Cochlear Implants

Each cochlear implant device is designed to last a lifetime. The externally worn processor, which converts sound into an electric signal for the internal component, can be easily upgraded (i.e., without a second operation) as technology evolves. Rarely, there may be a hardware of software failure, requiring removal and/or replacement.

Waiting for newer technology is not recommended, because the design and mechanics of the implanted component of the device have changed minimally in the last several decades. The externally worn processor can be upgraded as technology becomes available.

Cochlear Implants are surgically implantable hearing devices that are designed to restore hearing in patients with severe degrees of hearing loss who no longer receive benefit from a hearing aid.

Cochlear Implants function by converting sound input into electrical impulses for the hearing nerve. Therefore, Cochlear Implants do not restore “normal” hearing, they are a highly effective in allowing patients to have improved hearing, communication, and speech recognition. An externally worn microphone and speech processor transmits sound information to the internal component, which sends the encoded electrical signal to the hearing nerve.

Typically, a cochlear implant is “activated,” or turned on, by your audiologist several weeks after the surgery. Over a period of weeks to months, your hearing nerve and brain will learn to interpret the electrical impulses from the device and perceive sound.

Cochlear implants are safe and effective implantable hearing devices. They have been approved by the Food and Drug Administration for use in both children and adults. Cochlear implants have been in use since the 1970s.

After healing from surgery, patients with cochlear implants can swim, bathe, and participate in water activities if they are not wearing the external component of the device.

Sounds perceived from a cochlear implant evolve over time, as the hearing nerve and brain learns a new form of hearing. It is important to recognize that hearing with a cochlear implant is a process that requires patience and motivation. Initially, some patients perceive distorted or “robotic” type sounds; as you continue to use the device, the cochlear implant gradually sounds more natural. Some patients may “feel” a sensation when the device is initially activated, and it may take some time before actual auditory perception is experienced. Although the sound is not equivalent to normal hearing, many long-term cochlear implant recipients report that the sound quality is natural.

Cochlear Implants are designed to improve speech perception in patients with severe degrees of hearing loss, however, a wide range of sound (e.g., environmental sounds) can be perceived.

Older adults with severe degrees of hearing loss may benefit greatly from a Cochlear Implant. Studies have demonstrated that elderly patients perform just as well with a Cochlear Implant as younger patients. Sometimes, medical factors (e.g., severe comorbidities or significant cognitive impairment) may result in your doctor recommending against a Cochlear Implant.

A Hybrid Cochlear Implant is a device in which a cochlear implant and a hearing aid can be used in the same ear. These devices are for patients who have severe hearing loss in the high frequencies (high-pitched sounds) but preserved hearing in the low frequencies (low-pitched sounds).

To determine Cochlear Implant candidacy, an audiologist and ear surgeon must do a thorough evaluation consisting of a medical and audiologic workup. Patients with severe degrees of hearing loss who are not receiving benefit from hearing aids are usually referred for a “Cochlear Implant Evaluation,” during which specialized audiologic tests are performed while the patient wears their hearing aids. The performance on the Cochlear Implant Evaluation determines candidacy.

Some patients who have severe hearing loss in the high frequencies (high-pitched sounds) but preserved hearing in the low frequencies (low-pitched sounds) after cochlear implant surgery can use both a cochlear implant and hearing aid in the same ear. Electrical impulses from the implant supply hearing for the high frequencies while the low frequencies are amplified by a traditional hearing aid.

After hearing from surgery, patients with cochlear implants can travel on airplanes. You will need to bring your cochlear implant identification card and show it to the airport security officials, because the implant may set off security detectors.

The externally worn component must be taken off before sleeping.

Patients who only have severe hearing loss in one ear may be candidates for cochlear implantation. These patients, who have “single-sided deafness,” may use a cochlear implant in the deaf ear while having normal hearing in the other ear. If the better hearing ear has milder degrees of hearing loss, a hearing aid may be used as well. Cochlear implants were approved by the Food and Drug Administration for single-sided deafness for patients ages 5 and older.

Patients who only have severe hearing loss in one ear with milder degrees of hearing loss in their other ear may be candidates for cochlear implantation. These patients, who have “asymmetric hearing loss,” may use a cochlear implant in the deaf ear while using a hearing aid in their better hearing ear. This is called “bimodal” stimulation, and studies have shown that patients with bimodal stimulation have improved sound localization and speech recognition in the setting of background noise. Cochlear implants were approved by the Food and Drug Administration for asymmetric hearing loss for patients ages 5 and older.

Older cochlear implants were not compatible with MRIs because the internal component contains a magnet. However, newer devices are MRI compatible with most MRI machines.

After healing from surgery, patients with cochlear implants can participate in almost all sports activities if they are not wearing the external component of the device. Protective is recommended for sports in which head impacts are anticipated.

To determine the cost of a Cochlear Implant, patients need to contact their health insurance provider. Your audiologist or surgeon's scheduler may be able to help identify the correct diagnoses and procedure to report to the insurance company.