How exactly does one biomedium outperform another one? It's not as though they will nurture different species of bacteria, some of which are better nitrificators than others. A biomedium does one thing and one thing only: it provides a surface suitable for colonization by nitrifying bacteria. That's it. So the only real measure of how well a given medium works is how much useable surface area it provides for this purpose.
So, on the face of it, the "best" medium is the one that has the most surface are per unit volume...right? Well, maybe not. The surface area also has to be exposed to an excellent flow of aerated aquarium water, carrying food to the bacteria and also providing them with sufficient oxygen. So...a medium that, over time, clogs up and reduces the flow to part or all of its surface area won't be as "good" as one that remains clear and unclogged, with no reduction in flow over time. I have never used ceramic media, so I certainly don't know for certain...but I can't help but suspect that over time, biofilm will coat most of its surface area, perhaps even clogging some of the minute pathways through which water flows when it is clean and new. In a practical sense, this doesn't matter, as long as the remaining surface area is still sufficient to maintain the required bacterial colony. Like most biomedia, it has such a large surface area that losing a good portion of it will not impact the effectiveness of the filter. Any tank requires a bacterial colony that is the correct size to utilize the ammonia being produced; beyond that point, having extra surface area is immaterial, since a given bioload will produce only so much ammonia, and that will support only so many bacteria. If surface area per unit volume is your Holy Grail, I seem to recall seeing a chart here on MFK comparing this feature of various biomedia, and Poret foam (a huge favourite of mine) was right at or near the top.
I personally consider many other aspects when choosing a biomedia, and since my filters tend to be oversized, with much more volume than the existing bioloads will ever require, actual surface area is pretty far down my list. A much higher priority is weight; I don't want 20 pounds of biomedia when an alternative choice would give me the same surface area while weighing only 2 pounds. Again, ceramic is pretty heavy and this alone would turn me off its use.
How about cost? Ceramic is expensive stuff; where's the benefit of it compared to much more inexpensive media? Cost is, of course, a major consideration for most people...and sometimes for opposite reasons. There are aquarists like me who are simply too cheap to pay more than is required...and there are others, like one of my friends in Ontario, who won't buy something expensive when there is the option to buy something extremely expensive. Some of these guys also worry about the appearance of their media and filters, while others (like me) don't care about the appearance of a filter and can't understand why anyone would. Oops, scratch that...one of my sumps has a few gallons of micro K1 churning and swirling around; it's there strictly because my granddaughters think its cool to watch, so I suppose I do assign some value to appearance.

But...I got it in a trade, essentially for free; no way I would pay what that stuff costs.
Ease of cleaning is a biggie, one that is largely tied in with weight. The biomedia in one of my filters takes up a volume of around 20 gallons, but weighs maybe a couple pounds and is easily lifted out with one hand, rinsed under a faucet (unchlorinated well water at the correct temperature) and replaced in minutes. I'd love to see a video of an aquarist cleaning 100 pounds of ceramic media.
So, in the grand scheme of things as seen from my perspective, ceramic is heavy, expensive, possibly losing some of its effectiveness over extended periods of use due to clogging, a PITA to clean (which is admittedly something that is rarely done, but still...) and in general has virtually nothing to recommend it...to me. But to each his own; if you need your filter to be as cool as your fish, fill your boots!
