What Is a Cochlear Implant?

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young girl with model of ear structure
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When sound waves enter your ear, they must travel through your middle ear to your inner ear, where the auditory nerve sends signals to your brain. Any interruption in this flow in the ear can cause hearing loss or deafness. In the 1950s, scientists began working on a device called a cochlear implant, which would bypass damage or blockages in the ear. This allows sound to directly reach the nerve. The device became available to the public in the 1980s.

If you or a loved one is considering a cochlear implant, the most important thing is to learn about the device, who it can help, what’s involved in cochlear implant surgery, the differences of cochlear implants vs. hearing aids, and adjusting to new hearing with an implant.

Cochlear Implants vs. Hearing Aids

If you have a hearing impairment, you may have read about options for helping you hear better, including hearing aids and cochlear implants. While both help improve hearing, they work differently and have different outcomes.

Hearing aids have been around in some form or another for generations. Some people compare them to eye glasses that improve or correct your vision. However, while the lenses in glasses may correct your vision almost perfectly, hearing aids don’t restore normal hearing. They amplify sounds so you are more likely to hear them. This means that all the sounds around you are amplified. Hearing aids are helpful to millions of people with mild-to-moderate hearing loss, but they are not as effective for more severe or complete hearing loss.

Cochlear implants work in a more direct and specific way. A cochlear implant is surgically attached to the exterior surface of your skull, just under the skin. It connects to electrodes placed in the cochlea. An external sound processor collects the sounds and sends them directly to the implant, which then transmits the signals to the auditory nerve.

You can have a single implant, or one for each ear. Your doctor will determine which you need. For example, some people have a hearing aid in one ear and a cochlear implant in the other.

Cochlear Implant Surgery

An ear, nose and throat surgeon performs cochlear implant surgery. The surgeon usually performs it with a general anesthetic. The surgeon makes a small incision behind the ear to insert the implant’s internal device, the receiver, and a thin wire that leads to electrodes placed in the cochlea. The surgeon also creates a small hole in the mastoid bone of the skull to access the cochlea.

After a 4- to 6-week recovery for healing, you are fitted with the external microphone and processor. The microphone is worn like a hearing aid, but the processor attaches directly to the head with a magnet, or worn in a harness.

The cochlear implant surgery success rate is generally good, but there are some risks to keep in mind. Potential complications related to cochlear implant surgery may include:

  • Leaking cerebrospinal fluid

  • Dizziness or vertigo

  • Changes in taste

  • Numbness around the ear

  • Ringing in the ears

  • Damage to the facial nerve

  • Implant failure

Another possible complication related to cochlear implants is bacterial meningitis, including pneumococcal meningitis. This may be due to the device itself or a malformation in the ear. For this reason, the Centers for Disease Control and Prevention recommend that children and adults who receive a cochlear implant also receive the pneumococcal vaccine, which helps prevent meningitis.

The surgeon and support team should explain the benefits, risks, and possible complications to you well in advance of surgery.

Adapting to a Cochlear Implant

Surgery to receive the implant is just the first part of regaining some hearing. Next, an audiologist meets with you to program the device. This appointment can last a few hours. It can be a momentous occasion, especially for hearing impaired people with little to no hearing prior to device activation.

During the session, the audiologist determines what levels of sound are comfortable for you. The external processor stores a base level of information. Once this is complete, you will meet with your audiologist and speech therapist for regular sessions so you can learn how to identify and process new sounds, and how to speak clearly.

Each person’s situation is different, but usually people who receive a cochlear implant are followed closely by their doctor for the first 24 months, with appointments at least every 3 to 6 months. After that, unless there are problems with the device, appointments may be only once a year.

Generally, the younger you are when you receive a cochlear implant, the better the resulting hearing and speech. Adults who once could hear but lost their hearing also tend to do better post-implant than adults who never had significant hearing.

Once your implant is in place, your surgeon’s office should give you a wallet card with the name of your device and other important information. It is important you keep this with you for the following reasons:

  • The implant may set off security detectors.

  • It explains to security personnel why you want to be scanned with a handheld wand, rather than a full body scan.

  • Some types of medical tests and treatments may not be possible because of the implant. The ID card tells your doctor and dentist what type of cochlear implant you have. Dentists also may do procedures, such as electrosurgery, that should not be done if you have a cochlear implant.

Once you are comfortable with your device, there are only a few activities you can’t participate in, like scuba diving or sports where you may sustain bad blows to the head, such as boxing. If you aren’t sure about what activities are safe, speak with your doctor or audiologist.
Cochlear implants can be life-changing. If you feel you may benefit from a cochlear implant, speak with your doctor about your options.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 11
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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