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David Vernick, M.D. is assistant clinical professor of otology and laryngology at Harvard Medical School and interim chief of the Division of Otology and Laryngology at Beth Israel Deaconess Medical Center.
Question:
I've been evaluated and accepted for a cochlear implant. I wear two hearing aids now, and compensate visually as well, but it's becoming increasingly difficult to remain productive at work. I'm fearful of something going wrong during the implant procedure and losing what small amount of hearing I have. What are the pros and cons of having this surgery?
Answer:
Cochlear implants are devices that are surgically implanted in the inner ear of deaf individuals. Before people qualify for a cochlear implant, their hearing has to have deteriorated to a level where hearing aids give them little more than awareness of sound around them. Surgery to implant the device requires enlarging one of the openings into the inner ear (the round window) and threading an electrode array into the inner ear.
A cochlear implant does not restore normal hearing. In fact, it usually, but not always, leads to loss of any residual natural hearing the ear might be still capable of. The electrodes will then take over to detect sounds. It does not change the hearing in the opposite ear. It does not prevent someone from wearing a hearing aid in the non-implanted ear.
The pros of cochlear implant surgery are the expected improvement in clarity and better understanding of spoken words and other sounds. It helps when nothing else can.
The cons are the risks of the surgery, including the possible loss of any residual hearing in the implanted ear, the possibility of postoperative dizziness, the small risk of injury to the facial nerve (the nerve that controls motion to that side of the face) and the loss of taste to one side of the tongue. There is also a small risk of meningitis afterward.
Success of a surgery can never be guaranteed, and no procedure is complication free. For those that qualify, the hearing gained from a cochlear implant is usually substantial, with limited risk of a complication. Review the results of the implant program you are considering. Understand and compare the program's expectations to yours before proceeding. A cochlear implant has been a fantastic device to restore hearing to many individuals.