A cochlear implant is a small electronic device that helps people hear. It can be used for people who are deaf or very hard of hearing. A cochlear implant is not the same thing as a hearing aid. The device is surgically implanted and works in a different way.
There are many different types of cochlear implants. However, they made up of several similar parts. One part is implanted into the bone around the ear (temporal bone) using surgery. It is made up of a receiver-stimulator. This part of the device accepts, decodes, and then sends an electrical signal to the brain.
The second part of the cochlear implant is outside the ear. It is made up of a microphone/receiver, a speech processor, and an antenna. This part of the device receives the sound, changes the sound into an electrical signal, and sends it to the inside part of the implant.
WHO USES A COCHLEAR IMPLANT?
Cochlear implants allow deaf people to receive and process sounds and speech. To some degree, these devices allow deaf people to "hear." It is important to note that these devices do not restore normal hearing. They are tools that allow sound and speech to be processed and sent to the brain.
Both children and adults can be candidates for cochlear implants. They may have been born deaf or became deaf after learning to speak. Children as young as 1 year old are now candidates for this surgery. The basis for selection may vary slightly from adults to children. The basic guidelines are:
HOW IT WORKS
In a normal ear, sounds are transmitted through the air, causing the eardrum and then the middle ear bones to vibrate. This sends a wave of vibrations into the inner ear (cochlea). These waves are then converted by the cochlea into electrical signals, which are sent along the auditory nerve to the brain.
A deaf person does not have a functioning inner ear. A cochlear implant attempts to replace the function of the inner ear by turning sound into electrical energy. This energy can then be used to stimulate the cochlear nerve (the nerve for hearing), sending "sound" signals to the brain.
Most cochlear implants have similar parts.
HOW IT IS IMPLANTED
During the surgery:
RISKS OF SURGERY
Most of the time, a cochlear implant is a safe surgery. However, all surgeries pose some risks. Common risks include:
These are problems are rare now that the surgery can be done through only a small cut.
Less common complications include:
RECOVERY AFTER SURGERY
Following your operation:
The implant will be attached to the outside processor when the surgery is healed. You will begin to work with specialists to learn to "hear" and process sound using the cochlear implant. These specialists may include:
Working with the specialists after surgery is a key part of the process. You will need to make a joint effort with your health care team to get the most benefit from the implant.
Results with cochlear implants vary widely. How well you do depends on:
Some patients can learn to communicate on the telephone. Others can only recognize sound. Getting the most results can take up to several years. You need to be motivated. Patients are often enrolled in hearing and speech rehabilitation programs.
LIVING WITH AN IMPLANT
Once you have healed, you may need to make some changes. Most activities are OK. However, some health care providers recommend avoiding full-contact sports. This is to lessen the chance of trauma to the implanted device.
Most patients with cochlear implants cannot get MRI scans, because the implant is made of metal.
Balkany TJ, Brown KD, Gantz BJ. Cochlear implantation: Medical and surgical considerations. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 159.
Brown KD, Balkany TJ. Benefits of bilateral cochlear implantation: a review. Curr Opin Otolaryngol Head Neck Surg. 2007;15:315-318.
Papsin BC, Gordon KA. Cochlear implants for children with severe-to-profound hearing loss. N Engl J Med. 2007;357:2380-2387.
Sparreboom M, van Schoonhoven J, van Zanten BG, et al. The effectiveness of bilateral cochlear implants for severe-to-profound deafness in children: a systematic review. Otol Neurotol. 2010 Sep;31(7):1062-71.
Updated by: Ashutosh Kacker, MD, BS, Associate Professor of Otolaryngology, Weill Cornell Medical College, and Associate Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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