What are cochlear implants?

Generally speaking, cochlear implants are for patients with severe-to-profound, sensorineural hearing loss. There are approximately 500,000 patients in the USA with severe-to-profound hearing loss. Cochlear implants are only recommended after the patient has tried appropriately fitted hearing aids and has not shown sufficient benefit from hearing aids. Cochlear implants are devices that are " permanently " surgically implanted into the inner ear.

Cochlear implantation is a surgical procedure performed by otolaryngology surgeons. Cochlear implants have been FDA approved for almost two decades and the advances and improvements in the technology have been amazing. The Food and Drug Association (FDA) and the American Medical Association (AMA) recognize cochlear implants as safe and effective treatment for severe-to-profound sensorineural hearing loss. Most insurance programs pay for cochlear implantation.

Appropriately identified adults as well as profoundly deaf children (aged 12 months or older) can be implanted. Research demonstrates that the earlier a deaf child is implanted, the better the long term result will be with respect to speech and language development. Following surgery, rehabilitation is necessary, as the child must learn to associate the sound signals with normal sounds. Regarding deaf adults, research suggests that adults who receive cochlear implants are less lonely, have less social anxiety, are more independent, have increased social and interpersonal skills, and of course, they hear better with the cochlear implant! The majority of cochlear implant recipients wearing digital cochlear implants are able to use the telephone.

Cochlear implants are utilized in the patient who cannot benefit from hearing aids. The cochlear implant is a device used to bypass the nonfunctional inner ear and converts sound into electrical impulses that directly stimulate the cochlear nerve. The implant consists of an external portion comprised of a microphone, sound processor, and external coil and an internal portion that must be surgically implanted. The surgical procedure involves the placement of an internal receiver beneath the skin behind the ear, and a stimulating electrode array is inserted into the cochlea. The electrical signals are manipulated and controlled by the audiologist to maximize speech perception. The brain interprets these electrical impulses as sound. Again, not all patients are surgical candidates, and not all cochlear implant recipients receive the same benefit.

It is important to remember that the vast majority of patients who receive cochlear implants are actually " deaf " prior to implantation and they have not been successful with traditional hearing aids. Your audiologist is a very knowledgeable resource regarding cochlear implants and will be happy to discuss them with you.

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How does a cochlear implant work?

A cochlear implant works by electrically stimulating the hearing nerves. When a patient receives a cochlear implant, it means their ear is not working in a typical or natural way. Therefore, the cochlear implant is surgically placed behind their ear, and rather than using the natural ear (pinna, ear canal, ear drum, ossicles etc) to receive sound and send it to the inner ear, the sound is received at the cochlear implant's microphone and then changed to electrical signals, which are sent directly to the inner ear, bypassing the normal sound delivery system. Modern cochlear implants are amazing. The majority of patients receiving cochlear implants can speak on the phone, and cochlear implants in 2005, are about the same size as traditional behind-the-ear hearing aids.

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