Cochlear Implants

A cochlear implant is a tiny yet complex electronic device that is designed to provide sound to a person who is severely hard-of-hearing or profoundly deaf. It consists of an external portion that sits behind the ear and another portion (the inner one) that’s surgically placed under the skin.

Below are the parts of a cochlear implant:

Microphone – picks up sound from the environment

Speech processor – selects and arranges sounds picked up by the microphone

Transmitter and receiver/stimulator – receive signals from the speech processor converting them into electric impulses to the brain

Electrode array – a group of electrodes that collects impulses from the stimulator and sends them to different parts of the auditory nerve of the brain.

Take note – a cochlear implant WILL NOT restore normal hearing. However, a cochlear implant CAN give a hearing-challenged person USEFUL representation of sounds that will play a big role in understanding speech. 

Cochlear implants and hearing aids may have one goal – to give better hearing and speech understanding; however, they are VERY DIFFERENT from each other.

While hearing aids amplify sounds so it may be detected by damaged ears, cochlear implants bypass the damaged portions of the ear and directly stimulate the auditory nerve to facilitate hearing.

Signals are then generated by the implant and sent to the auditory nerve of the brain, where the signals are recognized as sound. Just like with hearing aids, hearing through a cochlear implant is significantly different from normal hearing and NEEDS TIME for learning or re-learning.

If used properly, a cochlear implant CAN HELP hard of hearing people recognize warning signals, understand speech in person/over the telephone, and understand other sounds in the environment.

In treating or managing hearing loss, hearing aids are known to be the most common tools. But what if hearing aids only provide little or no improvement? Is there still any hope? YES there is, in the form of a cochlear implant.

Adults and children who are deaf or diagnosed with severe hearing loss can get cochlear implants. In the United States, more than 58,000 devices have been implanted in adults and 38,000 cochlear implants have been used by children.

Let’s go back a little and learn about the roots of cochlear implants. FDA first approved cochlear implants in the mid-1980s to treat adult hearing loss. Fast forward to 2000 and FDA finally approved cochlear implants for eligible children starting 12 months of age.

Adults who have lost MOST or ALL of their hearing later in life can benefit from a cochlear implant and learn to associate signals from the implant with sounds they KNOW or REMEMBER. In this case, speech may be recognized without needing any visual cues such as sign language or lip reading.

A common misconception about cochlear implants is that it may not be suited for very young children. But the truth of the matter is, a cochlear implant can help young children be exposed to sounds during the stage of developing speech and language skills, known to be a “make or break” period.

According to research, young children who received cochlear implants and intensive therapy before they are 18 months old are able to hear better, speak better, and comprehend sound and music EARLIER than their peers who receive implants at an older age.

Eligible children who receive a cochlear implant before 18 months of age can also DEVELOP language skills at a rate that’s quite similar to children with normal hearing, and many even succeed in mainstream school settings.

Getting a cochlear implant requires surgery AND therapy to learn or relearn the sense of hearing. Just like hearing aids, not everyone performs at the same level with cochlear implants. What might be 99% effective to Patient A may only be 70-75% successful to Patient B. The important thing to look out for is IMPROVEMENT.

Deciding to get a cochlear implant involves thorough discussion with various medical specialists, especially with an experienced cochlear-implant surgeon. The whole process MAY BE expensive – not all personal insurance can cover the expenses.

Some people may be hesitant to get a cochlear implant for many personal reasons – some may be scared of undergoing a surgical procedure or some may be experiencing financial constraints, or simply not yet ready to make such a big decision. Whatever the reason may be, it is always best to talk things through with family and a hearing specialist.

Some would prefer to use hearing aids over cochlear implants mainly because the former is non-invasive. However, while surgical implantation is needed to get a cochlear implant, it is generally SAFE. Of course, the risk factor cannot be eliminated, just like all other surgery procedures.

When getting a cochlear implant, it’s like trying to LEARN a whole new way to hear again. Sounds created by an implant are not the same as normal hearing, nor with sounds picked up by hearing aids.

Getting used to a cochlear implant takes TIME and PRACTICE. Audiologists and speech-language pathologists play a big role in the learning process.

Here’s an overview of the steps to get a cochlear implant – 

Hearing Test –  a hearing health professional or audiologist needs to carry out several medical and audiological evaluations like MRI, X-rays and CT scans. A hearing aid trial will also be done to confirm that the patient is not receiving enough benefit from the said devices.

Insurance approval – some insurance plans MAY cover hearing implants. It would be best to check with the insurance company ASAP about the eligibility of coverage if you are already planning to get a cochlear implant. 

Choose the right device – All cochlear implants are designed to restore a person’s access to sound. However, there are noticeable differences between the devices. Choosing the right cochlear implants may be overwhelming, but as long as you are working together with an audiologist, you won’t be left in the dark. 

Outpatient Surgery – Once all requirements get a green light, the cochlear implantation surgery will push through. Cochlear implant procedures may last for a couple of hours or less and are performed under general anesthesia. Most patients can return to their normal routine after a few days.

Activation / Fitting – This is the exciting part – after the recommended healing period, you will be getting the sound processor from the audiologist. Adjustments will be done to match your needs and initial testing will be done at the clinic. 

Take note that hearing will not be 100% improved during the first phase. Hearing improvements from a cochlear implant will vary depending on the length and degree of hearing loss.  How well your child hears at this first visit will vary depending on length and degree of hearing loss.