for iPhone (MFi) and Audio Streaming for Hearing Aids (ASHA) technology (more compatibility information can be found here.) She explained that I would only need the AudioLink device—which would have to be purchased separately—for more complex tasks (like using it as a remote microphone) or to connect to media that are not compatible with hearing aids and cochlear implants.

This was a relief, and I couldn’t help but think, “Music to my ears”—pardon the pun! I had originally thought that if I chose the Rondo 3, I would need to buy the AudioLink for rehabilitation exercises on my smartphone, but it turns out that’s not the case. Just to double-check, (ever the cautious consumer), I messaged Med-El on Instagram messenger, and they confirmed this. 

Choosing the Colour of My Processor

I was informed that the only colour available to me for the Rondo 3 was black, and any other covers could be purchased separately. The Sonnet 3, on the other hand, offered more customization, allowing me to choose different colours for each component.

Next Steps

Following the call, the Med-El rep sent me information on the cost and payment details, via email, for each device. The next step would be to make my decision, pay the fee, and notify them once I’d done so, letting them know my activation date so that they could send the processor to the hospital in time for the big day. 

My Decision

I’ll start with a black cover but plan to add colourful designs in the future. I love talking about my hearing journey, and I’m looking forward to showing off my processor when the mood strikes!

Resources That Helped Me

Processors comparison: https://www.medel.com/hearing-solutions/cochlear-implants/audio-processor-comparison

Connectivity features: https://www.medel.com/hearing-solutions/accessories/connectivity 

The next step is activation day – roll on December 18th!