Cochlear implants are electronic devices that reduce hearing loss. They don’t restore hearing. Instead, they improve your ability to understand speech and hear more sounds. Most people who receive cochlear implants benefit by having audiologic therapy that helps them relearn how to hear.
Cochlear implants are electronic devices that reduce hearing loss. Cochlear implants don’t restore your hearing, but they can improve your ability to understand speech and hear other sounds.
Cochlear implant types differ depending on the location of the external sound processor. External sound processors are one of the pieces of equipment used in cochlear implants. The processor may be:
To understand how cochlear implants work, it may help to know more about how you hear. Hearing starts with sound that travels from your outer ear and your middle ear to your inner ear. Your inner ear contains your cochlea, which supports hearing.
Part of your cochlea contains very tiny hair cells. These hair cells connect with your hearing (auditory) nerve. Sound traveling from your outer ear to your inner ear hits your cochlea, sparking an electrical signal that your hearing nerve carries to your brain’s temporal lobe. Your temporal lobe perceives the electrical signal as sound that your brain interprets as speech, music or other noise.
Cochlear implants essentially bypass your inner ear structure, creating a new pathway for sounds to make their way to your brain. It works like this:
There are two styles of processors. One style sits on your ear with a cable that attaches to a disc on the side of your head. Another style attaches to the side of your head and doesn’t require an ear unit.
Studies suggest there are many people who could benefit from having a cochlear implant, but only 2% of those people have implants. You don’t have to have complete hearing loss to benefit from having a cochlear implant.
The U.S. Food and Drug Administration (FDA) has approved cochlear implants for people with moderate, profound or severe hearing loss. This includes people with hearing loss in both ears, hearing loss in one ear (single-sided hearing loss) or who have normal hearing for low pitches that drops off to moderate to severe hearing loss. Children age 9 months and older may have cochlear implants.
If you’ve used hearing aids to cope with hearing loss, you may be a candidate for cochlear implants if your hearing aids work but you still don’t understand speech as well as you’d like.
In general, healthcare providers recommend cochlear implants if you:
Your hearing team may do the following:
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You’ll receive general anesthesia before surgery. Your surgeon then:
Cochlear implant surgery is an outpatient procedure. That means you won’t stay in the hospital overnight.
About two weeks after your surgery, you’ll have a follow-up appointment where your audiologist will:
Hearing is a learned behavior. If you have hearing loss, your brain needs to relearn how to process sounds. Most people with cochlear implants work with an audiologist or a speech-language pathologist (SLP) to help their brains understand what sounds mean. Patients need to be committed to doing auditory-based relearning to optimize the benefit.
That depends on the device. In general, the internal parts — the transmitter and electrodes — last indefinitely. The external parts — the sound processer and microphone — typically last five to 10 years.
There are many benefits to having a cochlear implant, whether you’re someone with complete hearing loss or someone who can still hear with the help of hearing aids but wants to hear better.
People with hearing loss who have cochlear implants can use phones and can often enjoy participating in conversations in groups or while in noisy places.
Children born with hearing loss often learn to speak as soon as children who don’t have hearing loss.
Hearing loss is different for everyone who experiences it. For example, success for children born with hearing loss depends on their families’ goals for their child’s hearing.
Almost all adults who develop hearing loss after having it throughout their lives do well with cochlear implants. How much benefit they get from cochlear implants depends on factors, including:
Likewise, success varies depending on people’s hearing loss goals and factors.
All surgeries come with risk, including risks associated with general anesthesia and infection. The benefits of cochlear implants far outweigh the risks of surgery. Risks specific to cochlear implant surgery include:
No, you won’t. Historically, you could expect to lose all hearing after cochlear implant surgery. But improved cochlear implant surgery techniques and implant design means about 50% of people who do have some hearing retain their hearing after surgery.
It may take some time before you notice a big change for the better. That’s because your brain needs time to get used to receiving information from your hearing nerve. In general, people’s hearing improves about a month after their implant is activated. In some cases, it takes three to six months for people to reach their full hearing potential.
In general, people’s hearing improves more quickly if they:
You may notice that what you hear sounds different from what you remember. At first, what you hear may sound artificial or mechanical. That’s because your implant sound impressions are different from regular sound impressions.
You’ll have this implant for life, which means you’ll work with audiologists and surgeons for the rest of your life. You’ll have regular appointments so your audiology team can confirm that:
A cochlear implant can be a life-changing device. In addition to improved hearing, however, you may have to manage challenges, including:
There are many things you can do to increase the chance cochlear implants will make a difference in your hearing. Some suggestions are:
No, they don’t. Cochlear implant surgery isn’t brain surgery. The electrodes in your cochlea send signals to your brain, but they don’t connect with your brain in a way that affects it.
That being said, cochlear implant surgery does improve cognition. Cognition is your ability to gain knowledge and understanding through your senses, including hearing. Studies suggest cochlear implants can delay or reverse cognitive decline.
You should contact your provider if you notice hearing changes or you have ear pain or discomfort in your ears.
A note from Cleveland Clinic
A cochlear implant may be life-changing. If your child was born with hearing loss, a cochlear implant could be their first step into a world of sounds. If you have moderate, severe or profound hearing loss, it may be a way back to a world you thought you’d never hear again. But cochlear implant surgery is just the beginning. You or your child may need hearing rehabilitation therapy to help the brain relearn how to process sound. Your journey may take some time, so it may help to know your hearing team will be with you every step of the way.
Last reviewed by a Cleveland Clinic medical professional on 03/23/2023.
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