Questions to Ask When Choosing a CI Company

Hey all! Long time no blog post :) The podcast has kept me SUPER busy, but now that my kids are ALL in school two mornings a week (cue high-fiving a million angels) I’m hoping to find some more pockets to write over here. I’m posting something today that is a little out of my norm, but it’s something I’ve been sharing with parents in a word document for years now and I want to have a central place for people to find it, especially because tomorrow I’ll be on the Child’s Voice podcast sharing about these questions. (Hello to anyone who’s come here from the podcast!) If you don’t have a kid with hearing loss, this isn’t super pertinent (but if you know someone with hearing loss who’s considering a cochlear implant- feel free to pass it along!). If you are in the deep with CI brands, processor options and facing a surgery for your child or yourself, well then, I hope this helps! This is what I wish I’d had when I was in your shoes all those years ago…


When we sat in the audiologist’s office a few years ago after learning our son had become a candidate for a cochlear implant we knew little about the device and even less about the different brands and choices we had to make with regard to this major medical equipment our son would likely use for the rest of his life.  But yet there we were, charged with an incredible decision, feeling woefully inadequate to the task.   Where do we start?  Are they all the same?  How do you pick?

Fast forward to today and I couldn’t be happier with our decision.   But what I remember most about that process was how overwhelmed I was regarding how to go about gathering information.  We were handed a stack of literature from three companies and told to choose.  I didn’t know at the time what questions to ask. And although we are so grateful for the path we ultimately did choose, I can’t help but think I may have felt less anxious and more confident during the process if I’d known what to ask our audiologist about the different devices.  I wish I’d asked these questions when we began the process.

Questions Regarding the Internal Implant

The first questions I would have asked would have been about the internal device implanted in my son’s head.  After all, this is what is going to be in him for the rest of his life!  How crucial it is to start there!

You can ask things like: What makes each internal implant unique?  What can you tell me about the electrode array and the placements of the electrodes across the different brands?  How does the placement affect how my child hears, or the ways his brain has to work to access sound?  What are the size and length comparisons of the device and electrode array?  How is the device inserted?  Are there any risks associated with the type of device or insertion process?  Are any of the brands better for maintaining residual hearing or preserving the structure of the cochlea?  Can my child get an MRI with this device?  At what tesla power?  Is there any risk of pain or down hearing time (meaning healing time where he is unable to wear his device) if he needs to get an MRI?  

All of these questions can help you to better understand the internal implant that will be in your child’s head.  The internal implant is probably the most important component as it is the part that works with your child’s brain to understand sound.  I heard one adult cochlear implant candidate joke, “It’s easier for me to divorce my husband than it is for me to get this thing out of my head.  I need to know what I’m agreeing to!”  

Questions Regarding the Cochlear Implant Company

The next set of questions to ask, in my opinion, revolve around the different cochlear implant companies themselves.  You will be working with the company you choose for the length of your child’s life, which for a child implanted at age one is a lot of years!  It’s so important to learn about the company behind your device.

I would ask about the philosophy of the company and even their history.  Where are they located?  What do you know about the reliability of the company and their products?  Have they had any recalls?  How many and when were they?  How long are the warranties on devices? What is the cost to me to replace things after they are no longer under warranty?  What is their customer service like?  How quickly do they fix/send replacement pieces?  Do they have a replacement policy for lost or broken items? Do they make sure that future external processors work with current or previous types of internal implants so that your child has access to future technology regardless?  Where/what county is the product made?  Is it all made in that country or are some pieces made elsewhere?

These are questions an audiologist may or may not be able to answer, but if they can’t they can connect you with representatives from the companies to help you.

Questions Regarding the External Processor

Lastly I’d ask about the external processor.  It may seem funny to leave this until the end, but I’ve realized that this is actually a lesser priority when it comes to choosing a particular brand.  The external processors will change over the years and you will have access to upgrades and future technology.  In the five years my son has been implanted I’ve seen all three companies come out with new versions of their external processors or new waterproofing options.  In this day and age of rapid technological advances companies are having to move fast to stay competitive.  The external processor is not a constant like the internal implant or the company itself.  If a company you love doesn’t have a feature you desire on their external processor right now, there’s a good chance they will sometime down the road.  

That being said, a few questions you can ask are things like, what external processor options are there?  Are there waterproofing options?  What kind of batteries do they take?  How long is the typical battery life?  Are there any interesting features on the device?  What kinds of color options do they have?  Does it come with assistive listening devices?  Do they have any apps I can use on my phone? What choices do I have as far as add ons?