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A cochlear implant is a small electronic device that helps people hear. It can be used for people who are deaf or very hard of hearing. A cochlear implant is not the same thing as a hearing aid. It is implanted using surgery, and works in a different way.
There are many different types of cochlear implants. However, they are usually made up of several similar parts.
WHO USES A COCHLEAR IMPLANT?
Cochlear implants allow deaf people to receive and process sounds and speech. However, it is important to understand that these devices do not restore normal hearing. They are tools that allow sound and speech to be processed and sent to the brain.
A cochlear implant is not right for everyone. The way a person is selected for cochlear implants is changing as the understanding of the brain's hearing (auditory) pathways improves and the technology changes.
Both children and adults can be candidates for cochlear implants. People who are candidates for this device may have been born deaf or become deaf after learning to speak. Children as young as 1 year old are now candidates for this surgery. Although criteria are slightly different for adults and children, they are based on similar guidelines:
HOW IT WORKS
Sounds are transmitted through the air. In a normal ear, sound waves cause the eardrum and then the middle ear bones to vibrate. This sends a wave of vibrations into the inner ear (cochlea). These waves are then converted by the cochlea into electrical signals, which are sent along the auditory nerve to the brain.
A deaf person does not have a functioning inner ear. A cochlear implant tries to replace the function of the inner ear by turning sound into electrical energy. This energy can then be used to stimulate the cochlear nerve (the nerve for hearing), sending "sound" signals to the brain.
HOW IT IS IMPLANTED
To have the surgery:
RISKS OF SURGERY
A cochlear implant is a relatively safe surgery. However, all surgeries pose some risks. Common risks include:
These are quite uncommon now that the surgery is performed through a small surgical cut.
Less common complications include:
RECOVERY AFTER SURGERY
You may be admitted to the hospital overnight for observation, although many hospitals now allow you to go home the day of surgery. Your health care provider will give you pain medicines and sometimes antibiotics to prevent infection. Many surgeons place a large dressing over the operated ear. The dressing is removed the day after surgery.
A week or more after surgery, the outside part of the cochlear implant is secured to the receiver-stimulator that was implanted behind the ear. It is only at this point that you will be able to use the device.
Once the surgery site is well healed, and the implant is attached to the outside processor, you will begin to work with specialists to learn to "hear" and process sound using the cochlear implant. These specialists may include:
This is a very important part of the process. You will need to work closely with your team of specialists to get the most benefit from the implant.
Results with cochlear implants vary widely. How well you do depends on:
Some people can learn to communicate on the telephone. Others can only recognize sound. Getting the maximum results can take up to several years, and you need to be motivated. Patients are often enrolled in hearing and speech rehabilitation programs.
LIVING WITH AN IMPLANT
Once you have healed, there are few restrictions. Most activities are allowed. However, your health care provider may tell you to avoid contact sports to lessen the chance of injury to the implanted device.
Most patients with cochlear implants cannot get MRI scans, because the implant is made of metal.
Balkany TJ, Gantz BJ, Gantz BK. Cochlear implantation: medical and surgical considerations. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 159.
Brown KD, Balkany TJ. Benefits of bilateral cochlear implantation: a review. Curr Opin Otolaryngol Head Neck Surg. 2007;15:315-318.
Papsin BC, Gordon KA. Cochlear implants for children with severe-to-profound hearing loss. N Engl J Med. 2007;357:2380-2387.
Sparreboom M, van Schoonhoven J, van Zanten BG, et al. The effectiveness of bilateral cochlear implants for severe-to-profound deafness in children: a systematic review. Otol Neurotol. 2010 Sep;31(7):1062-71.