Cochlear Implants

Frequently Asked Questions

What is a cochlear implant?

A cochlear implant consists of a speech processor and an internal electrode. The speech processor houses a microphone which picks up sound from the environment and then it converts these sounds to electric impulses. The internal electrode receives the impulses and sends them to different regions of the auditory nerve.

A cochlear implant does not restore your normal hearing. However, a majority of cochlear implant users experience an increase in their ability to understand speech and an improved quality of life.

What is a hybrid cochlear implant?

A hybrid cochlear implant is a cochlear implant that uses an internal electrode and a speech processor like a standard cochlear implant. However, this internal electrode may be shorter or have a slightly different design than a standard cochlear implant and the speech processor has a receiver that fits into your ear canal. It is a system that is part cochlear implant and part hearing aid. Your audiologist will tell you if you are a candidate for a hybrid cochlear implant and the unique features of these implants.

Am I am candidate for a cochlear implant?

You may be a candidate for a cochlear implant if your speech understanding in quiet is less than 50% while wearing hearing aids. To determine if you are a cochlear implant candidate, we recommend having a cochlear implant evaluation.

At a cochlear implant evaluation, we will perform a hearing test if you have not had one in the last 6 months. If you have had a hearing test in the last 6 months, please bring a copy of the results to your appointment.

We will also perform advanced speech testing. This will consist of repeating sentences and/or words in quiet and in background noise. This testing will be done while wearing a hearing aid.

After testing is completed, you will meet with an audiologist who will tell you about your options and show you the different types of processors from each cochlear implant company. The audiologist will also help you establish realistic expectations for your results and answer any questions you may have.

You will also need to meet with a neurotologist who will give you an otologic exam, discuss the surgery, answer questions, and order and review a CT scan.

Occasionally, you will be required to obtain medical clearance from your general practitioner or other specialists you see in order to verify you are healthy enough for surgery. 

How well will I hear with a cochlear implant?

There is a broad range of experience for cochlear implant users. Some implant users will only have improved awareness of environmental sounds while others will be able to have conversations in background noise with little difficulty. Several factors will impact your results such as the cause of your hearing loss, the length of time you have had hearing loss, your age, your motivation to hear better, and the support of your family and friends. Your neurotologist and audiologist will be able to give you an idea of your projected outcome at your cochlear implant evaluation.

Are cochlear implants for children?

Yes! Children can be implanted as young as 12 months old. There are three important factors that help to determine the outcome for implanted children. 1.) Age at onset of deafness and duration of deafness before implantation. 2.) Progression of hearing loss. 3.) Educational setting. Generally, earlier implantation favors more rapid development of oral communication ability. Children with progressive hearing loss, which allows for the development of speech reading skills and sometimes speech, generally do very well with a cochlear implant. Placement in a school setting that stresses oral communication is also important for a good outcome. It is important that children have a collaborative team including the caregivers, cochlear implant audiologist, school audiologist, and speech language pathologist to ensure the best possible hearing for our young cochlear implant patients.

Tell me more about surgery.

Cochlear implant surgery is performed under general anesthesia through an incision behind the ear and involves opening the mastoid and middle ear. Surgery lasts about 2 and a half hours. Occasionally, your hair will need to be shaved above and behind the ear.

A coil (internal receiver) is embedded under the skin behind the ear and a wire (active electrode) is placed into the fluid filled cochlea (inner ear). Residual hearing in the implanted ear may be lost. Hearing in the opposite ear is not affected.

You are usually discharged from the hospital the day of the surgery or after a night in the hospital.

The choice of which ear to implant is ultimately up to the patient. Generally, the ear with better speech understanding is recommended since residual hearing predicts better outcomes. If both ears are equally impaired, implantation of the ear with the shorter duration of deafness is encouraged. The neurotologist and audiologist will also make recommendations based on speech scores and the CT results.

What will happen after surgery?

Four to six weeks after surgery, you will return for a two hour appointment called “hook up.” At the Hook up appointment, you will be fit with the speech processor. The internal implant will be tested and the speech processor will be programmed. Initially the sound will be very artificial and voices may sound robotic or like a cartoon character. The care and use of the speech processor will be explained along with any accessories you may have chosen.

You will return for further programming once a week for the next two weeks. This is needed to “fine tune” the processor as your brain begins to understand the new signals.

More programming will be needed after the first month. You will discuss this timeline with your audiologist but at minimum you will need to return once a year for follow up.

It is very important to wear the speech processor daily and to interact with people. Your audiologist may recommend reading out loud or using a computer program to ensure you are getting enough practice using the speech processor. Sometimes you may be referred to an audio-verbal therapist to help you make the most of your new cochlear implant. 

Will I be able to hear on the telephone?

Typically 50% of cochlear implant users can hear on the telephone. The other 50% usually have good results using a speakerphone. Many cochlear implant users enjoy using a voice captioned telephone like Cap-Tel so that they can read the message and hear the voice at the same time.

Will I be able to hear sounds in my environment?

Typically yes! Many of our cochlear implant patients report they had forgotten their microwave beeped, or that the turn signal in the car has a clicking sound. Many implant patients also report feeling more secure as they can now hear approaching footsteps, fire alarms, and the open and close of doors. 

I currently have tinnitus (ringing or buzzing in the ears). Will a cochlear implant fix that?

Severe tinnitus may be decreased by the implant but it can also remain unchanged. Rarely tinnitus is worse. If this is a concern, please discuss it with your neurotologist and audiologist.

Which cochlear implant is the most reliable?

All of the cochlear implant companies have great reliability. We encourage you to read the reliability reports found on their websites. To help simplify that process, we have combined the reliability reports into one document.

I am 85 years old. Am I too old for a cochlear implant?

No! Many of our patients obtained their implant when they were over 80 years old with some of our patients being 90+ years old! Our 80+ year old patients show the same rate of improvement as our below 80 year old patients.