How to Connect Your CI to Hearing Aids

Seamless Sound: Your Definitive Guide to Connecting Cochlear Implants and Hearing Aids

For individuals navigating the intricate world of hearing loss, the concept of bimodal hearing – combining a cochlear implant (CI) in one ear with a hearing aid in the other – represents a significant leap forward in optimizing auditory experiences. This synergistic approach leverages the strengths of both technologies: the CI provides clarity and access to a broad range of sounds, while the hearing aid amplifies remaining acoustic hearing and enriches sound quality, particularly low-frequency sounds. The result is a more natural, immersive, and comprehensive auditory landscape.

However, achieving this seamless integration requires understanding the various connectivity options, navigating technical nuances, and often, collaborating closely with hearing healthcare professionals. This in-depth guide aims to demystify the process, providing actionable steps and insights to help you connect your CI to your hearing aid, unlocking a world of enhanced sound and improved communication.

Understanding Bimodal Hearing: The Power of Two

Before diving into the “how-to,” it’s crucial to grasp the fundamental benefits of bimodal hearing. Our brains are designed to process sound from two ears, enabling us to localize sound sources, understand speech better in noisy environments, and perceive a fuller, richer sound spectrum. When one ear receives amplified acoustic input from a hearing aid and the other receives electrical stimulation from a cochlear implant, the brain learns to integrate these distinct signals.

Key Benefits of Bimodal Hearing:

Improved Speech Understanding in Noise: This is arguably one of the most significant advantages. The combined input from both devices helps the brain separate speech from background noise, making conversations in challenging environments, like crowded restaurants or busy streets, significantly easier.
Enhanced Sound Localization: Having input from both sides allows your brain to pinpoint where sounds are coming from, improving your awareness of your surroundings and making activities like driving safer.
Richer Sound Quality: The hearing aid can provide access to low-frequency sounds that the cochlear implant might not fully capture, contributing to a more complete and natural sound experience, particularly for music appreciation.
Reduced Listening Effort: When your brain receives more comprehensive auditory information, it doesn’t have to work as hard to fill in the gaps, leading to less listening fatigue throughout the day.
Adaptability to Various Environments: Bimodal solutions often come with programs and settings that can be adjusted to optimize hearing in different acoustic scenarios, from quiet one-on-one conversations to bustling social gatherings.

The Connectivity Landscape: A Spectrum of Solutions

Connecting your CI and hearing aid isn’t a one-size-fits-all endeavor. The methods largely depend on the brands and models of your devices, their inherent technological capabilities, and the accessories available. Broadly, connectivity can be categorized into direct streaming, intermediary devices, and integrated bimodal systems.

1. Direct Streaming: The Age of Wireless Convenience

Direct streaming has revolutionized how individuals with hearing devices interact with their digital world. This technology allows audio to be transmitted wirelessly from a smartphone, tablet, or other compatible device directly to both your CI sound processor and your hearing aid simultaneously.

How it Works:

Bluetooth Low Energy (LE Audio): This is the latest and most promising standard for direct streaming. LE Audio offers improved sound quality, lower power consumption, and the potential for multi-stream audio, meaning you could connect to multiple devices or even public audio broadcasts (Auracast™) in the future. Many newer CI sound processors and hearing aids are becoming LE Audio enabled.
Made for iPhone (MFi) Hearing Devices: For Apple users, MFi compatibility allows direct pairing of compatible CIs and hearing aids with iPhones, iPads, and even Macs. This provides seamless audio streaming for phone calls, music, podcasts, and more, directly into both devices.
Android ASHA (Audio Streaming for Hearing Aids): Similar to MFi, ASHA is Google’s protocol for direct streaming from compatible Android devices to hearing aids and, increasingly, cochlear implants.

Actionable Steps for Direct Streaming:

Check Device Compatibility: This is the absolute first step. Visit the manufacturer’s website for both your CI and hearing aid to ascertain if they support direct streaming and with which operating systems (iOS, Android) or specific device models. For example, some Cochlear Nucleus 7 and 8 Sound Processors are MFi compatible, and some MED-EL SONNET series processors with an AudioStream cover support bimodal streaming with various Android phones and hearing aids.
Ensure Bluetooth is Enabled: On your smartphone or tablet, navigate to your device’s settings and ensure Bluetooth is turned on.
Put Devices in Pairing Mode: The method for this varies by manufacturer:
- Battery-powered devices: Often involves opening and closing the battery door.
- Rechargeable devices: May involve pressing and holding an on/off button for a few seconds, or simply removing them from their charger.
- Consult your specific CI and hearing aid user manuals for precise instructions.
Initiate Pairing on Your Smartphone:
- For iOS (MFi): Go to Settings > Accessibility > Hearing Devices. Your devices should appear under “MFi Hearing Devices.” Select them and tap “Pair” when prompted. You might see two pairing requests, one for each device.
- For Android (ASHA): The process can vary slightly between Android versions and phone manufacturers. Generally, you’ll go to Settings > Connected devices > Bluetooth or Settings > Accessibility > Hearing devices. Look for your hearing devices and follow the on-screen prompts to pair.
Confirm Connection: Once paired, you should hear a series of beeps or a confirmation tone, and your devices will appear as “connected” in your phone’s settings.
Test Streaming: Play some music, make a phone call, or watch a video to confirm audio is streaming to both your CI and hearing aid. You should experience synchronized sound in both ears.

Example: Imagine you have a Cochlear Nucleus 8 sound processor and a ReSound OMNIA hearing aid.

Ensure your iPhone’s Bluetooth is on.
Turn off and then on your Nucleus 8 and OMNIA hearing aid to put them in pairing mode.
On your iPhone, go to Settings > Accessibility > Hearing Devices.
You’ll see your devices listed. Tap on your name (e.g., “John’s Hearing Devices”).
Tap “Pair” for each device when prompted.
Once paired, open Spotify and play your favorite song – it should now stream clearly to both your CI and hearing aid, providing a rich, stereo listening experience.

2. Intermediary Devices (Streamers/Accessories): Bridging the Gap

For devices that don’t support direct streaming, or for enhancing connectivity with non-smartphone audio sources, intermediary devices often serve as a crucial bridge. These typically take the form of small, wearable streamers or dedicated accessories.

Types of Intermediary Devices:

Bluetooth Streamers: These devices, often worn around the neck or clipped to clothing, receive Bluetooth audio from phones, tablets, or other Bluetooth-enabled devices and then transmit it wirelessly to both your CI and hearing aid. They often act as a remote control, allowing volume adjustments and program changes.
- Example: Oticon Medical’s Streamer XM can connect to a Neuro 2 CI and an Oticon hearing aid, streaming audio from a smartphone. Cochlear also offers Phone Clips for hands-free calling and streaming to compatible sound processors.
TV Streamers: Designed to connect directly to your television’s audio output, these devices wirelessly transmit TV sound to your CI and hearing aid, allowing you to control your personal volume without affecting others in the room. This can significantly improve TV enjoyment, especially for those who struggle with distant sound sources or background noise.
Mini Microphones: These portable microphones can be given to a speaker (e.g., a teacher, a colleague in a meeting) or placed in the center of a table to pick up speech and transmit it directly to your hearing devices. This is invaluable in noisy or reverberant environments and for long-distance listening.
- Example: Cochlear’s Mini Microphone 2+ can be used to stream speech directly to compatible Cochlear sound processors and paired hearing aids.
Remote Controls: While not strictly “streaming” devices, many remote controls for CIs and hearing aids allow for synchronized adjustments of volume and program settings across both devices, providing unified control.

Actionable Steps for Using Intermediary Devices:

Identify Compatible Accessories: Consult your audiologist or the device manufacturer’s website to determine which streamers or accessories are compatible with your specific CI and hearing aid models.
Pair the Streamer with Your Devices: This usually involves a specific pairing sequence, often pressing a pairing button on the streamer and then putting your CI and hearing aid into pairing mode. Refer to the streamer’s user manual for detailed instructions.
Pair the Streamer with Your Audio Source: If it’s a Bluetooth streamer, pair it with your phone/tablet like any other Bluetooth device. For a TV streamer, connect it to your TV’s audio output (e.g., optical, RCA, or headphone jack) and then ensure it’s transmitting.
Test the Connection: Play audio through your chosen source (phone call, music, TV) and confirm that sound is being streamed clearly and simultaneously to both your CI and hearing aid. Adjust volume levels as needed, typically through the streamer itself or its associated app.

Example: You want to stream audio from your smart TV to your MED-EL SONNET 2 CI and a compatible hearing aid.

Acquire a MED-EL TV Streamer.
Connect the TV Streamer to your TV’s optical audio output using the provided cable.
Put your SONNET 2 CI (with AudioStream cover) and your hearing aid into pairing mode.
Press the pairing button on the TV Streamer.
Once connected, the TV’s audio will be streamed directly into both your CI and hearing aid, allowing you to hear dialogue and sound effects clearly at your preferred volume.

3. Integrated Bimodal Systems: Designed for Synergy

Some manufacturers offer integrated bimodal solutions where the CI and hearing aid are designed to work together seamlessly from the ground up, often sharing underlying technology platforms for enhanced communication and synchronized features. This typically occurs when a cochlear implant company is part of a larger hearing healthcare group that also produces hearing aids.

How it Works:

Shared Platform Technology: Devices from the same corporate family (e.g., Advanced Bionics CIs with Phonak hearing aids, or Oticon Medical CIs with Oticon hearing aids) are often built on similar processing platforms. This allows for deeper integration, synchronized processing, and features like “StereoZoom” (Advanced Bionics/Phonak) which uses microphones from both devices to focus on speech in noise.
Unified Control: These systems often allow for controlling both the CI and hearing aid simultaneously through a single mobile app or a dedicated remote control, simplifying user experience.
Optimized Algorithms: The sound processing algorithms in both devices are often specifically tuned to complement each other, ensuring a more cohesive and balanced auditory input to the brain.

Actionable Steps for Integrated Bimodal Systems:

Consult Your Audiologist: This is paramount. Your audiologist will be best equipped to recommend and fit integrated bimodal solutions, as they understand the specific compatibility and features of these advanced systems.
Professional Fitting and Programming: Unlike general Bluetooth pairing, integrated bimodal systems require precise professional fitting and programming to ensure optimal synchronization and performance. Your audiologist will “map” your CI and program your hearing aid to work in harmony.
Utilize Dedicated Apps: Download and familiarize yourself with the manufacturer’s dedicated smartphone app. These apps provide comprehensive control over both devices, including volume adjustments, program changes, and access to advanced features.

Example: You have an Advanced Bionics (AB) Marvel CI and a Phonak Link M hearing aid.

Your audiologist will facilitate the initial pairing and programming, ensuring the devices recognize and communicate with each other.
Download the AB Remote mobile app (or Phonak app, depending on the unified control method).
Through the app, you can adjust the volume for both devices simultaneously, switch between different listening programs (e.g., “Restaurant,” “Music”), and potentially even activate features like StereoZoom to focus on a conversation in a noisy environment. The devices will work in concert to provide a unified listening experience.

Beyond the Basics: Advanced Considerations and Troubleshooting

Connecting your CI to your hearing aid is more than just pairing devices; it’s about optimizing your entire hearing experience.

Audiologist’s Indispensable Role

Your audiologist is your primary partner in this journey. Their expertise is crucial for:

Device Selection and Compatibility: They can guide you through the complex landscape of CI and hearing aid models, ensuring compatibility for bimodal use and recommending the best options for your specific hearing loss and lifestyle.
Initial Fitting and Mapping: For cochlear implants, the “mapping” process is critical for programming the device to your unique auditory needs. Similarly, hearing aids require precise programming. Your audiologist will ensure both are optimally configured for bimodal hearing.
Fine-Tuning and Optimization: Over time, your hearing needs may change, or you might encounter specific listening challenges. Your audiologist can fine-tune the settings of both devices, individually and in tandem, to maximize your hearing performance.
Troubleshooting: When connectivity issues arise, your audiologist is the first point of contact. They can diagnose problems related to device settings, software updates, or hardware malfunctions.
Patient Education and Rehabilitation: Audiologists provide invaluable guidance on how to use and maintain your devices, as well as strategies for maximizing communication in various environments.

Common Troubleshooting Tips

Even with seamless technology, occasional glitches can occur. Here are some common troubleshooting steps:

“Turn it Off and On Again”: The classic solution often works. Power down both your CI sound processor and your hearing aid, wait a few seconds, and then power them back on. This can resolve temporary software conflicts.
Check Battery Levels: Low batteries are a frequent culprit for connectivity issues or intermittent sound. Ensure both devices are adequately charged or have fresh batteries.
Verify Bluetooth is Enabled and Devices are in Range: Double-check that Bluetooth is active on your streaming device (smartphone, tablet) and that your CI and hearing aid are within the recommended range (typically 30 feet or 10 meters, reduced by obstacles like walls).
“Forget” and Re-Pair Devices: If a previous pairing isn’t working, go to your phone’s Bluetooth settings, “forget” or “unpair” your hearing devices, and then repeat the pairing process from scratch.
Check for Software/Firmware Updates: Manufacturers frequently release updates to improve connectivity, performance, and introduce new features. Ensure your CI sound processor, hearing aid, and any associated mobile apps have the latest firmware/software installed.
Clear Obstructions: Ensure no physical obstructions (e.g., earwax in the hearing aid receiver, debris in the CI microphone) are impeding sound transmission. Regular cleaning is essential.
Minimize Interference: Other Bluetooth devices in the vicinity or strong electromagnetic fields can sometimes cause interference. Try moving to a different location or temporarily disabling other Bluetooth devices.
Consult User Manuals: Your device manuals contain specific troubleshooting sections for connectivity issues.
Contact Your Audiologist: If basic troubleshooting doesn’t resolve the issue, contact your audiologist. They have specialized diagnostic tools and expertise to identify and fix more complex problems.

Maintaining Your Connected System

Proper maintenance is key to long-term optimal performance:

Regular Cleaning: Clean your CI sound processor and hearing aid regularly as per manufacturer guidelines to prevent earwax buildup and ensure clear microphone input.
Battery Management: For rechargeable devices, adhere to charging recommendations. For disposable batteries, carry spares and replace them promptly when low.
Protect from Moisture and Heat: Both CIs and hearing aids are sensitive to moisture and extreme temperatures. Use drying kits or dehumidifiers, especially in humid climates or after strenuous activity.
Safe Storage: When not in use, store your devices in their protective cases to prevent damage.
Routine Audiologist Appointments: Schedule regular follow-up appointments with your audiologist for check-ups, cleaning, adjustments, and firmware updates.

The Future of Bimodal Connectivity

The landscape of hearing technology is constantly evolving. We can anticipate even more seamless and sophisticated connectivity solutions in the future:

Wider Adoption of LE Audio and Auracast™: As LE Audio becomes more widespread, direct streaming to CIs and hearing aids from a broader range of devices, including public audio systems, will become standard. Imagine walking into an airport and having announcements streamed directly into your ears, or attending a lecture and receiving the speaker’s voice clearly.
Enhanced AI and Machine Learning: Artificial intelligence will continue to play a larger role in optimizing sound processing and connectivity, adapting to individual preferences and environmental changes in real-time.
Telehealth Integration: Remote care capabilities, allowing audiologists to adjust settings or troubleshoot issues remotely, will become even more prevalent, offering greater convenience and accessibility.
Miniaturization and Discretion: Devices will continue to shrink, becoming even more discreet and comfortable to wear, while maintaining powerful processing capabilities.

Conclusion

Connecting your cochlear implant to your hearing aid is a transformative step towards experiencing a more complete and natural world of sound. Whether through direct streaming, intermediary devices, or integrated bimodal systems, the technological advancements in hearing healthcare offer unprecedented opportunities for improved communication and quality of life. By understanding the available options, meticulously following connection protocols, and proactively engaging with your audiologist, you can unlock the full potential of your bimodal hearing solution, embracing a future where every sound is a possibility.