How does a cochlear implant device work?

Hearing loss normally occurs when the hair cells responsible for hearing degrade over time. Unlike a hearing aid, which amplifies sound waves through your inner ear cells, a surgically placed cochlear implant bypasses the hair cells and delivers sound directly to your hearing nerve. The sound signal travels from the hearing nerve to the brain, where the sound is identified.

Cochlear implant sound may not be quite as “natural” as normal hearing, but with time most people experience significantly improved sound awareness and language understanding.

What is the evaluation and pre-operative process like?

You’ll be evaluated by a neuro-otology surgeon and a specialized audiologist to:

• Ensure that all non-surgical options have been considered.
• Help you understand the implantation process.
• Discuss your particular needs and chances of success with cochlear implant.

Prior to surgery, you’ll get imaging of the inner ears to ensure that you have a working hearing nerve and to rule out any abnormalities.

You’ll also be instructed to get the Pneumovax 13 and Prevnar 23 vaccines at least eight weeks apart to reduce risk of a serious infection (meningitis).

What is cochlear implant surgery and recovery like?

Surgery typically takes two to three hours under general anesthesia. Most patients go home the same day.

After surgery, most people take up to a week off from work. You shouldn’t engage in strenuous activity for three to four weeks while the implant heals.

Your surgeon will assess your healing seven to ten days after surgery.

About one month after surgery, your implant will be “activated” and you’ll start working with an audiologist to relearn how to hear.

What can I expect from the program after surgery?

The program includes:

• Multiple visits with the audiologist to optimize implant function.
• Months of retraining your brain how to hear again, including listening to books on tape and participating in conversations.
• Practice. People who are highly motivated to practice hearing and brain retraining do better with cochlear implant and are more satisfied in the long run.

Are implants placed in one ear or both ears?

For people with hearing loss in both ears, the cochlear implant device is typically placed in the worse hearing ear. You can continue to use your hearing aid in the better hearing ear.

In some cases, cochlear implants may be placed in both ears, or special “hybrid” implants may be placed to try to preserve residual hearing. Your doctor will talk to you about these special circumstances.

Are there any reasons I may not want a cochlear implant?

A cochlear implant may not be the right choice for you if:

• You have been profoundly deaf in an ear for more than ten years.
• You suffer from severe heart or lung disease, or have other major medical conditions.
• You have severe balance problems.
• You have a history of repeated and ongoing ear infections.

What are the risks of cochlear implantation?

Cochlear implantation is generally a very safe surgery. However, all surgeries have risks, such as bleeding, infections or scarring. Possible risks related to cochlear implant include:

• Taste changes (typically temporary).
• Dizziness (typically temporary).
• Failure of the cochlear implant device itself (rare).
• Little to no hearing improvement (rare).
• Injury to the facial nerve (very rare).

Will insurance and Medicare pay for a cochlear implant?

Medicare and private insurances typically cover cochlear implantation for people with severe to profound hearing loss in both ears and who fail to achieve benefit from hearing aids.

Medicare does not cover cochlear implantation for patients with hearing loss in only one ear. Some private insurances will cover the cochlear implant program; check with your insurance carrier.