If you have severe hearing loss, you may benefit from a cochlear implant. This is a device that’s surgically implanted in your cochlea, the spiral-shaped bone in your inner ear.

A cochlear implant converts sounds into electrical impulses, which are interpreted by the brain. It aims to replace the cochlea’s function.

However, the device isn’t suited for everyone, and there are potential complications. Successfully using a cochlear implant also requires extensive therapy and training.

In this article, we’ll explore how the device works and what the procedure entails. We’ll also cover the cost, pros, and cons.

A cochlear implant is a small electronic medical device that improves moderate to severe hearing loss. It’s used to help hearing loss in adults, children, and babies.

The device works by electrically stimulating the cochlear nerve. It has external and inner components.

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Illustrations by Diego Sabogal

The external component is placed behind the ear. It consists of a microphone, which receives sound waves. A speech processor analyzes the sounds and turns them into digital signals.

These signals are sent to a transmitter, which forwards them to the internal receiver. The transmitter and receiver are held together by a magnet.

The internal portion is implanted beneath the skin, behind the ear. When the receiver gets the digital signals, it turns them into electrical impulses.

These impulses are sent to electrodes in the cochlea, which stimulates the cochlear nerve. The nerve forwards them to the brain. The result is a sense of hearing.

Though the brain will notice the sounds, they’re not the same as normal hearing. Speech therapy and rehabilitation are necessary to learn how to properly interpret these sounds.

A cochlear implant isn’t suitable for everyone. Babies, children, and adults may be good candidates if they have:

  • severe hearing loss in both ears
  • not found benefits from hearing aids
  • no medical conditions that could increase surgery risks

As an adult, you might also be an ideal candidate if you:

  • have hearing loss that disrupts spoken communication
  • lost all or most of your hearing later in life
  • depend on lip reading, even with hearing aids
  • are willing to commit to rehabilitation
  • understand what cochlear implants can and can’t do

An audiologist and ear, nose, and throat (ENT) surgeon can determine whether the device is right for you.

A hearing aid is also a medical device for hearing loss. But unlike a cochlear implant, it doesn’t transmit sound signals via electrodes.

Instead, hearing aids use a microphone, amplifier, and speaker to make sounds louder. This can help you hear things better.

Also, hearing aids aren’t surgically implanted. They’re worn inside or behind the ear.

Hearing aids are typically ideal if you have mild to moderate hearing loss. The device’s level of amplification depends on your degree of hearing loss.

Certain hearing aids may help severe hearing loss, but sometimes they still won’t benefit speech understanding. In this case, a cochlear implant might be the better choice.

Without insurance, a cochlear implant can cost between $30,000 and $50,000 on average, according to Boys Town National Research Hospital.

Most insurance providers cover cochlear implants or a portion of them. The device is also covered by Medicare, Medicaid, and Veterans Affairs.

Over time, you’ll likely need to replace parts like microphones and magnets. You may also need repairs. Some insurance plans cover these costs.

You’ll want to talk to your insurance provider to find out exactly what’s covered and whether you’ll have any out-of-pocket expenses.

Like most other medical devices, there are pros and cons of cochlear implants.

Pros

If you have severe hearing loss, a cochlear implant could improve your quality of life.

The benefits depend on your procedure and rehabilitation process. With a cochlear implant, you might be able to:

  • hear different sounds, like footsteps
  • comprehend speech without lip reading
  • hear voices on the phone
  • hear music
  • watch TV without captions

For babies and toddlers, the device could help them learn how to talk.

Cons

Cochlear implant surgery is a generally safe procedure. However, it presents potential risks, such as:

Your specific risks depend on your overall health and medical conditions.

Also, cochlear implants don’t restore normal hearing. For some individuals, it might not help at all.

Other potential cons include:

  • having to remove the external component to bathe or swim
  • regularly recharging batteries or using new ones
  • losing remaining natural hearing in the ear with the implant
  • damage to the implant during sports activity or accidents
  • extensive rehabilitation to help you learn how to use the implant

If your doctors decide you could benefit from a cochlear implant, they’ll explain what it entails and schedule the surgery.

Here’s what usually happens:

  1. Before the surgery, you’re given general anesthesia to make you sleep.
  2. Once you’re asleep, your surgeon creates an incision behind your ear and makes a slight indentation in the mastoid bone.
  3. Your surgeon makes a tiny hole in the cochlea. They then insert the electrodes through the hole.
  4. Next, they insert the receiver behind your ear, beneath the skin. They secure it to the skull and stitch the incision.
  5. Once the surgery is complete, you’ll be moved to the recovery unit, where you wake up. You’ll be closely monitored to make sure you don’t have any side effects from the surgery.
  6. You’ll typically be discharged a few hours after the surgery or the next day.

Before you leave the hospital, a healthcare professional will show you how to care for the incision.

You’ll have a follow-up appointment about a week later, so your surgeon can check the incision and see how it’s healing. The incision needs to heal before the implant is activated.

About 1 month after surgery, your doctor will add the external parts. The internal components will then be activated.

During the next couple of months, you’ll need to regularly see your doctor for adjustments. You’ll also need therapy called audiologic rehabilitation. This will help you improve your hearing and speech skills. It usually involves working with an audiologist or speech-language pathologist.

If hearing aids aren’t able to improve your hearing or speech, you might be a good candidate for a cochlear implant.

This device, which is surgically implanted in your cochlea, converts sounds into electrical impulses, which are interpreted by your brain.

An audiologist will use hearing exams and imaging tests to help determine whether it’s right for you, as well as your level of hearing loss.

After surgery, it’s important to commit to audiologic rehabilitation. This is essential for improving your outlook and using the cochlear implant successfully.