Cochlear Implants: 9 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Marijke Vroomen Durning, RN on May 11, 2021
  • girl with cochlear implant
    What Doctors Want You to Know About Cochlear Implants
    A cochlear implant is a device inserted surgically behind your ear, with small electrodes in your inner ear to allow you to hear sound. It can’t help everyone with a hearing impairment because the device only helps bypass damaged parts of the ear that may cause hearing loss. Here are nine things that cochlear implant surgeons would like you to know about the procedure and the device itself.
  • woman with hearing aid meeting with audiologist
    1. “Cochlear implants help people with inner ear hearing loss.”
    “Many people tell me they were told they can’t have a cochlear implant because they have inner ear deafness,” says J. Thomas Roland, Jr, MD, co-director of the Cochlear Implant Center at NYU Langone in New York City. Most hearing loss occurs from a problem in the middle or inner ear that interferes with sound waves reaching the auditory nerve. “This is what we used to call nerve deafness or inner ear hearing loss.” This is exactly what cochlear implants are for.
  • doctor examining senior male patient's ear
    2. “As long as you’re healthy, you’re not too old for a cochlear implant.”
    “As long as you’re healthy enough to undergo the one-hour outpatient procedure, there shouldn’t be a barrier to receiving a cochlear implant,” says Oliver Adunka, MD, a pediatric otolaryngologist (ear, nose and throat specialist) and director of the Hearing Program at Nationwide Children’s Hospital in Columbus, Ohio. Dr. Adunka has performed implants on people of all ages. “One of my friends did a 100-year-old patient, but the oldest I’ve done was about 92 or 93.”
  • ear anatomy illustration with text labels
    3. “Cochlear implants aren’t advanced hearing aids.”
    Hearing aids amplify sound, just as you might turn up the volume on a movie. The sound still needs to travel through the middle and inner ear to the auditory nerve. Cochlear implants bypass the middle ear and sound is sent directly to the cochlea, where it goes to the auditory nerve. “For folks who heard before [they developed hearing loss], they describe the talking [they hear after the implant] as Mickey Mouse and Donald Duck early on, very high pitched,” explains Dr. Adunka. “And then, for a vast majority of people, it turns into their normal hearing. It may take a few months for that to happen.”
  • hearing test on baby
    4. “Cochlear implants in young children helps them develop language.
    Dr. Roland has implanted these devices in over 300 children between the ages of 6 and 8 months. “There’s some very good data and science that shows the earlier you get auditory information to this young, growing brain, the better they are going to do in the long run,” he says. “So, we’re implanting as young as 6 months on a regular basis.” Early intervention is key to helping children develop language as normally as possible before they get to school.
  • woman showing cochlear implant
    5. “You don’t outgrow your cochlear implant.”
    “The cochlea is adult-size from birth, as is the middle ear,” explains Dr. Roland. “The only thing that changes is the distance from the skull to the cochlea.” But a bit of extra wire between the device and the electrodes in the cochlea can accommodate for this growth. “The only time you would need repeat surgery is if the device fails. I usually tell parents of an infant that the child will probably need two surgeries during their lifetime because of device failure or maybe technology improvement.”
  • Group of friends drinking beer at a pub
    6. “Cochlear implants help improve quality of life, improve safety.”
    “Cochlear implants work very well. There’s no doubt about this,” says Dr. Adunka. “In children, they can provide them with spoken language and the ability to communicate.” For adults who have lost hearing, implants help keep them from becoming isolated, as hearing impairments can cause people to withdraw and avoid socializing. The renewed ability to hear also helps keep them safe as they can once again hear sirens and warning sounds, and they allow people to safely and accurately communicate with others.
  • Young Caucasian girl in hospital bed smiling and holding teddy bear
    7. “The procedure can be done under local anesthetic.”
    Usually, a cochlear implant is done with a general anesthetic, but it can be done with a local if a patient can’t tolerate general anesthesia. “It’s about a one-hour operation with local anesthesia, in good hands,” says Dr. Roland. The surgeon makes a small incision behind the ear and opens the mastoid bone of the skull to access the cochlea and place the electrodes. The receiver is then placed under the skin behind the ear, with wires connecting to the electrodes. The outer part, the processor, comes a few weeks later and is attached by magnet to the outside of the scalp or held in a special pouch.
  • young girl splashing water
    8. “You can stay active and participate in sports with a cochlear implant.”
    “You can live your life with a cochlear implant. There are no restrictions really, not even in kids,” says Dr. Adunka. “With some newer cochlear implants, the external part is waterproof or at least water resistant, so you can even go swimming. But even with the older devices, you would just take off the external piece and jump in the water. It’s easy to just live your life.”
  • patient using response button during hearing test
    9. “Not enough adults who need a cochlear implant, get one.”
    “One of the issues we face is that only about 3% to 5% of adults who are candidates actually receive the device,” says Dr. Adunka. “We could implant people with moderate to profound hearing loss, but people wait too long.” Many adults don’t realize they are candidates and think that hearing loss is just a part of aging. Others think the implants are only for those who are profoundly deaf. “This isn’t true,” Dr. Adela says. “People need to know that even with residual hearing, they’ll do much better with a cochlear implant.”
Cochlear Implants: 9 Things Doctors Want You to Know
  • J. Thomas Roland, Jr, MD - Healthgrades - Cochlear Implant: 9 Things Doctors Want You to Know
    Otolaryngologist, co-director, Cochlear Implant Center, NYU Langone, New York City.
  • Oliver Adunka, MD - Healthgrades - Cochlear Implant: 9 Things Doctors Want You to Know
    Pediatric otolaryngologist, director of the Hearing Program at Nationwide Children’s Hospital in Columbus, Ohio.

About The Author

Marijke Vroomen Durning, RN, has been writing health information for the past 20 years. She has extensive experience writing about health issues like sepsis, cancer, mental health issues, and women’s health. She is also author of the book Just the Right Dose: Your Smart Guide to Prescription Medications and How to Take Them Safely.
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Last Review Date: 2021 May 11
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