How They Work:

• Traditional hearing aids make sounds louder, like turning up the volume on a TV.
• Cochlear implants work by sending electrical signals to the hearing nerve.

Internal Component:

• Cochlear implants need surgery because they have an internal part.
• Hearing aids don’t require surgery.

Sound Quality:

• Cochlear implants don’t sound like regular hearing or hearing aids initially. It takes time to get used to the sound.

Who They Help:

• Hearing aids assist people with various types and levels of hearing loss.
• Cochlear implants are for those with moderate to profound hearing loss in both ears who don’t benefit from hearing aids.

1. Restored Hearing: Cochlear implants can provide a sense of hearing for individuals with severe to profound hearing loss, allowing them to perceive sounds and speech.

2. Improved Speech Understanding: Cochlear implants enhance speech understanding, enabling users to communicate more effectively in various environments.

3. Enhanced Quality of Life: Implants contribute to an improved overall quality of life by restoring the ability to engage in conversations, enjoy music, and participate in social activities.

4. Early Intervention for Children: Cochlear implants, when implanted early in life, can significantly improve language development and communication skills in children with hearing loss.

5. Access to Auditory Cues: Cochlear implants allow users to access important auditory cues, including alarms, environmental sounds, and warning signals, contributing to increased safety.

6. Integration with Technology: Many cochlear implants are designed to connect with external devices such as smartphones and audio streaming accessories, providing seamless integration with modern technology.

7. Educational and Occupational Opportunities: Improved hearing through cochlear implants can positively impact educational and occupational opportunities, opening up a wider range of possibilities for individuals with hearing loss.

8. Reduced Social Isolation: Cochlear implants help individuals reconnect with their social circles, reducing feelings of isolation and fostering better social integration.

9. Customizable Programming: Cochlear implants offer customizable programming, allowing users to adapt the device to different listening environments and personal preferences.

10. Long-Term Solution: Cochlear implants are a durable and long-term solution for individuals with severe hearing loss, providing consistent access to auditory information over time.

Adults and children may be candidates for cochlear implants. The following list is just a guideline; it’s important to consult your hearing health professional if you’re interested in a cochlear implant for yourself or a loved one. 

Adults:

• Age Requirement: 18 years or older
• Hearing Loss: Severe to profound sensorineural hearing loss in both ears
• Speech Understanding: Little or no speech understanding even with well-fitted hearing aids
• Communication: Primarily communicate through spoken language
• Expectations: Realistic expectations about the cochlear implant outcomes
• Motivation: Strong motivation and commitment to being part of the hearing world
• Health: No medical contraindications

Children: (Ages 12 months to 17 years)

• Age Requirement: 12 months or older
• Hearing Loss: Severe to profound sensorineural hearing loss
• Amplification Trial: Limited benefit from a binaural amplification trial
• Health: No medical contraindications
• Education: Enrollment in an appropriate educational program with an emphasis on developing auditory/oral skills
• Motivation and Expectations: Family and/or child with good motivation and realistic expectations about the cochlear implant

Preparation and Anesthesia:

• Before the surgery, you’ll go through a pre-operative assessment to ensure you’re fit for the procedure. 
• You’ll be given specific instructions on how to prepare for your surgery by your surgeon, which will detail when you should stop eating and drinking prior to the surgery. 
• On the day of surgery, you’ll be administered general anesthesia, ensuring you’re completely asleep and unaware during the procedure.

During the Surgery:

• The surgeon typically makes a small incision behind the ear. Sometimes, a portion of hair might be shaved for better access.
• The incision exposes the mastoid bone, a critical structure behind the ear.
• A mastoidectomy is then done, which involves carefully drilling into the mastoid bone. This process allows access to the middle ear and cochlea.
• The surgeon then places the internal part of the cochlear implant, which includes the receiver-stimulator, into the mastoid bone.
• Electrodes from the implant are gently threaded into the cochlea, the spiral-shaped structure responsible for hearing.
• After the implant is securely in place, the surgeon closes the incision, often with dissolvable stitches or sutures.

After Surgery:

• Once the surgery is complete, you’ll be monitored in a recovery area as you wake up from anesthesia.
• Postoperative assessments, including imaging studies, may be performed to ensure the proper placement of the implant.

Hospital Stay and Recovery:

• Cochlear implant surgery is often performed as an outpatient procedure, allowing you to leave the hospital on the same day. 
• Recovery time may vary, but most individuals can resume normal activities after a few days.

It’s important to note that risks and outcomes can vary for each individual. Thorough discussions with your healthcare team are essential for a full understanding of the surgical process and potential outcomes.

After the surgery, there’s a 3-6 week healing period where the ear needs time to recover, and you won’t hear in the ear with the cochlear implant. At the activation appointment, the audiologist sets up the cochlear implant, helps you get used to the new sound (listening practice), checks the sound processor and accessories, and does tests on how well the implant works and your speech understanding. You’ll have a few more appointments in the first year and then yearly check-ups.

If it makes sense for you, you might wear a hearing aid in the ear without the implant. Usually, people who use both a cochlear implant and a hearing aid (bimodal) do better than those with just the implant.

Several things affect how well you hear with the cochlear implant, like when you lost your hearing, when you got the implant, your experience with hearing aids, the condition of your cochlea, and any other disabilities or diagnoses (like cognitive disabilities or dementia). Both kids and adults need rehabilitation after the implant. Developing good listening skills with the cochlear implant takes time and practice. It’s important to keep in touch with your healthcare team for personalized guidance on your cochlear implant journey.

More recently, there have been advancements in other types of implants that help individuals with different kinds or levels of hearing loss.

Hybrid Implants:

Hybrid implants and sound processors provide both electrical (cochlear implant) and acoustic (hearing aid) stimulation (known as EAS) in the same ear. People eligible for these implants have good hearing in low frequencies but experience severe to profound hearing loss in high frequencies. The criteria for eligibility are slightly different from cochlear implants.

Bone Anchored Hearing Aids (BAHA):

BAHA devices consist of an implantable device and an external sound processor. The sound processor sends sound to the implant, which then transmits vibrations through bone conduction to the inner ear. Similar to cochlear implants, BAHA devices are approved by Health Canada as medical devices.

These implantable devices might be suitable for adults and children (aged 5 and older) who:

• Have conductive or mixed (conductive and sensorineural) hearing loss, and/or
• Experience chronic external or middle ear issues, or
• Are born with ear malformations.