Cochlear implants a sound alternative to hearing aids
Q: I’m 70 years old and have worn hearing aids for a decade. Over the past several years, my hearing seems to be getting worse. I have tried several different kinds of hearing aids, but I feel as if they are not effective any longer. A friend suggested I ask an audiologist about cochlear implants. I thought those were just for people who are deaf. Could a cochlear implant help me?
A:
A cochlear implant could be a good alternative to hearing aids in your situation. It’s true that when they were introduced in the 1980s, cochlear implants were used for people who had complete hearing loss. Today, however, they often are used to help people who have more advanced hearing loss that cannot be fixed with hearing aids.
Your ear has three areas: the outer, middle and inner ear. Sound waves pass through the outer ear and cause the eardrum to vibrate. The eardrum and three small bones of the middle ear transmit the vibrations to the inner ear. In the inner ear, the vibrations pass through fluid in a snail-shaped structure, called the cochlea.
Inside the cochlea are tiny sensors, called hair cells, that turn the vibrations into electrical signals that are sent to your brain through your auditory nerve. The vibrations of different sounds affect these tiny hairs in different ways, causing the nerve cells to send different signals to your brain. That’s how you distinguish one sound from another.
In most people who develop hearing loss, the hair cells in the cochlea are damaged or missing, usually due to aging,
exposure to loud noise or genetic reasons. The electrical signals can’t be transmitted efficiently to the brain, and the result is hearing loss. A cochlear implant replaces the hair cells by sending electrical signals directly to the hearing nerve and giving the brain the ability to perceive sound once again.
The implant has two pieces: an external processor that fits behind your ear and an internal receiver implanted under the skin. The processor captures and processes sounds and then sends those signals to the receiver. The receiver sends the signals to electrodes that are placed in the cochlea during implantation. Those signals are received by the auditory nerve and directed to your brain, and your brain interprets those signals as sound. All parts of a cochlear implant are small, and the external processor looks like a hearing aid. These devices are relatively inconspicuous.
Cochlear implantation requires a consultation with an otolaryngology surgeon who would perform a short outpatient procedure. A small incision is made behind the ear to
insert the device. Most people have little discomfort during the surgery.
Once a patient has had a chance to heal — usually several weeks — an audiologist connects the processor to the implant for the first time. The patient should be able to hear immediately, but many report that they needed to adjust to the sounds they hear with their implant. This adjustment process often takes several months, with many patients reporting that the sound quality and their ability to understand speech continue to improve for a year or more.
Talk to a provider who specializes in hearing loss to find out if you would be a good candidate. Most people who receive a cochlear implant find that they can communicate better with the people around them.