What is a Cochlear Implant?

Understanding Cochlear Implants: A Lifeline for Profound Hearing Loss

Introduction

Hearing loss, particularly severe to profound hearing loss, can significantly impact one's quality of life. In cases where traditional hearing aids are no longer effective, cochlear implants offer a groundbreaking solution. This blog post explores the science, benefits, and process of cochlear implantation, drawing upon the expertise of Dr. Cliff Olson, founder of Applied Hearing Solutions in Phoenix, Arizona, and information from reputable sources such as the National Institute on Deafness and Other Communication Disorders (NIDCD) and the American Speech-Language-Hearing Association (ASHA).

What is a Cochlear Implant?

A cochlear implant is a sophisticated medical device designed to bypass damaged structures in the inner ear and directly stimulate the auditory nerve, enabling some individuals with profound hearing loss to perceive sounds and speech​​. Unlike hearing aids, which amplify sounds, cochlear implants convert sound vibrations into electrical signals that stimulate the auditory nerve, effectively bridging the gap caused by damaged hair cells in the inner ear​​.

Components and Functioning

A cochlear implant comprises two main components: an external part that sits behind the ear and an internal part surgically implanted under the skin. The external part includes a microphone, a speech processor, and a transmitter. The microphone picks up sounds, the processor converts them into digital signals, and the transmitter sends these signals to the implanted internal part. This internal part consists of a receiver and an electrode array, which stimulates the auditory nerve directly​​​​.

The Miracle of Hearing Restoration

Cochlear implants are a beacon of hope for those with profound hearing loss. Dr. Olson describes witnessing patients' transition from zero speech understanding with hearing aids to significant improvement with cochlear implants as nothing short of miraculous. The implants enable recipients to perceive and interpret sounds that were previously inaccessible, dramatically improving communication and overall quality of life​​.

Candidacy and Process

Cochlear implantation is a detailed process involving a comprehensive assessment to determine candidacy. The candidate's age, medical history, extent of hearing loss, and communication needs are considered. The procedure is typically an outpatient surgery lasting about two hours, followed by a recovery period before the device is activated​​​​.

Post-Implantation Rehabilitation

After the surgery, patients undergo a period of rehabilitation, including programming and adjusting the device, learning to interpret the new auditory signals, and integrating them into daily life. This rehabilitation is crucial for maximizing the benefits of the implant​​.

The Role of Audiologists

Audiologists play a pivotal role in the cochlear implant process. They provide patient-centered care in the prevention, diagnosis, and treatment of hearing and balance disorders. They guide patients through the implantation process, from initial assessment to post-surgery rehabilitation​​.

Realistic Expectations

It's essential to have realistic expectations about cochlear implants. While they significantly improve hearing capabilities, they do not restore normal hearing. The degree of benefit varies based on several factors, including the age of implantation, previous hearing experience, and post-implantation rehabilitation​​.

Conclusion

Cochlear implants represent a monumental advancement in the treatment of severe to profound hearing loss. They offer a chance for improved communication and a better quality of life. If you or a loved one are experiencing limited benefits from hearing aids, it might be time to consult with an audiologist or a cochlear implant specialist.

For those seeking professional guidance in this journey, the HearingUp network is an excellent resource. HearingUp providers are committed to best practice standards in hearing aid fittings and can guide you towards the best treatment for your hearing needs, including cochlear implant referrals when appropriate. Find a local hearing professional at HearingUp Providers to explore your options and take the first step towards better hearing.

Video transcript

Video transcript

Cochlear implants are the closest thing to a medical miracle that I've witnessed in my life. Hi guys. Cliff Olson, Dr of audiology and founder of Applied Hearing Solutions in Phoenix, Arizona, and in this video I'm explaining what a cochlear implant is and how it works. Coming up.

A cochlear implant or CI for short can look a lot like a hearing aid or just a small disc on the outside, but also has an implanted portion that directly stimulates the auditory nerve and restores the ability to hear. Back in 19 57, 2 Frenchmen electrophysiologist, Andre Giorno and otolaryngologist Charles Za are credited with being the first to stimulate the auditory nerve. However, the first true cochlear implant was implanted by two Americans, otologist William House and neurosurgeon John Doyle in Los Angeles, California on January 9th, 1961. Since that time, the cochlear implant has completely changed the world when it comes to treating individuals with severe to profound hearing loss and deafness. But before I explain exactly what a cochlear implant is and how it works, if you could do me a huge favor and click the like button, it really helps out my channel because it gets these videos in front of a bigger audience.

And while you're at it, if you have not yet hit that subscribe button with notification bell, go ahead and do that as well, because that ensures that you never miss one of my newly released videos and I release multiple new videos every single week. That being said, I really appreciate it. Now let's take a look at what a cochlear implant actually is. A cochlear implant is comprised of two general components. You have the external component and the internal component that both work together. The external component has a speech processor with microphones that pick up sound and converts it into an electrical signal and a transmitter with a magnet that sends that electrical signal to the internal component that is implanted under the scalp. The internal component also has two parts, the receiver stimulator that also has a magnet that receives the electrical signal from the external transmitter and the electrode array, which typically houses anywhere between 12 and 24 individual electrodes that stimulate different regions of the auditory nerve, which is implanted into the cochlea otherwise known as your hearing organ.

The purpose of a cochlear implant is to directly stimulate your auditory nerve with electrical impulses when your cochlea is no longer capable of taking acoustic information and converting it into a signal that can be understood by your brain. In other words, when using a hearing aid to amplify sound no longer provides you with benefit, a cochlear implant can bypass all of the damage structures inside of your ear to stimulate your auditory nerve directly and give you clarity of sound back, and it typically does a very good job at this. Now, I will not get into the criteria that are required for you to actually qualify for a cochlear implant, but I do have a variety of other videos that explain this process that I will link in the description. Instead, I'm gonna take this opportunity to explain how a cochlear implant works. Sound is a vibration of air particles.

That vibration is picked up by the microphones located on top of the processor, very similar to how a hearing aid will pick up sound. This acoustic sound is converted into an electrical signal inside of the processor and sent to the transmitter behind the ear. The transmitter is connected magnetically through the scalp to the implanted receiver under the scalp. The implant receives the electrical signal from the transmitter and sends it down the electrode array that is implanted inside of the cochlea where the signal is converted into electrical impulses that stimulate your auditory nerve directly. Once the auditory nerve receives these electrical impulses, it will send them up the nerve to the brain so you can hear your cochlea is what we call tonotopic, meaning that different regions of the basilar membrane inside of the cochlea are responsible for the perception of different frequencies of hearing. Each electrode stimulates a different frequency region inside of your cochlea that is then transmitted up your auditory nerve to your brain.

The implantation of the internal component of a cochlear implant seems a lot more intimidating than it really is. It is an outpatient procedure that only takes about two hours. Basically, the surgeon will make an incision behind your ear, install the implant, and insert the electrode array into your cochlea, so you back up and that's it. Recovery from the surgery is typically very quick and most individuals do not even need prescription pain medication. The external processor is usually activated one to four weeks after your surgery is completed. The programming of your processor is modified over the course of several visits by your cochlear implant audiologist, very similar to how a hearing aid would be custom programmed for you over time, and that's it. Now you know what a cochlear implant is and how it works. Now, you might be asking yourself, well, how good does a cochlear implant work?

Well, I've personally worked with individuals who had 0% speech understanding when using their hearing aids, who went up to 80% or higher speech understanding when using a cochlear implant that my friend is what we call a miracle. Generally speaking, a cochlear implant at this point is pretty straightforward and it should be something that you're willing to consider if you're receiving limited benefit with hearing aids. Just keep in mind that in many cases, lack of benefit with hearing aids is most likely due to those hearing aids not being fit in programmed by a hearing care professional who follows best practices. Now, if you do not know what best practices are, I highly recommend that you check out my video that I will link in the description because best practices are the only way to ensure that you're receiving the maximum amount of benefit from your hearing aids.

If you want an easy way to find a hearing care professional who follows best practices, make sure that you check out my website hearing up.com to find a hearing up network member near you. Hearing up network members are committed to following comprehensive best practices when selecting fitting and programming hearing aids, and will get you referred for a cochlear implant when appropriate. Cochlear implants are amazing pieces of technology that have the ability to restore your hearing when hearing aids are no longer effective, and now that you know what they are and how they work, it might be worth asking your hearing care professional about if you're not receiving significant benefit from your hearing aids.

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