What is a Cochlear Implant?
A Cochlear Implant is
an electrical device used to help patients
who have severe hearing loss and do not get adequate
benefits from hearing aids. There are several
parts to a cochlear implant. The first part is
the receiver-stimulator. The receiver-stimulator
is the device, which is implanted underneath the
skin behind the ear. A small wire from the receiver-stimulator
is placed at surgery into the inner ear. The skin
is sewn back together and the device is completely
underneath the skin.
The speech processor is an
external device, which has a microphone that connects
with the internal device by radio transmission.
A small magnet on the speech processor attached
to a wire adheres to the skin over the internal
device by magnetism. The speech processor receives
sounds and speech from the environment and sends
a signal to the internal device (the receiver-stimulator).
The receiver-stimulator then sends a signal down
Cochlear Implant Receiver to the wire into the
inner ear, which the patient can hear as sound.
“A.W., a cochlear implant recipient, has done
extremely well with his implant. He began to understand
words on the first day. Like most patients, he
shows continued improvement over time. He has
been very happy with his results.”
What are the results with the Cochlear Implant?
The vast majority of patients have improvement
in their communication after cochlear implantation.
Some patients are able to understand speech much
better than previously. Some people are even able
to understand speech on the telephone, and some
do not need to lip read anymore. However, there
is some variability in the results of individual
patients. In many cases, this relates to deterioration
of the hearing nerve during the period of deafness.
Fortunately, the number of patients who do poorly
with a cochlear implant is small. Most patients
note significant improvement.
What does speech sound like with a Cochlear Implant?
Most patients say that speech has a higher pitch
than normal but is usually understandable. Many
patients describe the sound as "mechanical".
Patients have generally much improved awareness
of sounds around them. This can be very helpful
for safety issues, such as hearing an oncoming
car. A few patients are actually able to regain
an appreciation for music, but this is less common.
Does the cause of hearing loss affect whether
a patient is a candidate for a Cochlear Implant?
Interestingly, the exact cause of hearing loss
does not affect whether a patient will benefit
from a cochlear implant. As more and more patients
with different types of ear disorders receive
cochlear implants, we are finding that the cause
is generally not important. Patients have the
potential to do well with many different
causes of hearing loss. One important note is
that patients who are deafened from meningitis
and develop new bone inside the inner ear do not
have as much benefit from an implant as other
How does the patient get evaluated for Cochlear
Patients are initially evaluated in the ENT office
at Eastern Carolina Ear, Nose, and Throat. A search
is made for potentially treatable causes of hearing
loss. If the patient has not yet tried hearing
aids, a hearing aid trial is begun. If the patient
is not sufficiently successful with hearing aids,
then a complete cochlear implant audiological
evaluation is carried out. If the patient is deemed
to be a candidate on detailed hearing and speech
testing, they then return for evaluation with
the physician and a CAT scan is obtained to study
the structure of the inner ear. The patient then
has an opportunity to learn more about the surgical
procedure and a final decision is made together
with the patient and physician. We are currently
using the Clarion cochlear implant. To learn about
Clarion, click here. To learn about cochlear implants from the cochlear corporation, click here.
The Cochlear Implant Team
P. Bradley Brechtelsbauer, MD
SANDRA ROYLE-TABAK, Au. D., CCC-A, F-AAA
ELLEN POLAND, Ph.D., Au.D., CCC-A, F-AAA
NAN TAYLOR, Masters of Science, Certificate of Clinical Competence in Audiology
HOLLIE LILLEY, OTO-Tech, Hearing Instrument Specialist
Lisa Collins, MS, CCC-SLP
Morgan Greve, MA, CCC-SLP