Things to consider before a cochlear implant – Guidelines

Hearing loss in adults and children is a common health condition around the world. It affects over 360 million people worldwide, and nearly 50 million Americans.

Almost one in three people over the age of 65 have hearing loss, impacting communication, and contributing to social isolation, anxiety, depression, and cognitive decline. Hearing loss in a child can affect its ability to develop speech, language, and social skills.

Cochlear implants are small, complex electronic devices designed to provide a sense of sound to persons who are deaf or severely hard-of-hearing. According to the FDA, roughly 42,600 adults and 28,400 children in the United States received cochlear implants in 2010, while in 2012, 58,000 devices were implanted in adults and 38,000 in children.

Unlike hearing aids that amplify sounds to be detected by damaged ears, cochlear implants directly stimulate the auditory nerve, bypassing damaged portions of the ear. The system has two parts: an external sound processor that sits behind the ear and the actual cochlear implant that is surgically placed under the skin. Incoming sounds, picked up by a microphone, are processed into electric impulses that are transmitted directly to the hearing nerve from a stimulator. The brain recognizes the signals as sound. Cochlear implants, in other words, mimic the natural hearing function of the inner ear through electronic stimulation.

Hearing through a cochlear implant differs from normal hearing, and the implant does not restore normal hearing. Instead, it can give a person a useful representation of sounds and help the person understand speech.

With cochlear implants, adults who lost all or most of their hearing later in life can learn to associate the signal from the implant with sounds they remember. This provides them with the ability to understand speech solely by listening, without requiring any visual cues. Cochlear implants, coupled with intensive post implantation therapy, give the young children with exposure to sounds during a critical period when they learn speech and language skills. Most children receive implants between 2 and 6 years old.

How does one receive a cochlear implant?

The use of a cochlear implant requires both a surgical procedure and significant therapy to learn or relearn the sense of hearing. This process takes time and practice. Speech-language pathologists and audiologists often participate in this learning process.

The decision to get an implant needs to involve consultation with medical specialists, including a cochlear implant surgeon. Surgical implants are almost always safe, although complications can occur, as is the case with any operation.

Some known complications are injury to the facial nerve, meningitis, perilymph fluid leak, infections, blood or fluid collection at the site of surgery, dizziness, tinnitus, taste disturbances, numbness, reparative granuloma. All factors should be taken into consideration before implantation.

Is a cochlear implant right for you?

If you are a hearing aid user, ask these questions to yourself. If you answer “yes” to any of one them, you might be the right candidate for a cochlear implant.

  • Do I always ask people to repeat themselves in a quiet room, even at one-on-one conversations?
  • Do I rely on lip-reading to understand what they’re saying?
  • Am I exhausted at the end of the day because listening takes so much effort?
  • Do I have a hard time keeping up at work?
  • Is it hard to talk on the phone?

Questions to ask before a cochlear implant

Even though all cochlear implants work on the same principles, how they are designed and produced may vary. It is essential to understand the distinctions and ask the right questions so that you or your child can choose the best implant solution.

1. Can I rely on the implant for life?

Remember that with the implant, you are entering into a lifelong relationship with your cochlear implant manufacturer. The reliability and quality of the implant are critical. The implant should last for a lifetime. So, it is worth asking if the manufacturer has any known history of technical complications or problems, beyond the first year of implantation. Find out all you can from healthcare professionals and parents with implant experience. The reliability data is reported as the Cumulative Survival Rate (CSR).

2. How good is the implant for speech understanding?

The cochlear implant should be able to improve your hearing and speech comprehension in everyday settings. Of course, activities like enjoying music are essential, but the priority should be to develop speech and spoken language skills.

3. Is the implant flexible for all activities?

In addition to durability, the versatility of the external sound processor in the implant is vital. With minimal disruption, it should let you enjoy daily life. Whether it’s listening to music, talking on the phone, bathing, playing sports, or even getting caught in the rain. Not all sound processors offer the same high water-resistance level. Therefore, you should consider your needs carefully. Manufacturers provide various battery options for the external sound processor – both rechargeable or disposable. Rechargeable batteries are often preferred, although disposable batteries are convenient when traveling, camping, or caught by a power outage.

4. Will you have easy access to future upgrades?

Implanted parts are usually compatible with improved external components. That way, as advances in technology, develop, one can upgrade his or her implant by changing only its outer parts. This is an essential factor to consider as you will live with the implant for a lifetime. It’s important to know that the manufacturer is committed to investing in new, improved technologies and making them available to recipients.

5. Will you get rehabilitation and education services?

Rehabilitation is essential for a new cochlear implant and sound processor to obtain the best hearing and speech outcomes. Regardless of the technology, the successful results depend on the teamwork between the recipient, audiologist, speech, and language therapist. Since you will need to put time into an ongoing habilitation, consider how well the manufacturers support these services.