Cochlear implants are hearing loss treatment devices used for patients with sensorineural hearing loss who are unable to use or fully benefit from hearing aids. These devices are surgically implanted and provide direct electrical stimulation to the auditory nerve. They also have an external component worn on the skull in the area behind the ear. Cochlear implants are recommended when severe to profound hearing loss is present and benefit from traditional amplification is minimal. Please take a look through the pages in this section of our website to learn more about getting a cochlear implant evaluation. in Louisville and how Heuser Hearing Institute’s expert team of hearing care providers can help you or your loved one live a full life with hearing loss.
Cochlear Implant Candidacy
Sensorineural hearing loss occurs when there is damage to the tiny hair cells in the cochlea of the inner ear. In patients with severe sensorineural damage, sound cannot reach the auditory nerve. In these cases, hearing aids are not a sufficient treatment plan and your hearing loss doctor may recommend a cochlear implant evaluation. The devices, which are surgically implanted and then mapped for a patients’ hearing loss, bypass the damaged hair cells entirely and directly stimulate the auditory nerve. Cochlear implants do not result in “restored” or “cured” hearing. They do, however, allow for the perception of sounds and sometimes can hear within normal ranges.
Once a person is referred to Heuser Hearing Clinic’s cochlear implant center, a thorough assessment is done to determine whether the person is a suitable candidate. This evaluation usually includes extensive audiological testing, psychological testing, an examination and battery of tests performed by the surgeon, x-rays, an MRI, a physical examination, and counseling to ensure suitability and motivation to participate in the process long term. It is important that the candidate understands what a cochlear implant will and will not do and the commitment required for care and follow-up services.
WHO IS BEST SUITED FOR A COCHLEAR IMPLANT?
Research is constantly providing new information and technology resulting in changes in cochlear implant procedures and instrumentation.
Adult Cochlear Implants
It is generally agreed that the best adult candidates are those who:
- Have severe to profound hearing loss in both ears
- Have had limited benefit from hearing aids
- Have no significant problems that would make the surgery risky
- Have a strong desire to be part of the hearing world and communicate through listening, speaking, and speech reading
Pediatric Cochlear Implants
Children are considered eligible for cochlear implants based on the above criteria and should have a FDA’s age restriction:
- Children 12–23 months with profound deafness
- Children 24 months and up with severe-to-profound deafness
Cochlear Implant Treatment
Treating hearing loss with cochlear implants is not a one-step process. Once you’ve worked with a Heuser Hearing Clinic otologist, audiologist, and/or surgeon and decided cochlear implants are the right option for you or your child, treatment will begin. Once the internal component is implanted and healed, you will be fitted with the external portion of the implant and the device will be “mapped” for your individual hearing needs using advanced programming technology. After mapping the implant, you should expect to return to our Louisville cochlear implant center regularly for follow-ups, adjustments, and training.
In order to understand more about hearing loss treatment using cochlear implants, it’s important to get to know the devices themselves.
COCHLEAR IMPLANT COMPONENTS
Cochlear implants have two parts that work together allowing the patient to hear.
The external portion of the device is worn behind the ear like a hearing aid and includes a microphone, speech processor, and transmitter. Similarly to traditional hearing aids, cochlear implants pick up sound via the microphone. This sound is then sent to the speech processor, which is a computer that analyzes and digitizes the sound signals. The resulting coded signals are then sent from the processor to the transmitter, which communicates with the receiver implanted just under the skin.
The internal (implanted) portion of a cochlear implant includes a receiver and electrodes. The receiver takes the coded electrical signals from the transmitter and delivers them to the array of electrodes that have been surgically inserted in the cochlea of the inner ear. The electrodes stimulate the fibers of the auditory nerve, and sound sensations are perceived.
COCHLEAR IMPLANT TREATMENT PROCESS
Once you’ve opted to receive cochlear implants, the first step is the surgical procedure to place the internal component. Less than 6 (2-6) weeks after surgery, you’ll return to the center to be fit with the microphone and speech processor and to activate and program the implant. Children learn to use the implant as they acquire language. Children will also participate in speech and language education. This process is called cochlear implant mapping. The initial fitting process is done over several days and may include additional visits over several months as each electrode in the cochlea is activated, adjusted, and programmed into the speech processor. As you learn and develop skill using the cochlear implants, further adjustments and reprogramming will be necessary. Once all electrodes are activated and we obtain optimum programming, you’ll only need to make annual visits to our Louisville cochlear implant center for checkups and maintenance.
Cochlear implant users will also receive extensive rehabilitation services from our audiologists and speech-language pathologists as they learn to listen, improve speech, use speech reading, and manage communication. Patients are taught how to use the implant and respond to the sounds received. For those who have heard before, sounds through the cochlear implant may seem unnatural at first. Those who have never heard must learn about each sound. Adults implant patients are encouraged to participate in our group rehabilitation course post-implantation. Group classes include rehabilitation exercises, understanding how to use the processor, telephone training, music appreciation, and practice for real-life difficult listening situations.
Cochlear Implant FAQs
If you’re considering cochlear implants for yourself or a loved one, we understand you have many questions. This page aims to answer some of the first questions our patients have, but we encourage you to make an appointment at our Heuser Hearing Clinic’s Louisville cochlear implant center to find out more.
WHAT IS A COCHLEAR IMPLANT?
A cochlear implant is a hearing loss treatment most often used for patients who no longer benefit from hearing aids or who have a severe to profound hearing loss. These devices directly electrically stimulate the auditory nerve in patients where amplification alone is unable to do so. In cases of severe or profound sensorineural hearing loss, there is so much damage to the tiny hair cells in the cochlea that sound can’t reach the auditory nerve.
WILL A COCHLEAR IMPLANT CURE MY HEARING LOSS?
In short—no! But it can restore your ability to hear and perceive sounds in a different way, and most patients are able to communicate normally with dedication, perseverance, and help from a group of professional cochlear implant specialists. Once patients learn how to process the signals delivered by the implant to the auditory nerve, they will gain a perception of sound “sensation.”
HOW DOES A COCHLEAR IMPLANT WORK?
In people with normal hearing or mild to moderate sensorineural hearing loss, the auditory nerve is stimulated by small hairs in the cochlea, which then sends a signal to the brain’s auditory center, which is transformed into sound. Cochlear implants bypass the first steps in the process and directly stimulate the auditory nerve without requiring a working cochlea. They gather, process, and transmit sound via an external abutment worn behind the patient’s ear. The sound is then transmitted to a receiver implanted within the ear, which stimulates the auditory nerve through electrodes.
WHERE ARE COCHLEAR IMPLANTS AVAILABLE?
There are cochlear implant centers around the country, and Heuser Hearing Clinic is the premier Louisville cochlear implant facility. Teams of professionals work together with adults and children from start to finish. Team members include an audiologist, otologist/surgeon, medical specialists, and, as needed, psychologists, counselors, and speech-language pathologists. We work with potential candidates and their families to determine candidacy for an implant, perform the surgery, and provide follow-up care both through the center and through local agencies or school districts in the recipient’s community.
HOW LONG DOES THE PROCESS TAKE?
The answer to this question varies from patient to patient. The surgery itself typically takes about 3–4 hours, and requires somewhere between 2-6 weeks of healing. After this, we begin the cochlear implant mapping process, in which we gradually activate the electrodes in the implant and then program them. This can take a few weeks to months depending on the patient. In addition, some adults require training, counseling, and education to learn how to use their cochlear implant.
WHO IS BEST SUITED FOR A COCHLEAR IMPLANT?
Cochlear implants aren’t for everyone, and we go through a lengthy and thorough assessment process to determine candidacy. Patients two years and up are considered candidates if they have severe to profound hearing loss and experience limited benefits from hearing aids. Cochlear implants are not approved for single-sided deafness and are recommended for those with binaural (two-sided) hearing loss. Candidates should also have no significant problems that would make the surgery risky and a strong desire to be part of the hearing world and communicate through listening, speaking, and speech reading.