Vivien Williams: Cochlear implants work for most people who have them, but there's always the chance they won't. Aida's brother, parents, grandparents and cousins were all there the day audiologists at Mayo Clinic attached the outside piece behind Aida's ear and turned it on for the first time.
Vivien Williams: To people in that room, witnessing Aida hear for the first time was to witness a miracle. Matt Little: Just to be able to hear, — hear the sounds around her — that's what I'm looking forward to. Vivien Williams: For Aida to be able to hear the happy sounds of childhood. Vivien Williams: If hearing aids don't work for you, cochlear implants might.
New technology is helping to make cochlear implants even better. Colin Driscoll, M. Vivien Williams: Dr. Colin Driscoll says some people who choose cochlear implants do have some level of hearing. It's just not good. Before the new technology was available, any residual hearing that did exist was lost during surgery to implant the device.
Vivien Williams: The new technology allows Dr. Driscoll and his team to monitor hearing levels during surgery to make sure implantation does not disrupt existing hearing. It allows patients to…. Hang on to what you have and then augment what you don't have. One type of cochlear implant has an external unit that attaches to the side of your head and combines a speech processor, microphone and transmitter in one device.
It can be charged when needed. In one type of cochlear implant, the external sound processor fits behind your ear and the transmitter attaches to the side of your head. Cochlear implants can restore hearing in people with severe hearing loss who are no longer helped by using hearing aids. Cochlear implants can improve their communication and quality of life. Cochlear implants may be placed in one ear unilateral or both ears bilateral.
Cochlear implants in both ears have started to be used more often to treat bilateral severe hearing loss — particularly for infants and children who are learning to speak and process language. Adults and children who are as young as six to 12 months old can benefit from cochlear implants. People who have cochlear implants report improved:. Cochlear implant surgery is done under general anesthesia. This means you or your child will be in a sleep-like state during the procedure.
You or your child might need to:. You or your child will need a detailed medical evaluation to determine if cochlear implants are a good option. A doctor will conduct an evaluation that may include:. Your surgeon will make a cut incision behind your ear, and form a small hole in the portion of skull bone mastoid where the internal device rests.
Your surgeon will then create a small opening in the cochlea in order to thread the electrode of the internal device. The skin incision is stitched closed so that the internal device is under your skin. An audiologist won't turn on activate the cochlear implants for about two to six weeks after your surgery — to give the surgery site time to heal. The internal part of a cochlear implant includes a receiver, which is located under the skin on the temporal bone, and one or more electrode arrays.
The receiver collects the signals from the transmitter and converts them to electrical pulses. It then dispatches the pulses to the electrodes that have been inserted deeply into the inner ear.
These electrodes directly stimulate the auditory nerve throughout a portion of the cochlea and the brain then interprets these signals as sound. To determine if you or a loved one is eligible for an implant, you will first need to undergo audiological and psychological testing, a medical exam and imaging studies.
You also may receive counseling to make sure you understand the large follow-up commitment required after the implant surgery, as well as what to expect regarding device performance and limitations. After that step, the next step is usually implantation surgery, which is done under general anesthesia.
It typically takes between two and four hours and most people spend one night in the hospital. The person will not be able to hear yet. Although the internal components have been placed, the surgical site must heal before the external device is placed.
About four to six weeks after the surgery, the patient will return to the cochlear implantation center to be fitted with the external device. At this appointment, the audiologist will activate the cochlear implant and begin the process of mapping the processor for the individual's specific needs.
When the cochlear implant is "turned on," this is the first time many children and adults are experiencing sound. Whether first hearing a spouse's voice, their own voice, a parent's voice or the audiologist, it's quite an emotional and memorable milestone for the patient or parent. This first appointment will be followed by other fine-tuning and adjustments to the cochlear implant map as the patient begins his or her new hearing journey. Many people need several follow-up visits over a few months to adjust the mapping of the signals to the electrodes, as well as to help the person become accustomed to his or her device.
Especially for those who've never heard sound before, an auditory training program is necessary to help the brain learn how to process the new auditory stimulation.
Much like hearing aids, people will want to schedule regular visits with their audiologist for occasional adjustments and hearing tests. In many cases, cochlear implants are covered by Medicare or Medicaid and many private and commercial insurers.
Coverage can vary widely, and patients may still be responsible for significant out-of-pocket costs. Most surgeons who perform cochlear implants have dedicated insurance experts on staff who can help patients understand and navigate individual plans and answer questions. Cochlear implants may require a prior authorization in order for insurance to pick up the tab.
Cochlear implants are covered under the statutory Medicare benefit provision for prosthetic devices. Medicare has a longstanding policy of providing coverage for cochlear implants when the patient meets the coverage criteria and without regard to whether the implant is unilateral or bilateral one ear or both ears.
Medicare reimbursement rules, however, are complex and can change. As with any surgical procedure involving an implanted medical device, there are risks. According to the FDA, they include:. In the U. Your ENT doctor and audiologist will recommend the best cochlear implant for you, based on your hearing exam results and anatomical considerations.
Cochlear now makes a hybrid design , which only stimulates the cochlea in the high frequencies for people who have high-frequency hearing loss. These devices work best for people with severe-to-profound hearing loss at high frequencies, yet who still have some residual, lower-frequency hearing abilities.
The first hybrid cochlear implant was approved by the FDA in March If you are interested in learning more about whether you might be a good candidate for cochlear implantation, talk to an ENT physician or audiologist for a referral to a cochlear implant center.
Speech-language pathologists and audiologists are frequently involved in this learning process. Prior to implantation, all of these factors need to be considered. Scientists are exploring whether using a shortened electrode array, inserted into a portion of the cochlea, for example, can help individuals whose hearing loss is limited to the higher frequencies while preserving their hearing of lower frequencies. Researchers also are looking at the potential benefits of pairing a cochlear implant in one ear with either another cochlear implant or a hearing aid in the other ear.
The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language. Use the following keywords to help you find organizations that can answer questions and provide information on cochlear implants:. Breadcrumb Home Health Information. Cochlear Implants. On this page: What is a cochlear implant? How does a cochlear implant work? Who gets cochlear implants? How does someone receive a cochlear implant?
It then processes the sound and transmits it to the internal part of the implant. The internal part is placed under the skin behind the ear during an outpatient surgery.
A thin wire and small electrodes lead to the cochlea, which is part of the inner ear. The wire sends signals to the cochlear nerve, which sends sound information to the brain to produce a hearing sensation. Although normal hearing is not restored, with appropriate therapy and practice, the improved hearing experience can mean an increased awareness of sounds in the environment, as well as better communication through easier lip reading and listening.
A cochlear implant may help someone with hearing loss restore or improve the ability to hear and understand speech. A cochlear implant is different than a hearing aid. A hearing aid makes sounds louder but may not significantly improve speech understanding. When a person struggles to understand speech, even with appropriately fitted hearing aids, a cochlear implant should be considered.
When the device is tuned appropriately and the recipient is committed to rehabilitation therapy, the -cochlear implant can significantly increase hearing in adults. Cochlear implants in infants and toddlers may help them listen and learn to speak. You, your health care provider and an audiologist may consider a cochlear implant if you are experiencing hearing loss and continue to rely heavily on lip reading.
Candidates for cochlear implant surgery include individuals who:. In cases of more moderate hearing loss, a partially inserted cochlear implant is used to preserve hearing so that both a hearing aid and the cochlear implant may be used simultaneously in the same ear.
In more severe cases of hearing loss, however, a fully inserted cochlear implant is needed to achieve the full benefit of electrical hearing. How much cochlear implants help varies from person to person. Most individuals note a significant growth in their awareness of sounds within days after their cochlear implant is turned on, which is about four to six weeks after surgery.
Speech understanding improves more gradually, with most individuals experiencing the largest improvement within the first six months.
The size of this improvement varies considerably between people. Improvements in speech understanding can be aided with auditory, or hearing, therapy after surgery. If you are thinking about whether to pursue a cochlear implant now or wait, it is important to know that improvements decrease the longer hearing loss continues. With a successful surgery and rehabilitation, a person may be able to:. Before thinking about a cochlear implant, it is important to understand certain facts.
These include:. Cochlear implant surgery is a safe and well-tolerated procedure.
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