Key Takeaways:
-
Cochlear implants are a surgical option for people with severe or profound hearing loss who get little benefit from hearing aids.
-
Children and adults, including seniors, may be candidates if they meet health and hearing criteria.
-
The implant process involves surgery, follow-up care, and long-term mapping and therapy for optimal results.
What Is a Cochlear Implant?
Cochlear implants are electronic medical devices designed for people with severe to profound hearing loss. Unlike hearing aids, which amplify sound, cochlear implants work by directly stimulating the auditory nerve. This bypasses damaged parts of the inner ear, offering the sensation of sound to those who cannot benefit from amplification alone. For more information, you can read this article by the NIH.
Each device has two main components: an external processor and an internal receiver. The external part captures sound and converts it into digital signals, while the internal component sends these signals to electrodes in the cochlea to stimulate hearing.
People often ask how this compares to hearing aids. Hearing aids rely on residual hearing, while cochlear implants are for those who no longer gain enough clarity or benefit from amplification. Learn more about how cochlear implants differ from hearing aids and explore sensorineural hearing loss, the condition most commonly addressed with implants.
Who Is a Candidate?
Children
Children as young as 9 to 12 months may be considered if they have profound hearing loss in both ears. Early implantation is linked to better language development because it allows exposure to sound during critical learning years.
Candidacy also depends on the child’s response to hearing aids, general health, family support, and readiness for the speech-language therapy that follows surgery.
Explore more on childhood hearing loss and the connection to language development.
Adults
Adults with severe or profound hearing loss in both ears and little benefit from hearing aids may qualify. Both post-lingually and pre-lingually deafened adults can be considered, though those who lost hearing after language development tend to adjust faster.
Older adults are increasingly opting for implants. Age is not a disqualifier—some recipients are in their 80s and 90s. For more on this, read about age-related hearing loss and see how hearing loss impacts brain health.
How Cochlear Implants Work
The cochlear implant system has two key parts:
-
External sound processor: Worn behind the ear or on the head, it includes a microphone and speech processor that picks up and codes sound.
-
Internal receiver and electrodes: Surgically implanted under the skin and within the cochlea, these send electrical impulses to stimulate the auditory nerve.
This setup allows many people who are deaf or severely hard of hearing to experience sounds—though they are different from natural hearing. For more on hearing technology, explore how Bluetooth hearing aids work.
The Process: From Testing to Activation
Evaluation
Before surgery, you’ll undergo a comprehensive hearing test, medical exam, and imaging. Psychological assessments and counseling also ensure you understand the commitment involved.
Surgery
Cochlear implant surgery typically takes 2–4 hours and is done under general anesthesia. Patients often go home the same or next day.
Activation & Mapping
After 4–6 weeks of healing, you return to get fitted with the external component. At this point, the implant is activated—often a powerful emotional milestone. The device will need fine-tuning (called mapping) over time to match your hearing needs.
Follow-Up
Expect multiple appointments to adjust your implant, undergo hearing tests, and receive training. It takes time and practice to interpret the new sounds. Learn more about how hearing aids are fitted—many principles apply here too.
Insurance and Costs
Cochlear implants are often covered by Medicare, Medicaid, and private insurance, especially if the patient meets clinical guidelines. However, out-of-pocket costs may still apply. Most cochlear implant centers have staff who can help patients navigate these details.
If you're comparing cost options, check out our guide to hearing aid pricing or learn about CareCredit financing.
Risks and Considerations
As with any surgery, cochlear implants come with potential risks, including:
-
Infection
-
Facial nerve damage
-
Dizziness
-
Tinnitus
-
Changes in taste or numbness
Additionally, there's a learning curve for interpreting new sounds. Outcomes can vary based on the person’s age, duration of deafness, and motivation to follow through with therapy.
Read more about sudden hearing loss and inner ear damage, both of which may lead to cochlear implant consideration.
Alternatives and Hybrid Devices
Some people may be better served by bone-anchored hearing aids (BAHS) or hybrid cochlear implants designed for those with high-frequency hearing loss. Others might use a hearing aid in one ear and an implant in the other (bimodal hearing).
Your audiologist will recommend the best fit based on your hearing profile, ear anatomy, and lifestyle. Learn more about the types of hearing aids and what makes a good hearing aid.
FAQ: Cochlear Implants
Can cochlear implants restore normal hearing? No. Cochlear implants do not restore hearing but provide a way to experience sound when hearing aids are no longer effective.
Are cochlear implants painful? The surgery is performed under anesthesia, and while discomfort after the procedure is expected, serious pain is rare and manageable.
Do both ears need implants? Some people benefit from a single implant, while others may eventually need one in each ear. It depends on your specific hearing profile and goals.
Can children outgrow their implants? Cochlear implants are designed to grow with children. The internal component typically remains the same, while the external processor can be updated.
Are cochlear implants visible? The external part is typically noticeable, though newer designs are more discreet. Some companies are developing fully implantable models currently in trials.
Need help deciding if a cochlear implant is right for you or a loved one? Talk to your audiologist or schedule a hearing test to get started.
For further reading:
