Frequently Asked Questions About Cochlear Implants

Below are frequently asked questions about cochlear implants and cochlear implant surgery. For questions related to cochlear implants for children, please refer to the Pediatric Cochlear Implant FAQ.

What is a cochlear implant?

A cochlear implant is a surgically implanted electronic device that provides a sense of sound to a person who is severely hard of hearing, profoundly deaf, or has single-sided deafness. The internal device sends electrical signals into the hearing nerve inside the cochlea, which in turn sends the impulses to the brain where the electrical impulses are perceived as sounds. Read more about how a cochlear implant works here.

How is the external transmitter held in place?

The transmitter and receiver both contain magnets which attract to each other to stay aligned and keep the two communicating across the intact scalp.

Does a cochlear implant provide normal hearing?

No. A cochlear implant provides the perception of sound to the hearing system by electrically stimulating the remaining nerve fibers in the cochlea which takes the electrical equivalent of sound up to the part of the brain that will interpret the sound. A patient will need to learn to listen to these new sounds and interpret them. It is important to discuss realistic expectations for cochlear implant use with both your audiologist and your physician.

How long have cochlear implants been available?

The U.S. Food and Drug Administration (FDA) first approved cochlear implant devices for adults in 1985 and for children in 1990.

Who is eligible to receive a cochlear implant?

The FDA has specific criteria for cochlear implant recipients. People who meet the current candidacy criteria and are medically healthy for surgery may qualify regardless of age. People with inner ear abnormalities, in which the cochlea does not develop, would not be eligible. Those without a cochlear nerve also cannot receive cochlear implants. Certain other conditions may disqualify some people from eligibility. It is best to discuss your medical candidacy with your physician. If you are struggling with hearing aids, or have single-sided deafness, you may be a candidate for cochlear implantation.

What is the surgery, hospital stay, and recovery like?

Cochlear implant surgery typically takes two hours under general anesthesia. At the time of the surgery, after the implant has been placed, our audiologists will take internal measurements to gauge current flow within the cochlea as well as record the electrical activity within the hearing nerve after stimulation with the device. The surgical procedure is performed as an outpatient procedure, so patients go home the same day as their surgery. Usually, patients return to work 1-2 days after surgery. They should not lift more than 10 pounds in the first two weeks after surgery.

What kind of follow-up care will be required?

In our cochlear implant program, we wait three weeks for the swelling to resolve before the initial activation of the device. All of the sutures used in the three layers close the incision are resorbable, so there is no need to return to the office until the activation. When possible, we use telehealth visits to minimize the commuting otherwise needed to receive follow-up care. The programming of the external sound processor is more frequent in the beginning, but over time these visits may be reduced to once per year or when there are new software updates that would result in improved performance.

What outcomes can be expected from a cochlear implant?

The vast majority of patients who receive cochlear implants use them successfully. However, there are factors that can affect outcomes. These issues will be discussed with you during the evaluation process. Cochlear implants are also very effective in reducing or eliminating tinnitus (ringing of the ear) with use. For patients with single-sided deafness, improved spatial awareness, better listening in noisy environments, and sound localization ability are frequently described by those who receive a cochlear implant.

Should I receive one implant or two?

Unless one ear can still use a hearing aid along with the first cochlear implant, virtually all of the patients we care for receive two cochlear implants. This is a decision you make along with our cochlear implant team. Most adults receiving a cochlear implant through our center will begin with one cochlear implant. The initial implant will provide you with access to sounds in your environment and most importantly, speech. Two implants improves the ability to hear speech in noisy situations and help with localization or knowing the direction of where the sound is coming from. After some time using one cochlear implant successfully, we can discuss implanting the second ear. For people with single-sided deafness, only the deaf ear would receive a cochlear implant.

How long will a cochlear implant last?

The internal device is designed to last for your lifetime, and the manufacturers offer a ten year warranty, with some restrictions. While rare, internal devices can and do fail. For adults who received implants as young children, a device failure offers the opportunity to upgrade the internal device. Contemporary internal devices are now MRI-compatible and the technology is vastly superior than cochlear implants from 15-20 years ago.

Is re-implantation possible if my implant breaks?

Yes, re-implantation is almost always possible. It may take time for the patient to return to his or her previous level of hearing should re-implantation be necessary, but with upgraded internal devices where large improvements in technology have been achieved, with time, results have been reported to be as good as or better than the previous device. An older implant is never removed/replaced if it is still working unless there is a decline in performance. The cochlear implant manufacturers release new software which is updated in the external sound processor; however, just like with personal computers, new hardware upgrades occur approximately every 7-8 years. When these new sound processors become available, we secure insurance authorization and then purchase the upgraded equipment for you.

Can the sound processor be removed at night?

Yes. The sound processor should be removed at night to let the scalp rest and to charge the sound processor’s batteries. The sound processor should be stored in a storage device to remove moisture.

Can I use the implant while playing sports?

There are no restrictions with swimming and most sports related to the internal device only. Most external sound processors may be worn while playing sports. All sound processors are water resistant and some sound processors are waterproof. Ask your audiologist if the device chosen may be used in water.