Unlike hearing aids, cochlear implants require regular rehabilitation and updates throughout your life.

A young woman wearing a cochlear implant just behind her ear. Share on Pinterest
Stocksy/Erin Brant

Some people in the Deaf community may opt to receive cochlear implants.

Implants are very different from hearing aids. A hearing aid amplifies sound so you can hear it better. Cochlear implants work by stimulating the auditory nerve, which transmits signals to the brain that are interpreted as sounds.

Because of this difference, the adjustment period after cochlear implants can be steep. It requires significant effort by the person to use them to function and navigate the hearing world effectively.

Understanding what to expect — whether you or a loved one is getting these implants — can help you manage the recovery period and prepare to experience sound.

Video clips of people using cochlear implants and hearing sounds for the first time are popular. You may assume that results are instantaneous. However, one of the most important things to remember is that these assistive devices do not immediately restore hearing.

The recovery period is twofold for cochlear implants. Not only do people need to recover from the actual surgery, but they also need rehabilitation to learn how to use their implants to interpret noise into coherent sounds.

Additionally, cochlear implants are two-piece devices: There’s the implant that’s inserted during the surgery and the external transmitter that’s necessary to accept noise that is then relayed as sound to the brain.

Because your incision needs to heal and doctors need to ensure there aren’t any complications, you won’t receive the transmitter until around 1 month after surgery.

Recovery after surgery

As with any surgery, following your doctor’s directions is critical to avoid complications such as infection.

It’s not uncommon to feel pressure sensations in the implanted ear. Nausea, dizziness, or feeling disoriented are all common experiences.

Some people may have a sore throat due to the breathing tube used during the surgery.

Typically, cochlear implants are an in-patient procedure. You’ll need to stay in the hospital for a day or two afterward. Additionally, you’ll have stitches and bandages that you’ll need to care for once you return home.

It may be several weeks before the implant is activated and you shift into the calibration stage of recovery.

Rehabilitation after cochlear implants are performed in stages.

Essentially, your brain needs time to adjust to the implant and learn how to accept noise and interpret it as recognizable sounds, such as music or speech.

Additionally, you need to learn to train your brain to ignore background noise so you can distinguish specific sounds in noisy environments.

Audiological rehabilitation

Getting your implants to work correctly is a process called audiological rehabilitation, or aural rehabilitation.

During this period, you typically make several visits to your audiologist to have your implant calibrated. Calibration simply means the device may need technical adjustments so it receives and relays sound correctly.

This training process takes time. Depending on your age, it can take longer to master.

Additionally, you often need to meet with a speech-language pathologist (SLP). Depending on how severe your hearing loss was before surgery, you may find the experience of hearing noises disorienting.

As a result, many people with cochlear implants also meet with a counselor or psychologist to help them adjust to their new normal.

Is auditory rehab covered by insurance or Medicare?

Determining whether a procedure is covered by insurance is often a confusing process, and cochlear implants are no different.

Ultimately, you need to check with your private provider to ensure that cochlear implants are covered and under which situations that coverage is accessible.

However, many private insurers cover some or all costs associated with having cochlear implant surgery and the rehabilitation process.

Additionally, Medicaid and Medicare recipients — including children — are eligible for cochlear implant coverage. Be sure to review the patient eligibility criteria to ensure you meet them.

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A variety of factors can impact your cochlear implant rehab timeline.

As mentioned above, age often plays a role in how easily people adjust to the implants and the overall auditory improvement that’s achieved.

The average timeline is at least 3–6 months postsurgery for rehabilitation. Sometimes this can take much longer.

Meanwhile, success rates can vary widely and depend on age and the severity of hearing loss.

A 2020 case paper review looked at studies with cochlear implant participants between 2000 and 2018. Researchers found that implant success rates can range from as low as 8.2% to as high as 53.9%.

The biggest factor determining success was whether someone was born with hearing loss (prelingual) or developed it after learning to speak (postlingual).

While results were usually self-reported by study participants, researchers found that in postlingual hearing loss adults who underwent cochlear implant surgery, roughly 82% of them recorded auditory improvement.

Meanwhile, in the prelingual group, only 53.4% noted any real improvement.

How often should you get mapping after a cochlear implant?

In the first year after surgery, you may have several visits to calibrate your device. However, as time progresses, most people usually only need to return for mapping roughly once a year, or if a new software update is released that enhances the implant’s functionality.

Not everyone is a good candidate for a cochlear implant. Likewise, not all insurance will cover it, although both Medicaid and Medicare will if certain criteria are met.

While cochlear implants can help people better engage with audible sensations, it takes time to adjust to the device and to retrain the brain to interpret sensory data as recognizable sounds.

If you’re considering cochlear implants for yourself or a loved one, working with an audiologist or other qualified healthcare professional can help you decide whether this device is the right choice.