The User Perspective on Closest to Natural Hearing

The term “closest to natural hearing” can mean many things to different people, and we’ve spoken with a variety of doctors and medical professionals about how they would define that term over the course of this podcast series. But in this episode, Ilona Anderson, PhD, MBA sat down with two MED-EL cochlear implant recipients to hear about their firsthand experience living with their hearing devices.

Dr. Anderson, the Corporate Director of Clinical Research at MED-EL, starts the conversation by asking each of her guests what closest to natural hearing means to them. Mariia Pazi explains that for her, the term’s meaning is twofold. She starts by explaining that “closest to natural hearing,” at its simplest, means getting as close to what she remembers her normal hearing used to be. But, she explains, the term also relates to the specific ways in which MED-EL’s technology mimics her natural ear.

The ear processes sound information in two distinct ways, depending on the pitch of the particular sound. The higher pitches rely on place-coding, that is, the location in the cochlea where the information is received. Most CI’s use this coding strategy. But MED-EL goes a step further by implementing rate-coding for lower pitches in addition to place-coding. Rate-coding refers to processing sound based off the frequency with which it stimulates the cochlea. The normal hearing ear uses both of these to process sound, and MED-EL is the only cochlear implant manufacturer that uses both in our sound coding strategy.

Next, MED-EL recipient Krystian Koper discusses how living with single-sided deafness gives him a unique perspective on “closest to natural hearing.” He explains that he can compare his hearing in his normal hearing ear with what he hears through the cochlear implant. “I can hear that closest to natural hearing when I can compare sounds and some sounds are really, really close to that natural hearing and even really, really good in terms of natural hearing.”

Dr. Anderson then asks Mariia about her experience testing the different sound coding strategies MED-EL has employed over the years.

MP: “I had a chance to test very different coding strategies, starting from an old one, which is CIS, which lacks time coding. It’s just place coding. And so I tried CIS, then I tried FS4, a more improved version of it—FS4-P—and then I tried anatomy-based fitting. I tried to listen to different music and compare them and see how they’re different.

When I tried CIS and tried listening to music, I understood how imbalanced that sounds. It’s very high pitched and it’s kind of hard to tell a violin from a flute because they’re very frequency-similar and you can’t tell one instrument from another.

Then I switched to FS4, and that’s when the balance was created between low-pitched and higher-pitched instruments and between vocals and instrumental components. And then I switched to FS4-P, which means the impulsation is aligned with the frequency of an incoming sound. That’s when I think music started to sound very much like what I remember.

After, that’s when we decided that we should see how my hearing would change when we used anatomy-based fitting. […] The most important outcome for me switching from clinical-based fitting to anatomy-based fitting was that for the first time since implementation, my own voice stopped sounding odd or unfamiliar or annoying.”

MED-EL’s cochlear implant philosophy is, and always has been, based on our technology adapting to our patients, not the other way around. This impacts everything we do and reinforces our mission to provide the closest to natural hearing. If you’d like to hear more from Mariia and Krystian, give the whole podcast a listen. Curious to learn more? Visit www.medel.com to hear about how we’re connecting our recipients to the sounds of life.