If you're deaf or severely hard of hearing and other hearing improvement methods haven't helped, cochlear implant surgery may be the right choice for you. More than 225,000 Americans have had the procedure over the years, in which a small electronic device is implanted under the skin behind your ear to enhance your sense of sound.
Amplifying your sense of sound with cochlear implants
When you struggle to hear what family and friends are saying or have to ask people to repeat themselves constantly, it can be frustrating, especially when devices like hearing aids don't seem to be improving your condition.
Our team has years of experience surgically implanting a small electronic device in the inner ear called a cochlear implant. This life-changing procedure can restore previously lost hearing or give the gift of sound for the first time.
Suppose a cochlear implant is right for you. In that case, we'll create a treatment path covering multiple senses — from rediscovering your voice with a speech-language pathologist to receiving regular device tune-ups.
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Conditions
Living with bilateral sensorineural hearing loss is one of the many factors we weigh when deciding if a cochlear implant is right for you. Having sensorineural hearing loss means there's damage to either the tiny hair cells in the inner ear or nerves connecting your inner ear to the brain. The "bilateral" piece means both ears are affected.
You may be a good candidate for a cochlear implant when your sensorineural hearing loss is diagnosed as severe or profound.
- People with profound hearing loss can no longer hear under 90 decibels, like a nearby vacuum cleaner or lawnmower.
- People with severe hearing loss can no longer hear sounds under 70 decibels, like a general conversation, birds chirping or even the shower running.
Testing
Because hearing loss can affect multiple senses, we'll tap our fellow specialists from audiology, speech-language pathology and surgery for your testing. We'll work together to understand what's causing your hearing loss and whether cochlear implants can help. Some of the tests we use include:
- Auditory brainstem response (ABR)
- Auditory function tests
- CT scan of inner ears
- Distortion product otoacoustic emissions (DPOAEs) testing
- Immittance battery testing
- Pure tone air and bone conduction testing
- Speech audiometry testing
- Speech-language functioning tests
Some people who receive a cochlear implant need help reaching their full listening potential. If that's the case for you, we'll connect you with a speech-language pathologist before the surgery and create a rehabilitation plan based on your hearing needs and goals.
Treatments
A cochlear implant takes sound from the world around you and makes it audible to your ears. With most hearing loss, the hairs of the inner ear are missing or damaged.
A hearing aid amplifies sounds so that damaged ears can better detect them. A cochlear implant is different from a hearing aid because it bypasses the damaged part of the ear to stimulate the nerve that directly controls your hearing.
It's important to have a strong support team at home to help you adjust to this new sense of sound and how you use it to communicate and live.
How cochlear implants work
A cochlear implant is made up of internal (inside the ear) and external (outside the ear) parts.
Internal parts of a cochlear implant include:
- Electrode placed in the cochlea of the inner ear
- Magnet
- Small stimulator, or receiver, placed under the skin behind the ear
The external parts of the cochlear implant are:
- Battery
- Headpiece
- Microphone
- Small cable
- Speech processor (worn either behind the ear or on the body)
Here's how the internal and external parts of a cochlear implant work together to deliver sound:
- The speech processor captures sounds from your surroundings through a tiny microphone.
- Then, the processor converts the sounds into digital information and sends it to the implant through a headpiece.
- The implant turns the digital information into electrical signals, which travel through thin wires to the electrode.
- The electrode delivers the electrical signals to the auditory nerve.
- The hearing nerve carries the information to the brain, where it's processed as sound.
Types of cochlear implants
We work with 3 brands of cochlear implants at Tufts Medicine. Each implant has unique features. Your implant team will help determine which is right for you.
- The Clarion implant made by Advanced Bionics Corporation
- The MAESTRO implant made by MED-EL
- The Nucleus implant made by The Cochlear Corporation
Cochlear implant surgical process
The cochlear implant operation usually takes 1.5–2 hours to insert the electrodes into the inner ear. You'll be placed under general anesthesia so that you're relaxed and asleep the entire time. Most people return home the following day.
Activation + programming
After about 4–6 weeks of recovery, we'll connect the transmitter headpiece and speech processor to get the device up and running. You'll work with your audiologist to see if any settings need fine-tuning.
Follow-up programming
If something doesn't sound quite right, your audiologist will be available to provide routine adjustments to your implant.
For some people, this may mean adjusting the implant once per month. For others, it may be once every 3 months. Once people feel fully comfortable with their implant, they usually check in with their audiologist once a year.
Aural rehabilitation
Aural rehabilitation is a type of therapy that helps people with hearing loss learn or re-learn to listen and communicate.
We'll be right by your side every step of your journey, with frequent follow-up visits and device training to help you get the most out of your implant. If you ever have any questions or just need to talk, we're here for you.
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