Cochlear implants: What, Why, When, How?

Cochlear implants: What, Why, When, How?


What is a Cochlear implant?

A Cochlear implant is an electronic device that partially restores hearing. It is meant for people who have severe hearing loss from inner-ear damage and who get limited benefit from hearing aids. A cochlear implant bypasses damaged portions of the ear to deliver sound signals to the auditory nerve unlike hearing aids, which just amplify sound. The components include:

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  1. A sound processor worn behind the ear, off the ear or on the body, captures sound and turns it into digital code. The sound processor has a battery that powers the entire system.
  2. The sound processor transmits the digitally-coded sound through the coil on the outside of  head to the implant.
  3. The implant converts the digitally-coded sound into electrical impulses and sends them along the electrode array placed in the cochlea (the inner ear).
  4. The implant’s electrodes stimulate the cochlea’s hearing nerve, which then sends the signals to the brain where they are interpreted as sound.

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Cochlear implants can improve communication and quality of life for people with severe hearing loss who receive little benefit from hearing aids. Increasingly, cochlear implants in both ears (bilateral) are accepted as standard care for the treatment of severe hearing loss, especially for infants and children who are learning to speak and to process language.

Adults and children who lost hearing after learning to speak can also benefit from cochlear implants. People who have cochlear implants report improved:

  • Ability to hear speech without needing visual cues such as reading lips
  • Recognition of normal, everyday environmental sounds
  • Ability to hear and enjoy music
  • Ability to listen in a noisy environment
  • Ability to find where sounds are coming from
  • Ability to hear television programs and telephone conversations

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To be eligible for a cochlear implant, one must have:

  • Moderately severe to profound hearing loss
  • Single sided deafness
  • Limited benefit from hearing aids as determined by specialized hearing tests
  • No medical conditions or factors that increase the risks associated with cochlear implants
  • High motivation to participate in rehabilitation sessions and to be part of the hearing world
  • Clear understanding of what cochlear implants can and cannot do for hearing

Children with hearing loss as young as 12 months old can be eligible for a cochlear implant. Experts recommend implantation as early as possible to expose children to sounds during the critical period of language acquisition. After implantation, they must undergo intense speech and language therapy in order to achieve the best possible outcome from the device.




Use of a cochlear implant requires both a surgical procedure and significant therapy to learn or relearn the sense of hearing. Not everyone performs at the same level with this device. The decision to receive an implant should involve discussions with medical specialists, including an experienced cochlear-implant surgeon. The process can be expensive. In some cases person’s health insurance may cover the expense, but not always. Some individuals may choose not to have a cochlear implant for a variety of personal reasons. Surgical implantations are almost always safe, although complications are a risk factor, just as with any kind of surgery. An additional consideration is learning to interpret the sounds created by an implant. This process takes time and practice. Speech-language pathologists and audiologists are involved in this learning process. Prior to implantation, all of these factors need to be considered.


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