What is a cochlear implant?

A cochlear implant can be life-changing technology for people with hearing loss. It consists of two parts that connect to each other with a magnet:

  • An implant surgically placed in the inner ear.
  • An external device worn on or near the ear.

The external piece, called a sound processor, takes incoming sound and sends it to the implant. The implant directly stimulates the hearing nerve to send the sounds that are picked up by the processor up to the brain, where they can be interpreted as speech, or music or environmental sounds.

The devices have been implanted in over 500,000 people worldwide since their development in the 1970s. Cochlear implants have been shown to reduce tinnitus (ringing in the ear), and improve people’s ability to understand speech. Implant recipients are often able to again participate in activities they found difficult with their hearing loss: attending church services, enjoying social gatherings and staying engaged in the workforce.

When are cochlear implants used?

Cochlear implants are no longer considered to be a last resort. When they were first developed, cochlear implants were recommended only when hearing aids didn’t help in either ear. Today more people can benefit from cochlear implants.

You don’t need to lose all hearing to receive an implant. For example, if your hearing aids work but don’t provide as much speech understanding as you’d like, cochlear implants can help. Many people with cochlear implant today have remaining “residual” hearing that helps them to hear some words and sounds, especially low-pitched sounds like vowels. That hearing can supplement what the cochlear implant provides.

For some people that means continuing to use a hearing aid in the unimplanted ear. For others, it means hearing amplified low pitches (similar to using a hearing aid) plus having the cochlear implant improve hearing for the higher pitches (like consonant sounds). You don’t have to wait until you’re struggling to hear well in both ears before considering an implant. Cochlear implantation can be done even if only one ear benefits.

Recipients do best with implants if they receive them as soon as possible after they become a candidate.

How is a cochlear implant different from a hearing aid?

Hearing aids amplify sounds louder so the hearing system can process them better. They are effective for people who need certain sounds to be louder in order to hear them clearly. Sound still travels through all the portions of the ear (outer ear, middle ear, inner ear) to the hearing nerve. But for some people, simply making sounds louder may not be enough to improve their clarity. They may be able to hear but not understand words clearly.

A cochlear implant essentially replaces key parts of the hearing system when they are no longer working optimally. The implant bypasses these structures and directly stimulates the hearing nerve with electrical energy. As a result words can be much clearer.

Learning to hear and understand with a cochlear implant take time and practice. Sounds are delivered to the hearing nerve in a very different way than they are with natural hearing or hearing aids. The brain needs to learn how to make the best use of the new sound it can hear.

An audiologist or auditory-based therapist can provide guidance about how to learn to hear best with a cochlear implant. Generally, improvement can be measured by one month of device use, and progress often continues for the next three to six months.

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