What Is a Cochlear Implant?

A cochlear implant is a surgically implanted electronic device designed to improve your ability to hear. Otolarnygologists (ear, nose, and throat doctors) and audiologists recommend cochlear implants for someone who has severe hearing loss or when hearing aids are no longer beneficial. The device won't restore your hearing back to normal, but it does partially restore your hearing ability. You can get a unilateral cochlear implant (one ear) or bilateral implants (both ears).

How Does a Cochlear Implant Work? 

A cochlear implant includes two separate pieces: 

  • Sound processor: This is a small device attached to your head and connected to a small device that sits behind the ear or above the ear via a magnet.
  • Receiver (stimulator): This device is surgically implanted in your ear and connected to the auditory nerve. This nerve takes electrical impulses from your ear to your brain, where you process them as different sounds.

Microphones on the sound processor pick up external sound, then convert it into an electrical signal. The signal travels through a small coil to the implant that is under the skin. Next the signal goes to the electrode inside the inner ear (the cochlea). Small nerve fibers on the auditory nerve in the cochlea pick up these signals and transmit them to the brain, where the signal is processed as sound. 

Cochlear Implants vs. Hearing Aids

Hearing aids and other similar devices work by amplifying sound. Most people with hearing loss use a hearing aid. However, for some people with severely damaged hearing or no hearing at all, amplifying sound does not work. Cochlear implants bypass ear damage to send a signal directly to the brain.

Who Is a Cochlear Implant Candidate?

Before you can get a cochlear implant, you must meet specific criteria, such as: 

  • hearing loss that is severe enough to affect your ability to communicate with others,
  • hearing loss that does not improve with the use of hearing aids, 
  • no other medical conditions that would increase the risks of getting cochlear implants, 
  • realistic expectations about how cochlear implants can improve your hearing, 
  • a clear understanding of the risks and benefits of cochlear implant surgery, and 
  • a willingness to participate in all the rehabilitation required to learn how to effectively use the device.

Some people with abnormal ear structure might not be eligible for a cochlear implant. You may need a referral for a CT scan or MRI to look at your ear anatomy in more detail and determine if you are a candidate for the implant surgery.

Cochlear Implant Pros and Cons

The specific benefits of a cochlear implant can vary from one person to another, depending on: 

  • how long they have experienced hearing loss, 
  • the severity of their hearing loss, and
  • rehabilitation success after hearing loss. 

Each patient is different, so the benefits of cochlear implants can vary from person to person. For those who are good candidates, benefits may include: 

  • improved sound awareness,
  • ability to hear everyday sounds,
  • ability to hear and understand speech (even with background noise), 
  • better lip-reading capabilities, 
  • improved speech, and
  • ability to use telephones and other audio devices. 

Risks

There is no guarantee that a cochlear implant will work. For some people, the implant does not transmit signals correctly to their brain, and does not improve hearing or only provides a small improvement. However, these implants will not make your hearing worse. 

There are also risks related to the surgery, including: 

  • bleeding, 
  • disrupted taste, 
  • dizziness, 
  • facial paralysis, 
  • infection, 
  • loss of current hearing, 
  • spinal fluid leaks,
  • trouble balancing, and
  • tinnitus (noise in the ears) that may get worse. 

Why Choose University of Utah Health?

The Utah Cochlear Implant Program has implanted more than 1,000 patients, both adults and children. Our typical volume is 100 to 150 implants per year. We implant devices from the three available manufacturers, and perform surgeries at University of Utah Hospital, Primary Children's Hospital, and LDS Hospital, depending on insurance and the age of the patient.

Our team is a multidisciplinary group of professionals, who are dedicated to providing the finest care to severely hearing impaired patients. This team includes implant audiologists, surgeons, deaf educators, members of the parent/infant program, and speech pathologists. The team meets monthly to discuss potential cochlear implant candidates and make recommendations for the best possible treatment. Our surgeons are fellowship-trained and board-certified or board-eligible in neurotology.

What to Expect at a Cochlear Implant Consultation

Before you schedule a cochlear implant consultation you will need a hearing test. You can bring your results from a prior hearing test or schedule a hearing test at U of U Health or another facility. 

Meeting with an Audiologist

An audiologist will review the results of your hearing test first to determine whether you meet the requirements to have a cochlear implant evaluation. If not, they will encourage you to continue seeing your audiologist, or make an appointment with one of our audiologists to discuss other hearing aid options. 

If you meet the threshold, our audiologist will: 

  • perform tests to verify your cochlear implant eligibility,
  • ask questions to learn more about your hearing impairment, 
  • explain cochlear implant devices and how they work, 
  • discuss the expected outcomes and results after cochlear implant surgery, 
  • discuss resources available for people with cochlear implants, and
  • make sure you understand the rehabilitation process after a cochlear implant.

Meeting with an Otolaryngologist

Next, the audiologist will refer you to meet with one of our otolaryngologists for a consultation. During the appointment our otolaryngologist will: 

  • evaluate your hearing loss, 
  • discuss your medical history,
  • examine your ear anatomy, 
  • determine whether you are healthy enough to get surgery, 
  • discuss details about the surgery and the recovery, and 
  • explain the requirement to get a meningitis vaccine prior to surgery. 

Our Cochlear Implant Specialists

Types of Cochlear Implants

At U of U Health we use cochlear implants from three manufacturers. All three devices are approved by the U.S. Food and Drug Administration (FDA). You can visit the manufacturers’ websites to find more information about the benefits and features of each device.  

All cochlear implant devices are high-quality and work in similar ways. The main differences to examine when choosing a device are: 

  • Aesthetics—Evaluate how the external sound processing device looks and how it fits. Some are designed to blend in more with hair or scalp, while others have lighter colors or different shapes for sound processing devices that may be more visible.
  • Features—Check what features are available with an implant, such as Bluetooth connectivity, waterproofing, ability to withstand impact (in sports, for example). 
  • Lifestyle factors—Find out which cochlear implants perform better in certain environments. For example, some work better for listening to music, while others are designed for active lifestyles or athletes.
  • Accessories and upgrades—Identify what accessories are available, how often you can upgrade the hardware, the length of the warranty, and other features that are important to you.

Your surgeon and audiologist will also make recommendations for which device they think will work best.

How Long Do Cochlear Implants Last?

Cochlear implants can last for many years, some people may even have the same device for decades. However, like any electrical device, parts can fail. If any part of the device fails, you can get it replaced. Replacing the external sound processor if it fails is a simple procedure. If the interior receiver fails, you will need surgery to replace it.

Cochlear implant manufacturers offer a 10-year warranty on their devices, and will replace the device if it fails within the warranty period. Most insurance companies will also cover the cost to upgrade your device after a certain number of years so you can get the latest technology. The specific timeframe for upgrades varies by insurance carrier.

Cochlear Implant Costs

Most insurance plans cover cochlear implants for patients who meet the criteria. These devices are different from hearing aids, so even insurance plans that do not cover hearing aids will usually cover cochlear implants. 

Request a Consultation for Cochlear Implants

Before you can schedule a consultation to discuss cochlear implants, you will need a hearing test and an evaluation by an audiologist (if you’ve never seen one). U of U Health staff can help you get scheduled for a hearing test at one of our facilities, or you can bring results of a hearing test from another doctor. 

If other hearing aid options do not work, your audiologist will refer you to see one of our cochlear implant surgeons for a consultation. 

Call 801-587-8368 to make an appointment for an evaluation or to ask questions.