Clinic consultation

Mayo Clinic Q&A: What is the advantage of cochlear implants over hearing aids? | Way of life

DEAR MAYO CLINIC: I am 70 years old and have been wearing hearing aids for about a decade. Over the past few years, my hearing seems to be deteriorating. Although I have tried several types of hearing aids, I feel that they are no longer effective. A friend suggested I ask an audiologist about cochlear implants. I thought it was just for deaf people. Could a cochlear implant help someone like me? How it works?

ANSWER: A cochlear implant might be a good alternative to hearing aids in your situation. It is true that when they were introduced in the 1980s, cochlear implants were mainly used for people with complete hearing loss. Today, however, they are often used to help people who have more advanced hearing loss that cannot be corrected 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 in the middle ear transmit vibrations as they travel to the inner ear. In the inner ear, vibrations pass through fluid in a snail-shaped structure called the cochlea.

Inside the cochlea are thousands of tiny sensors, called hair cells, that convert vibrations into electrical signals that are sent to your brain via your auditory nerve. The vibrations of different sounds affect these tiny hairs in different ways, causing nerve cells to send different signals to your brain. That’s how you tell 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. This means electrical signals cannot be transmitted effectively to the brain, and the result is hearing loss. A cochlear implant replaces the function of hair cells by sending electrical signals directly to the auditory nerve and restoring the brain’s ability to perceive sound.

The implant has two main parts: an external processor that fits behind your ear and an internal receiver implanted under the skin behind your ear. The processor captures and processes the sound signals, then sends these signals to the receiver. The receiver sends the signals to tiny electrodes that are placed directly into the cochlea when the device is implanted. These signals are received by the auditory nerve and directed to your brain, and your brain interprets these signals as sound. All parts of a cochlear implant are small, and the processor that sits behind your ear looks like a hearing aid. Due to the small size of these devices, they are relatively inconspicuous, especially among people with long hair.

Cochlear implantation requires consultation with an ear, nose and throat surgeon who would perform a relatively short outpatient surgery. A small incision is made behind the ear to insert the device. Most people experience little discomfort from the surgery and its overall risk is low.

After a patient has had a chance to heal – usually several weeks after surgery – an audiologist connects the processor to the implant for the first time. The patient should be able to hear immediately, but many cochlear implant users report that they have had to adjust to the sounds they hear with their implant. This adjustment process often takes at least six months, with many patients reporting that sound quality and their ability to understand speech continue to improve for a year or more.

Cochlear implants are a well-established technology. At first, doctors and researchers only recommended them for people with complete hearing loss. Over the years, however, research has shown that cochlear implants can be helpful for people who still have some hearing or who have useful hearing in only one ear. They can be particularly helpful for people who have difficulty understanding speech in everyday listening situations, despite using good hearing aids.

Speak to a healthcare professional who specializes in hearing loss to find out if you would be a good candidate for a cochlear implant. Most people who receive a cochlear implant find that they can communicate better with the people around them and participate more fully in conversations and other daily activities that require the ability to hear clearly. — Dr. Joseph Breen, ENT — Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida

___

©2022 Mayo Clinic News Network. Visit newsnetwork.mayoclinic.org. Distributed by Tribune Content Agency, LLC.