What is a Cochlear Implant?

Julia Biedenstein, MS, LSLS Cert. AVEd , Thu, 12 Mar 2020

Treatments for hearing loss have come a long way in the past 25 years. But one thing that has not changed is that the two most successful options for treating hearing loss continue to be hearing aids and cochlear implants. These two solutions help people hear in very different ways.

Treatments for hearing loss have come a long way in the past 25 years. But one thing that has not changed is that the two most successful options for treating hearing loss continue to be hearing aids and cochlear implants. These two solutions help people hear in very different ways. 
 

The difference between hearing aids and cochlear implants

A hearing aid amplifies sounds and relies on sensory cells in your ear to pick up that sound and send the message to the brain. Simply stated, a hearing aid makes incoming sounds louder in order to overcome the hearing loss.

However, for those with severe or profound sensorineural hearing loss, the sensory cells in the ear are damaged or missing so that no matter how loud the sound is, there is nothing there to pick up the information and deliver it to the brain. Many individuals with this kind of hearing loss report that even with hearing aids, they can hear, but they it isn’t clear. A cochlear implant is a great option for individuals with severe to profound hearing loss because it works differently than a hearing aid.
 

How a cochlear implant works

A cochlear implant is comprised of two major parts. There is an internal part that is implanted into the inner ear via surgery. It includes a thin, thread-like electrode array which is used to stimulate the hearing nerve. The external part includes a headpiece which attaches to the head via a magnet, and a sound processor, which is a small device either worn on the ear similar to a hearing aid or can be clipped onto a shirt.

Sounds in the environment are picked up by the sound processor, and sent via the headpiece to the electrode array inside the ear. The electrode array directly stimulates the hearing nerve, which then sends the message to the brain. In this way, the cochlear implant (CI) is able to bypass the damaged part of the ear. That is why it is a great solution for individuals who find that hearing aids are not giving them the help they need.
 

1

The microphone captures sound waves.

2

The sound waves are converted into detailed digital signals by the sound processor.

3

The headpiece sends the digital signals to the cochlear implant and electrode array in the inner ear.

4

The electrode array stimulates the hearing nerve.

5

The hearing nerve sends impulses to the brain, which interprets them as sounds.

Since cochlear implant technology can deliver a clear, crisp speech signal to the brain, many CI wearers report that the implant gave them their lives back. Due to their previous inability to understand what was being said, social situations were difficult, frustrating, and exhausting. Many chose to stop participating in these kinds of events and began to withdraw from the activities they once enjoyed. 

However, after being implanted and given the ability to understand conversations in both quiet and noise, many CI wearers are once again taking part in social gatherings such as dinner with friends and family celebrations. Most CI wearers report that they are able to talk on the phone, and enjoy TV and music again. This not only opens up more opportunities to connect with the world but also provides them more independence to do all the things they want to do.
 

How to determine if a cochlear implant is right for you

Do you have a severe or profound hearing loss? Are you currently wearing appropriately-fitted hearing aids but still having trouble understanding speech in quiet and/or noisy situations? Do you have difficulty talking on the phone? Do you find yourself relying on speechreading to help understand what is being said? Are you beginning to withdraw from social, educational, and professional activities as they are becoming too hard?  If you answered yes to two or more of these questions, you may be able to benefit from a CI. 

Your next step will be to set up a CI evaluation at a cochlear implant center near you to determine if you are a candidate. At this point, it is important to learn as much about CI’s as you can. Once you decide to move forward with the process, you will meet with a surgeon to set up a surgery date, and the CI center will look into your insurance for cochlear implant coverage. Since a cochlear implant is a medical device, most insurance companies and Medicare will cover most of, if not all, of the cost.
 

Cochlear implant surgery and activation

Cochlear implant surgery is usually is performed on an out-patient basis under general anesthesia, and lasts about 1.5 to 3 hours. Patients are advised to take it easy for a few days afterwards, but can usually resume normal activities with doctor’s approval. 

About two weeks later, you will return to the cochlear implant center to get your speech processor turned on. This is when you will start to hear through the CI for the first time. It may sound a bit funny at first while your brain is learning to make sense of the new signal. However, over the next days, weeks, and months, your brain will adjust and sounds will become increasingly clearer and more natural.

During the first year, you will visit your audiologist frequently so they can adjust your cochlear implant as your brain begins to understand the new signal.  Over time, your audiologists may also suggest additional accessories that may be helpful.

Although the internal part of the implant is designed to last for life, you will have options to upgrade your sound processor (external part) to take advantage of new technology as it is developed in the future. This provides you with the opportunity to improve your hearing even further as time goes by.
 

Choosing the right cochlear implant for you

Unlike hearing aids, the CI you choose is designed to be with you for life. So it’s important to do your research, and choose one that meets your hearing needs and lifestyle. When making this decision, be sure to think about your hearing challenges and what you would like to overcome with a CI.

First and foremost, choose one that can deliver a clear, crisp signal for better understanding of speech, especially in noisy situations. It is also important to look for a solution that allows you to hear with both ears. This will improve your listening ability in both quiet and noise, and the ability to determine where sounds are coming from.

It is also important to choose a CI that will allow you to hear your best while doing all the things you need and want to do—whether that is enjoying music, swimming, participating in meetings at work, attending a concert, or talking on the telephone. This is all possible with cochlear implants, so take the time to learn about the technology available and speak with your hearing care professionals about your needs and wishes.

So do your research. A good place to start is to speak with a CI specialist who can answer questions from the latest technology to insurance reimbursement, or connect with other individuals just like you who have made the decision to receive an implant.

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Written by:

Julia Biedenstein, MS, LSLS Cert. AVEd
COCHLEAR IMPLANT CONSUMER SPECIALIST

Julia began working for Advanced Bionics in 2014 as a Cochlear Implant Consumer Specialist. Prior to coming to AB, she worked in the field of deaf education for over 30 years serving as a teacher, school administrator, and researcher. She has lectured extensively throughout the US and has co-authored 3 widely used curricula for deaf children: SPICE: Speech Perception Instructional Curriculum and Evaluation; TASL: Teacher Assessment of Spoken Language; and Teaching Activities for Children Who are Deaf and Hard of Hearing.

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