Cochlear Implants

What are implantable hearing devices? 

For some individuals with hearing loss, hearing aids are not always the best solution. Implantable hearing devices are surgically implanted in the skull. There are two main types of implantable hearing devices: Cochlear Implants and Bone Conduction Hearing Devices.  

What is a cochlear implant? 

A cochlear implant is designed to help people with more severe hearing losses who can no longer derive benefit from a traditional hearing aid. Hearing aids work well for people with mild to severe hearing losses who have remaining healthy inner ears that can transmit sound clearly to the hearing nerve and brain. When the sound in both ears is no longer clear even when using a hearing aid, a cochlear implant may provide more hearing benefit. A cochlear implant uses electromagnetic energy to send sound information directly to the auditory nerve. It has two parts: an implant and a sound processor. The implant is surgically placed inside the skull, and the sound processor is worn on the outside of the head.

How does a cochlear implant work? 

A cochlear implant picks up sounds through the external processor and sends the sound information to the internal implant. The internal implant stimulates the hearing nerve directly, bypassing the damaged organ of hearing called the cochlea. The hearing nerves then send the sound to the brain to be processed.

Who is a good candidate for a cochlear implant?

Because getting a cochlear implant comes with some risk, there are guidelines and requirements necessary for someone to undergo surgery. Your audiologist and the cochlear implant surgeon will ultimately decide if you are a good candidate for cochlear implantation, but certain factors may affect cochlear implant candidacy. According to the Boystown National Research Hospital, adults may be good cochlear implant candidates if:  

• The patient has significant (severe to profound) hearing loss in both ears. 

• The patient struggles to understand speech even while wearing hearing aids. 

• The patient is able to attend regular doctors’ appointments, clean and take care of their cochlear implant, and is willing to complete cochlear rehabilitation at home (or has someone who is prepared to help them complete these tasks.) 

There are 2 main types of cochlear implant processors:

What should I do if I think I might be a candidate for a cochlear implant?

Talk to an audiologist
If you think you may be a cochlear implant candidate, the first step is to have a cochlear implant evaluation completed by an audiologist. This includes a hearing evaluation as well as other auditory tests. You may be asked to repeat words or sentences with and without your hearing aids on, and with background noise present. Depending on the results of the evaluation, your audiologist may refer you to an Ear Nose and Throat doctor.  

Talk to an ENT physician 
An ENT may evaluate you further to determine whether you are a good candidate for cochlear implant surgery. This often includes some type of imaging (like an MRI or a CT scan) so the doctor can check the anatomy of your hearing nerve and inner ear.   

Next Steps 
If you, your audiologist, and your ENT decide to move forward with surgery for a cochlear implant, you will need to prepare. Preparation typically includes one or more appointments with your audiologist to review cochlear implant options and to discuss what to expect for the surgery. You may also need to have additional medical testing (like blood work) done to check if you are in a healthy condition for surgery. Your audiologist will also educate you about the rehabilitation process that occurs after surgery. A cochlear implant is not like a hearing aid. It is a prosthetic device that takes time and practice to get used to. Cochlear implant candidates will need to be willing and prepared to practice using their implant.

What risks are associated with cochlear implantation?

Cochlear implantation is typically a very safe surgery. However, in rare cases there can be complications associated with getting a cochlear implant. According to Stanford Health Care, some of these risks include: 

• Risks associated with general anesthesia. Anyone undergoing the surgery will need to be placed under anesthesia for the procedure. 

• Increased risk of bleeding or damage to the facial nerve during surgery. 

• Risk of infection.  

• In rare cases, the device may malfunction and need to be surgically removed. 

One important risk associated with cochlear implantation includes hearing outcomes. Cochlear implant surgery damages the inner ear, which means that if you have some remaining natural hearing in that ear, surgery may completely eliminate it. Patients will need to rely on hearing with the implant instead of the natural hearing that they used to have. There is no way to restore this residual hearing after the surgery, so make sure you understand the potential risks associated with cochlear implantation before moving forward with surgery.