Hearing implants

Are hearing implants the right option for you?

If your hearing loss is too severe for standard hearing aids, implantable devices may be a viable option to improve your ability to hear. Hearing aids are removable devices that amplify sounds and reduce ambient noise. Implants work differently and require surgery. 

Since their introduction in the 1970s, cochlear implants have opened a world of sound to more than 550,000 people worldwide with severe permanent hearing loss. Several other types of hearing implants are available, each of which can help people with different types of hearing loss:

  • Bone conduction devices
  • Middle ear implants
  • Auditory brain stem implants 

555,000

people with severe permanent hearing loss were helped by cochlear implants

How do cochlear implants work?

A cochlear implant is a small implanted electronic device consisting of an external portion that sits behind the ear with a second element surgically placed under the skin. The external parts includes a microphone, sound processor, and transmission system. The internal device includes a receiver/stimulator and an electrode array. The surgically implanted part of the cochlear implant and electrode array should last a lifetime, while the external sound processor can be replaced when new and improved technology is available.

The device works by bypassing damaged hair cells in your inner ear (cochlea) and directly stimulating the auditory nerve to send information to your brain. While cochlear implants don’t cure hearing loss or restore hearing, they enable people with severe hearing loss or deafness to perceive the sensation of sound. 

Key things to keep in mind about cochlear implants

If you’re considering a cochlear implant for yourself or a loved one, you need to meet the following criteria.

  • Age 6-months or older
  • Sensorineural hearing loss
  • Presence of the cochlear and eighth cranial nerve with relatively preserved anatomy
  • Bilateral or single-sided deafness
  • Auditory neuropathy (inability to send sound from an intact inner ear to the brain)
  • Reliability to follow up with audiology and otolaryngology team
  • Ability to undergo general anesthesia and surgical procedure

It takes a recovery period of 2-4 weeks after surgery before the device is switched on. During this time, you can’t wear a hearing aid. It may take hours, weeks, or even months for your brain to adapt and process new sounds. It’s important to work with an audiologist and speech therapist to ensure you’re adapting properly and learning the necessary skills to reap the benefits of cochlear implants.

FAQs on cochlear implant

How does a bone conduction device work?

The Bone-Anchored Hearing Aid (BAHA), which became commercially available in 1987, is a surgically implanted device and the only one available to date that works through direct bone conduction. Efficient coupling of the sound processor to the underlying bone is achieved through a small connector across the skin, and an implant that directly bonds with the underlying bone. The BAHA consists of the titanium fixture, an abutment or magnet, and the external sound processor. This unique system enables the bone to transfer sound to your healthy inner ear rather than via the middle ear.

If you have a chronic middle ear condition, outer ear issue, or congenital ear defects, a BAHA may be a good option for you. The requirement is that you must have moderate or better hearing in one inner ear. Individuals with “single sided deafness” are also potential candidates for BAHA implantation. 

What are middle ear implants?

The last two decades have seen significant advances in middle ear implant technology. This system includes a receiver placed just below the skin that picks up the sound from the processor, as well as an implant attached to one of the bones in the middle ear, or near the membrane window of the inner ear. The implant directly moves the bones of the middle ear or causes the membrane window of the inner ear to vibrate, enabling amplified transmission of sounds.

An alternative to hearing aids, middle ear implants may be an option if you have mild to moderate conductive, sensorineural, or mixed hearing loss and can’t wear hearing aids. People with ear mold allergies; skin issues in their ears; outer ear infections; narrow, collapsed, or closed ear canals; or malformed ears have benefited from this technology. The Vibrant Soundbridge (VSB) system has a well-documented 20+-year success record in children and adults with ear malformations, chronic external ear infections, sensorineural hearing loss, and co-occurring vestibular disorders.

Who can benefit from auditory nerve implants?

A hearing aid or cochlear implant may not help if you have a severely abnormal inner ear or missing/underdeveloped auditory nerves. An auditory brainstem implant bypasses damaged auditory nerves and/or the abnormal inner ear, connecting directly to your brainstem to help you detect sounds. The implant consists of a microphone and sound processor positioned behind the ear, a decoding chip placed under the skin that transmits information from the microphone, and electrodes connected directly to the brainstem that alert the user when sound is stimulated.

Although hearing implants don’t restore normal hearing, they open a world of sounds and experiences to people with hearing impairments. If you think you might benefit from one of the implants described in this article, schedule an appointment with an audiologist or an ENT to discuss your options. 

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