Cochlear Implants

Interested in possibly getting cochlear implants? Coming to see us for an evaluation is the first step. It’s important to remember that implants don’t sound the same as typical hearing but can make it easier to hear and communicate. Implants basically bypass your inner ear and directly stimulate your hearing nerve to get sounds to your brain.

At your evaluation, your providers will ask you questions, like:

• Do you have significant hearing loss in one or both ears?
• Do you use hearing aids now but would like to hear better?
• Do you have any health conditions that might make surgery risky?

Then they may do some tests, like:

• Hearing tests: An audiologist will check to see how well you can hear and understand speech and sounds with and without hearing aids.
• Vestibular test battery: Your inner ear also controls how well you balance. This test lets us see if your inner ear is doing this part of its job.
• MRI and CT scans: These imaging tests let us take detailed pictures of the inside of your ear.

Meet Our Cochlear Implant Team

When you come to Cleveland Clinic for a cochlear implant evaluation, our experts will talk with you about whether a cochlear implant is the right choice for you. You’ll meet with different providers during your evaluation. You may see:

• Audiologists.
• Neurotologists (surgeon who treats the inner ear and will place the cochlear implant).
• Speech language pathologists (SLP).
• Nurse practitioners.
• Physician assistants.

A cochlear implant has two parts — an implant that we’ll place in your inner ear during surgery and an external device, the sound processor, which you’ll wear on or near your ear. A magnet connects the two parts. The processor picks up sounds and sends them to the implant, which triggers nerves to send these sounds as signals to your brain. Your brain then interprets the signals as sounds.

If you have cochlear implant surgery, you typically won’t need to stay overnight in the hospital and can go home that same day. You’ll need to have someone with you to drive you home.

Before surgery, a specialist will give you general anesthesia. You won’t feel any pain or be aware of what’s happening while surgeons place the implant.

To place the implant, your surgeon will:

• Make an incision (cut) behind your ear.
• Open the bone behind your ear (mastoid).
• Implant wires that send signals (electrodes) into the hollow, snail-shaped bone in your inner ear that helps you hear (cochlea) and tuck a device that receives electrical signals (receiver) near your skull, under the skin behind your ear.
• Close the incision with stitches.

After surgery, we’ll move you to a recovery area while you wake up from anesthesia. Your providers will check to make sure you’re OK before you’re able to go home.

Important things to know about cochlear implant surgery

Here are a few things to keep in mind before you get cochlear implants:

• You can get an implant in one ear or in both ears. Often, people start with one implant and use a hearing aid for the other ear. If your hearing gets worse in the hearing aid ear, you might opt to have implant surgery for that ear, too.
• If you have some natural hearing in your ear, it’s possible you won’t lose it after you get the implant.
• Once you get a cochlear implant, you’ll have it for the rest of your life. That means you’ll need to have regular appointments with your audiology providers. They’ll want to make sure your device is working the way it should and will need to make adjustments to help you continue to hear your best.
• You may not be able to have certain medical procedures or will need some accommodations. And playing some contact sports could be risky because you could dislodge your implant. Your providers will explain all these things to you and help you learn how to stay safe if you have cochlear implants.

After cochlear implant surgery

About two to four weeks after surgery, you’ll meet with your audiologist. They’ll:

• Program the sound processor by measuring what settings you need to hear sounds.
• Check to make sure the transmitter and electrodes are working.
• Turn on the device and determine what you can hear and understand.
• Make any necessary adjustments to the device.
• Discuss the practice that will be necessary to benefit fully from the cochlear implant.

It may take some time to relearn how to hear with your cochlear implant, so being patient and committed to full-time use and daily practice are key. Your brain needs to get used to hearing sounds again. And the sounds you hear may seem artificial or mechanical. That’s natural and expected. Wearing your implants consistently and working with your audiologist or speech language pathologist can help you get used to all the changes faster.

Taking the Next Step

Cochlear implants can be life-changing. In fact, one of the most common things we hear from people who choose this surgery is, “I wish I’d done it sooner.” Getting cochlear implants can help you hear the sounds you might’ve been missing and make it easier to interact with the world around you. Cleveland Clinic’s hearing experts are ready to help you make these new connections. We’ll help you understand what to expect and get ready to adjust to life with your new hearing device.