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Cochlear Implants: Facts, Benefits and Risks

  • Published: 2012-03-28 (Revised/Updated 2017-02-27) : Thomas C. Weiss (Disabled World).
  • Synopsis: Benefits and information regarding cochlear implants an implanted hearing device designed to produce hearing sensations useful to people with profound nerve deafness.
Cochlear Implant

A cochlear (koe-klee-er) implant is defined as an electronic medical device that replaces the function of the damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants do the work of damaged parts of the inner ear (cochlea) to send sound signals to the brain. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin. For manufacturers to sell cochlear implants in the United States, they must first show the FDA that their implants are safe and effective.

Main Document

Quote: "A cochlear implant receives sound from the person's outside environment, processes the sound, and then sends small electric currents near the person's auditory nerve."

A cochlear implant is a type of implanted electronic hearing device, one that is designed to produce hearing sensations that are useful to a person who experiences profound nerve deafness.

The device works by electrically stimulating nerves inside the person's inner ear. Cochlear implants usually include two main components. The first is an externally worn microphone, sound processor, and transmitter system. The second is an implanted receiver and electrode system; something that contains electronic circuits that receive signals from the external system, and send electrical currents to the person's inner ear.

Cochlear implant devices that are currently available have a magnet that holds the external system in place next to the implanted internal system. The external system can be worn behind the person's ear, or its parts can be placed in a person's pocket, in a belt pouch, or in a harness. Cochlear implants are designed to help adults and children who are profoundly deaf who receive little or no benefit from using hearing aids. Even people who experience severe or profound nerve deafness might be able to benefit from using cochlear implants.

A number of different things determine the successful use of cochlear implant use by a person. Among these are:

Additional factors bearing on the successful use of a cochlear implant include the following:

How Cochlear Implants Work

Fig 1. Diagram of a cochlear implant
About This Image: Fig 1. Diagram of a cochlear implant
A cochlear implant receives sound from the person's outside environment, processes the sound, and then sends small electric currents near the person's auditory nerve. The electric currents activate the person's nerve, sending a signal to their brain. The person's brain learns to recognize the signal and the person experiences the signal as, 'hearing.' The cochlear implant simulates hearing to a degree, with sound creating an electric current that stimulates the person's auditory nerve. The first commercially available types of implant devices were approved by the FDA in the 1980's, although research regarding them started all the way back in the 1950's.

The Reason for Different Types of Implants:

Current thought in the medical realm is that a person's inner ear responds to sound in at least two separate ways. According to the, 'place,' theory - cochlea respond more readily to a simple tone at one place along its length. Another theory suggests a person's ear responds to the timing of the sounds presented to it.

Researchers following the place theory devised implants that separate sound into groups. For example; the devices they created sent sounds with lower pitches to the area of a person's cochlea where it seemed to respond more readily to lower pitches. The researchers sent higher pitches to areas that respond more readily to high pitches. Following the place theory, the researchers used a number of channels and electrodes spaced out inside a person's cochlea. Due to timing theories, researchers also created implants that made sound signals into pulses in order to find out if a person's cochlea would respond more readily to different kinds of pulses.

The majority of modern cochlear implants are versatile and are somewhat capable of being adjusted to respond to sound in a number of ways. Audiologists attempt a variety of adjustments to find out what works best for each person.

The Risks of Cochlear Implant Surgery

The risks of pursuing a cochlear implantation surgical procedure involve a number of different things. The surgical procedure itself, as with any surgical procedure, present risks to the person. What follows are some of the risks involved.

Additional surgical risks include:

Difficulties with the Everyday Use of Cochlear Implants

People with a cochlear implant might experience various difficulties with their implant. A long list of potential issues have been noted in relation to the use of a cochlear implant, involving hearing, language, medical issues, the implant itself, technology, life activities, and more. What follows is a listing of the issues people have experienced with the everyday use of cochlear implants.

Inability to pursue certain medical examinations and forms of treatments, for example; MRI scans. MRI scans have become a routine diagnostic method related to the early detection of medical problems; however, even being close to an MRI imaging unit is dangerous for a person with a cochlear implant because it has the potential to dislodge their implant or demagnetize its internal magnet.

The FDA has approved some types of implants; however, that are safe in some types of MRI studies under controlled conditions. Additional medical treatments that are dangerous for persons with cochlear implants include ionic radiation therapy, electroconvulsive therapy, electrical surgery, and neuro-stimulation.

Lifestyle changes:

A person with a cochlear implant might have to pursue changes in their lifestyle for a number of reasons, particularly in relation to electronics. A person's implant may:

Hearing sounds differently:

Sound impressions from an implant differ from average hearing according to statements by people who could hear prior to becoming deaf. At first, people describe the sounds they hear as being, 'technical,' 'mechanical,' or, 'synthetic.' Their perceptions changed over a period of time, with the majority finding they did not notice the artificial quality of the sounds after a few weeks or using their implant.

Inability to upgrade the implant:

A person might not be able to upgrade their implant when new external components become available. Implanted parts are usually compatible with improved external parts. As advances in technology develop, a person can upgrade their implant through exchanges in external parts. Sometimes this doesn't work, and a person's implant needs to be changed.

Potential implant damage:

Car accidents, contact sports, slips and falls, as well as other types of impacts near to the person's ear with the cochlear implant all have the potential to damage the implant. What this might mean is the need for a new implant, along with another surgery and the risks involved with it. It is also unknown whether a new implant will work as well as the one the person had.

Static Electricity:

People with cochlear implants have to be careful of static electricity, something that can temporarily or even permanently damage their implant. A good practice may be to remove the processor and headset prior to making contact with static-generating items such as television screens, synthetic fabric, plastic play equipment, or computer monitors.

Avoiding Water:

The external parts of a cochlear implant cannot get wet. Damage from water might be expensive to repair and a person would be without hearing until their implant is repaired. It is therefore important for a person with an implant to remove the external parts of their implant before showering, bathing, swimming, or participating in water sports.

Longevity of the implant:

A person will use their cochlear implant for the remainder of their life. During a person's lifespan, the manufacturer of their implant might go out of business. The question of whether or not a person will be able to obtain replacement parts, or additional customer services in the future, is something that cannot be answered.

Infection requiring temporary or permanent removal of the implant:

If a person experiences an infection after implant surgery, they may have to have the implant removed either temporarily or permanently; although the complication is rare.

Unknown or uncertain effects:

A cochlear implant stimulates a person's nerves directly with electrical currents. While this type of stimulation seems to be safe, the long-term effects of using these electrical currents on a person's nerves is unknown.

Decreased ability to hear soft and loud sounds without changing the sensitivity of the implant:

The design of cochlear implants requires a person to manually change the sensitivity setting as their sound environment changes.

Implant failure:

Should this occur, a person would need to undergo an additional surgery to resolve the issue and would be exposed to the risks of another surgical procedure.

Inability to understand language well:

No test exists that a person can take prior to surgery that will predict how well they will understand language after implantation surgery.

Skin irritation:

A person may experience skin irritation where the external part of the implant rubs on their skin and they might have to remove it for a period of time.

Strange sounds:

A person might hear strange sound caused by interactions with magnetic fields, such as ones near airport screening machines.

Different hearing outcomes:

A person might not hear as well as other people who experience successful outcomes with their implants.

Potential loss of residual hearing:

Cochlear implants might destroy any remaining hearing in the ear that has the implant.

Dependency on batteries for hearing:

Some devices require new or recharged batteries on a daily basis.

The costs involved:

Surgery, recovery, and the replacement of lost or damaged parts can be expensive.

The Benefits of Using Cochlear Implants

The use of a cochlear implant can also provide a number of benefits. Adults; for example, many times receive an immediate hearing benefit and continue to improve over a period of around three months after their initial tuning sessions. After this period of time, their performance continues to improve, although at a slower rate. The performances of people who use cochlear implants can continue to improve over a period of several years. Other benefits can include the following.

People who are deaf and are pondering whether or not to pursue surgery to receive a cochlear implant have a number of different things to think about before they receive one. There are risks involved, as well as benefits. It is important to research cochlear implants, speak with a doctor, as well as an audiologist before making the decision.

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