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Cochlear Implants - Their Working, Placement, and Benefits

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Cochlear implants are indicated in patients with severe to profound hearing loss and who had no benefit from hearing aids.

Medically reviewed by

Dr. Satyabrata Panigrahi

Published At January 5, 2023
Reviewed AtApril 25, 2023

What Is a Cochlear Implant?

A cochlear implant is an electronic device that is given advice for patients who have severe to profound hearing loss. This device will help these patients to have a better sense of hearing who did not benefit from other hearing devices. When cochlear implants are given to infants, it will help them to listen and learn to speak.

The parts of the cochlear implant are:

  • Microphone- The microphone is the part of the cochlear implant which picks up sound from the surrounding.
  • Speech Processor- Speech processors process the sound that the microphone picks up.
  • Transmitter and Receiver- They receive the speech processor's signal and convert it into electric impulses.
  • Electrode Array- This part is a collection of electrodes that are involved in collecting and sending the impulse to different regions of the auditory nerve.

Unlike other hearing aids, the patient takes around three to six months of time to understand the signals received from a cochlear implant.

How Does a Cochlear Implant Work?

Cochlear implants are different from other hearing aids. The hearing aids work by amplifying the sound so the damaged ear can detect them. Whereas the cochlear implant works by bypassing the sound signals from the damaged portion of the ear and the sound signals directly stimulate the nerve. The auditory nerve sends the signals generated by the implant to the brain, which identifies the signals as sound.

What Are the Indications of Cochlear Implant?

The healthcare provider and the audiologist will consider someone for a cochlear implant if they have severe or profound hearing loss and need to rely on lip-reading to understand speech. This device will improve hearing and thereby enhance the quality of life.

The indications for getting a cochlear implant surgery are:

  • When one has hearing loss, and other hearing aids are not helping one to improve the hearing.
  • When one can hear in both eras, but there is clarity to what one hears.
  • Need to rely on lip-reading to understand the speech.

Children can use cochlear implants as young as six months to older adults. This device is seen to benefit people of both extreme ages suffering from hearing loss.

What Causes Severe to Profound Hearing Loss?

There are various conditions that can cause severe to profound hearing loss and they are as listed below:

  • Genetic - The most common type of hearing loss that is seen in children is genetic hearing loss. This can be caused due to some defect in the child's gene.

  • Ototoxicity - There are many medicines that can cause hearing loss, among which the most commonly causing is the aminoglycoside antibiotics.

  • Trauma - Trauma to the head and neck region can affect the hearing, in some cases, and result in hearing loss.

  • Infections - Some infections like meningitis and congenital cytomegalovirus infection, can result in severe hearing loss.

  • Meniere’s Disease - This disease is characterized by vertigo, hearing loss, and tinnitus (ringing sound). With the progression of the disease, this condition can result in profound hearing loss.

  • Noise-Induced Hearing Loss - This type of hearing loss is caused due to sudden exposure to loud noise. The hearing loss can be unilateral or bilateral. The hearing loss can be temporary or permanent. In case of permanent hearing l the condition can progress to a situation where just amplification cannot serve the purpose.

  • Presbycusis - This is a condition where the hearing loss occurs as a result of aging. Initially, the hearing loss begins with the high-frequency sounds, which will progress to impair the hearing of low-frequency sounds too. Patients with moderate to profound hearing loss will benefit from cochlear implants more than from other hearing aids.

What Are the Benefits of Cochlear Implants?

People who use cochlear implants have reported to have experienced:

  • Ability to understand the speech without the need to rely on lip-reading.

  • Able to recognize everyday sounds.

  • Ability to understand speech even when there are background noises.

  • They are now able to enjoy television programs, music and understand telephonic conversations.

What Are the Complications Associated With Cochlear Implant?

The cochlear implant is safe but can cause complications at times such as:

  • Loss of Residual Hearing- Sometimes, when the cochlear implant is given, some patients have experienced the loss of remaining unclear natural hearing in the ear where the implant is placed.

  • Meningitis- Meningitis is the inflammation of the surrounding brain and spinal cord membranes. Before cochlear implants are placed, the patients are given vaccines to prevent this.

  • Failure of the Implant- Sometimes, surgeries are needed to repair or replace the faulty implant.

The other complications associated with a cochlear implant such as:

  • Bleeding.

  • Facial paralysis.

  • Balance issues.

  • Change in taste.

  • Leakage of spinal fluid.

  • Infection from the device.

  • Dizziness.

  • Tinnitus (ringing sound in the ear).

  • Numbness around the ear.

  • Dry mouth.

  • Risks of general anesthesia.

There can be other risks involved in case one suffers other medical conditions.

How Is the Result After Using Cochlear Implants?

The results from using cochlear implants will vary from person to person and will depend upon the degree of hearing loss one had. The factors affecting the outcome after using a cochlear implant are the age when one had hearing loss and the time period they had hearing loss and received a cochlear implant. In the case of children born with severe hearing loss, the results will be better if they receive the implant at an early age. In the case of adults, the results will be better when the time duration between hearing loss and implant placement is short.

The predicted outcome of a cochlear implant includes:

  • Better Hearing- The people who start to use the cochlear implant will find that their hearing improves with time.
  • Improved Tinnitus- Even though tinnitus is not an indication for receiving cochlear implants but with time, the patient notices improvement in tinnitus. It can rarely increase the severity of tinnitus.


Cochlear implants are a device that is advised for patients with severe to profound hearing loss. Hearing loss is a condition that can affect the quality of life. If one has difficulty hearing or understanding speech, get a consultation from an ENT (ear, nose, and throat) specialist at the earliest. And most of the treatment options will have good results when the treatment is provided at the earliest.

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Dr. Satyabrata Panigrahi
Dr. Satyabrata Panigrahi



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