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Cochlear Implants: A Gift of Sound

Hearing loss affects people of all ages and can have different causes.

For those with mild or moderate sensorineural hearing loss, hearing aids are often the best treatment. For those with more severe hearing loss, a cochlear implant may help.

What is a cochlear implant?

A cochlear implant is a surgically implanted device that restores hearing for patients with significant sensorineural hearing loss.

The cochlea is a snail-shaped part of the inner ear that contains the hearing organ. Sensorineural hearing loss often occurs because the sensory cells in the cochlea, called hair cells, lose function. You can think of the sensory hair cells in the cochlea as the microphone of the ear, which then passes an electrical signal through a wire, the auditory nerve, to the brain. A cochlear implant works by bypassing the faulty microphone and directly stimulating the auditory nerve in order to restore hearing.

“Cochlear implants are a true success story for modern medicine and engineering. They were the first successful implants to directly interface with the nervous system and restore function,” said Nicholas Dewyer, MD, a neurotologist (inner ear surgeon) at Banner – University Medical Center Tucson with expertise in disorders of the ear, hearing and balance systems. “Prior to cochlear implants, there were no treatments that could restore hearing for patients with sensorineural hearing loss. Now, this is something that we routinely do.”

Dr. Dewyer answered some more questions about cochlear implants:

Am I a candidate for a cochlear implant?

To determine if you may benefit from a cochlear implant, you’ll want to first check with your ENT doctor or a hearing health care professional. In general, however, both children and adults with sensorineural hearing loss that is severe enough to cause them to struggle, even with a hearing aid, are likely candidates for a cochlear implant.

“It used to be that in order to be a candidate, patients had to be profoundly deaf in both ears,” Dr. Dewyer said. “Over recent decades, however, we’ve learned that cochlear implants are generally so safe and effective that we have expanded criteria to include patients with moderate sensorineural hearing loss and even patients with only one bad ear, called single-sided deafness.”

What is the process for getting a cochlear implant?

Evaluation

A cochlear implant evaluation involves both a medical assessment by an ear surgeon, called an otologist or neurotologist, and a hearing assessment by an audiologist. These assessments often include a number of different hearing tests, an ear exam and imaging of the inner ears.

If the test results indicate you are a good candidate for a cochlear implant, you’ll then work with the audiologist to pick out your implant and accessories and schedule your surgery.

Surgery

The operation to place the internal component of the cochlear implant is done in the operating room under general anesthesia and generally takes about two hours. You can expect to go home on the day of surgery for recovery. About two weeks after surgery, you’ll see the surgeon again to make sure everything is healing up well and the audiologist to have your implant activated.

Fitting and Adjustments

For the first few months after surgery, you’ll learn the basics of using and caring for the implant. And for the first year with the implant, you can also expect to see the audiologist frequently to check progress and fine tune the hearing settings. Learning to use it can be a slow process, but with commitment, you can have an improved quality of life.

“An important part of ensuring success with a cochlear implant is a realistic understanding of the rehabilitation process,” Dr. Dewyer said. “Sound from a cochlear implant doesn’t sound like it does from a normal-hearing ear, so the patient’s brain has to adapt to this. It’s a bit like learning a new language; you have to practice to get better. It can take some patients 3-6 months to get used to it. By this time, most patients are able to talk on the phone using their cochlear implant.”

Are cochlear implants expensive?

Although cochlear implants are quite expensive (about $30,000), most insurers will pay for the implant and the surgery for patients who meet criteria. You’ll also want to consider maintenance costs for replacing parts like microphones and magnets. Some insurance plans cover these costs, so check with your insurance provider to find out exactly what is covered and what out-of-pocket expenses you may incur.

Are there any risks with cochlear implants?

Cochlear implant surgery is quite routine and low risk for experienced surgeons, but as with all surgeries, there are some potential risks. Common symptoms after surgery, such as being off balance or noticing a change in how things taste, tend to be mild and resolve on their own in a few weeks.

“With an experienced cochlear implant surgeon, the risks of serious complications like injury to the facial nerve, which runs through the ear and controls movement of the face, or a serious post-operative infection are very low (far less than 1%),” Dr. Dewyer said. “Be sure to discuss any concerns you have with your surgeon before the procedure.”

What do cochlear implants sound like?

That’s a great question, although only those who’ve received a cochlear implant know the answer to this one. Dr. Dewyer shared what his patients have noticed.

“Many cochlear implant users initially report that voices sound more high-pitched or cartoonish than they did with normal hearing,” Dr. Dewyer said. “However, over time, the brain amazingly adapts to the new sound quality and it becomes less noticeable. The average patient is able to use the phone with their cochlear implant. It can be truly life-changing for patients.”

Dr. Dewyer added, “That being said, many cochlear implant users report that music doesn’t sound great, but researchers are working on ways to improve this.”

What is a hybrid cochlear implant?

A hybrid implant is a relatively new design that combines both a cochlear implant and a hearing aid on the same side. These devices may be useful for patients who still have good low frequency hearing but severe hearing loss in high frequencies.

“The idea is that the cochlear implant provides the high frequency signals and the hearing aid takes advantage of the residual acoustic hearing to provide a richer low frequency signal,” Dr. Dewyer said. “For certain patients, this can be an excellent hearing solution.”

Final Takeaway

If you use hearing aids and find that you’re still struggling with hearing, you might be a good candidate for a cochlear implant. Although it requires surgery to place the implant, the outpatient operation is routine and low-risk for patients of nearly all ages. For those with significant sensorineural hearing loss, a cochlear implant can restore hearing so that they may experience the sounds and hear the people in their lives.

If you or your loved one is struggling with hearing loss and you would like to learn more about treatment options, including cochlear implants, find a hearing specialist near you. Visit bannerhealth.com.

Ear, Nose and Throat
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