A cochlear implant may benefit those with severe hearing loss. Implanted in the cochlea, it’s less visible than hearing aids. It has many advantages, but there are also drawbacks.

The cochlea is the spiral-shaped organ in your inner ear. There’s a main difference between cochlear implants and standard hearing aids:

  • Hearing aids act as an amplifier to make sounds louder.
  • Cochlear implants transmit actual sound signals through electrodes. This converts sounds into electrical impulses, which are interpreted by the brain. It aims to replace the cochlea’s function.

Other differences include:

  • Hearing aids aren’t surgically implanted. They are worn inside or behind the ear.
  • Hearing aids are typically ideal if you have mild to moderate hearing loss.
  • Cochlear implants are good options when there’s severe hearing loss in one or both ears and loss of speech understanding.
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Illustrations by Diego Sabogal

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, what the procedure entails, the expected cost, as well as pros and cons of the implants.

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.

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.

Like most other medical devices, cochlear implants present pros and cons.


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.


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

  • bleeding
  • swelling
  • ringing in the ear (tinnitus)
  • dizziness
  • infection at surgery site
  • dry mouth
  • taste changes
  • facial paralysis
  • balance issues
  • increased risk of meningitis
  • surgery to remove implant (due to infection) or fix defective implant

Your specific risks depend on your overall health and medical conditions. It’s important to consult your doctor if you’re considering cochlear implants.

Also, cochlear implants don’t restore normal hearing. For some people, 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

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

  • severe hearing loss in one or 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.

Without insurance, a cochlear implant can cost between $30,000 and $50,000 on average.

Most major insurance providers such as Medicare, Medicaid, Tricare, and the Department of Veterans Affairs cover the cost of cochlear implants, or at least a portion of them.

However, sometimes they will not cover the device in cases where there are pre-existing conditions. You’ll need to speak to your insurance provider about whether they pay for the devices.

Over time, you’ll likely need to replace parts like microphones and magnets or need repairs. Some insurance plans can cover these costs, but in other cases you may need to pay for repairs out-of-pocket. Make sure to check if your cochlear implants are covered by a warranty or if your insurance provider pays for repairs.

In cases where you need a cochlear implant but insurance doesn’t cover the cost, there are a few organizations that may be able help you or any family members with payment.

One way to find out if you’re a good candidate for assistance is by consulting an audiologist, and they may be able to help direct you to resources, organizations, or charities that could be useful.

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. On a day prior to the surgery, you’re given a physical exam to medically clear you for surgery.
  2. On the day of the surgery, you’ll have general anesthesia to make you sleep.
  3. Once you’re asleep, your surgeon creates an incision behind your ear and makes a slight indentation in the mastoid bone.
  4. Your surgeon makes a tiny hole in the cochlea. They then insert the electrodes through the hole.
  5. Next, they insert the receiver behind your ear, beneath the skin. They secure it to the skull and stitch the incision.
  6. Once the surgery is complete, you’ll be moved to the recovery unit, where you’ll wake up. You’ll be closely monitored to make sure you don’t have any side effects from the surgery.
  7. You’ll typically be discharged a few hours after the surgery or the next day.
  8. You’ll go home without the device being activated.

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 or 2 months 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, or you experience severe hearing loss that can’t be fixed through a standard hearing aid, you might be a good candidate for a cochlear implant.

However, it’s important to talk with your doctor first to see if it’s a right fit. Also, go over the pros and cons with your doctor before making a decision.

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.