Intro:

Cochlear implants have been around in the United States for over 30 years now. The success of this implant has been quite noticeable in adults and especially in children. There is however a need to continue to educate the public on what a cochlear implant can do and what it cannot. This page is dedicated to those seeking information for the fist time, for those seeking to update the knowledge they already have or to use as a resource for loved ones seeking to understand more about the implants. 
Cochlear implants are a medical device. It is up to each individual / parent to choose whether this will help them or their child in their daily lives. The implant requires commitment. Just like any implant, it is necessary to take time to practice, to be patient and follow up with your audiologist for check ups and support.

All about Cochlear Implants:

A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin (see figure). An implant has the following parts:
  • A microphone, which picks up sound from the environment.
  • A speech processor, which selects and arranges sounds picked up by the microphone.
  • A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses.
  • An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve.
An implant does not restore normal hearing. Instead, it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech.  https://www.nidcd.nih.gov/health/cochlear-implants#a
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Myths and facts about hearing implants:

Cochlear implants are expensive
  • The NHS fully funds adults and children who qualify medically for a cochlear implant. See NICE guidance for cochlear implants
Cochlear implant placement involves major surgery
  • The surgery often doesn’t require an overnight stay. Most ear, nose and throat (ENT) surgeons regard it as a routine operation.
Cochlear implantation involves brain surgery
  • Not at all. The surgeon places the internal implant under the skin behind the ear and inserts an electrode into the cochlea, the spiral-shaped part of the inner ear. The surgeon doesn’t go anywhere near the cranial cavity, where the brain is held.
A cochlear implant will destroy your residual hearing
  • Some residual hearing may be lost but this is becoming less likely as surgical implant techniques and electrode designs continue to improve. The softer and more flexible the electrode, the less likely it is to damage the delicate structures of your inner ear. Rates of preserving the remaining hearing of a person are considerably higher today than they were ten years ago. This is due to better surgical techniques and improved electrode designs.
There is no problem with waiting until a child can make up their own mind whether to get cochlear implants
  • Unfortunately this isn’t the case. During the first few years of life, the brain’s capacity to learn to hear is at its peak. The baby’s cochlea is fully formed before birth and doesn’t grow afterwards, which is why it’s possible to implant babies from six months of age. However, if the brain’s auditory pathways (hearing part) are not stimulated, after about three and a half years, a person’s capacity to learn to hear and speak diminishes because that part of the brain is partially given over to other functions. A child needs to be able to hear in order to learn to speak and pronounce words correctly. If they can’t hear themselves, they will not be able to develop normal speech. This doesn’t mean that some benefit can’t be gained from cochlear implantations carried out later, but the results will not be as good as with an early implantation.Most children who are fitted with cochlear implants at an early age don’t display any significant differences in their hearing and speaking abilities from children without hearing problems. [1]Research shows that children with cochlear implants perform better at school, are more likely to attend mainstream schools and have better career prospects than their peers with similar degrees of hearing loss who don’t have implants. [2]An added benefit of early implantation is that speech and language development can also follow a fairly natural pattern.
Hearing with a cochlear implant isn’t like normal hearing
  • Children who receive implants in both ears at an early age have the potential to develop speech to the same level as children with normal hearing.Adults who receive a cochlear implant after losing their hearing tend to report that speech sounds mechanical and high-pitched initially but after rehabilitation, sounds normal again. This is because the brain has adapted to the new sound. However, results vary between individuals.It’s also important to note that the sooner the hearing loss is addressed in adults, the better the chances for a good hearing outcome. [3]
A cochlear implant will become out-dated and will need to be replaced often
  • A cochlear implant is made up of two parts – an internal implant and an external audio processor. The internal implant will last for many years, possibly for life, whereas the audio processor will be changed after a few years. However, most audio processors are specially designed to be ‘backwards compatible’ , which means they can be used with implants from previous generations of technology.
People with cochlear implants can’t go swimming
  • Swimming won’t damage the internal implant so if your audio processor isn’t waterproof, you can simply take it off before swimming. However, many audio processors now have waterproof accessories, which means you can swim and shower wearing them. Scuba diving with an audio processor isn’t recommended because of the increased water pressure at certain depths. Check with the manufacturer to what depth it is safe to dive with the internal implant.
People with cochlear implants cannot understand speech without reading lips
  • Most cochlear implant users don’t necessarily depend on lip reading, though some who relied on it before their operation may still use it in certain situations. Many recipients use the telephone, enjoy music or even play an instrument.
I’m too old for a cochlear implant
  • There’s no upper age limit. As long as you’re fit and healthy enough to undergo implant surgery and handle the device, you can have an implant. There are many users who received their cochlear implant in their eighties or nineties. The oldest person in Europe to have a cochlear implant fitted was Mollie Smith from Warwickshire in 2014, aged 99.
Cochlear implant users must stay away from WIFI devices
  • WIFI devices won’t interfere with your cochlear implants. In fact some modern cochlear implant processors use a form of WIFI to communicate with other devices.
You can’t play active sports if you have cochlear implants
  • It’s perfectly safe to play active sports with cochlear implants, though it’s important to wear suitable headgear in order to protect the audio processors (you don’t have to remove them).
There’s a big risk of facial paralysis with cochlear implants
  • The risk of temporary facial paralysis is now tiny – only 0.2%, according to a large UK audit on implantation in children, published in 2013. It used to be higher in the past as the surgery involves passing the electrode close to a main facial nerve. However, surgical techniques nowadays use a monitoring device, which is why the risk is now so low. In the same audit, there was no permanent facial paralysis. In fact, even the risk of major complications was found to be low, at 1.6%.[4] Your surgeon can explain the risks in more detail.
You can’t have an MRI scan with a hearing implant
  • If your cochlear implant is MRI compatible, you can have an MRI scan. Some are compatible up to 1.5 teslas and others up to 3.0 teslas, the latest technology that allows for really detailed images. If an MRI scan is necessary and your device isn’t sufficiently compatible, you would need to have the magnet in your implant surgically removed before the scan. The same magnet would then be placed inside the implant again.
Cochlear implants have wires coming out of the skin

Who qualifies for a Cochlear Implant:

Adults
  • Individuals 18 years of age or older
  • Moderate to profound sensorineural hearing loss in both ears
  • Limited benefit from amplification defined by preoperative test scores of ≤ 50% sentence recognition in the ear to be implanted and ≤60% in the opposite ear or binaurally1 
Children (2-17 Years)
  • Severe to profound sensorineural hearing loss
  • Limited benefit from binaural amplification
  • Multisyllabic Lexical Neighborhood Test (MLNT) or Lexical Neighborhood Test (LNT) scores ≤ 30%
Children (12-24 Months)
  • Profound sensorineural hearing loss
  • Limited benefit from binaural amplification
Important Considerations:
  • Remember that many individuals with residual low frequency hearing are CI candidates and can benefit from CI.
  • When appropriate, discuss use of acoustic hearing: Does your patient have a passion for music? Work in noisy or reverberant environments? What are lifestyle demands?
  • Determine motivation to experiment with hearing aids, in both the implanted and/or contralateral ears.
  • Discuss the opportunity to use acoustic hearing to manage expectations and rehabilitation options, when appropriate.
​Info from: http://www.cochlear.com/wps/wcm/connect/us/for-professionals/products/cochlear-implants/candidacy

Random Questions and Answers about Cochlear Implants:

How many companies make Cochlear Implants?
Here in the United States there are three companies that supply cochlear implants: 
  • Cochlear Americas                  Located in Australia
  • Med-El                                     Located mainly in Europe
  • Advance Bionics                      Located in the U.S.A
Each of these companies holds a convention either each year or every two years for recipients and professionals. Consider attending to learn, make new friends and have a great time. 
Is it always stuck to my head? 
No. It is attached to your head via a magnet and can be removed whenever you need it to be removed.
Do I sleep with it on?
No. You should take it off for your sleeping hours. You and your brain need rest. Your skin, where the cochlear is placed also needs air and time to dry. 
Is the external component, the processor water proof?
No. It is water resistant. However the various companies now have tools you can use to seal the processor and go swimming without concerns. 

Will I have to have surgery again if I want/need to upgrade?
No. Your internal component is for life. The company makes sure that the new generation is compatible with your current internal component.
Is one company better than the other? 
No. All three implants from the 3 companies do exactly the same thing, help you hear. What will vary is the design and the tools they have available for you.
Does the external component come in various colors?
Yes. Each company has their own design department with their own variety of colors. 
I understand there is a minimum age. Is there a maximum age in which you can get a cochlear implant? 
No. As long as your doctor deems your are in good health, can do the surgery safely and qualify for an implant, there is no age limit for adults. 
My child already uses ASL, will a cochlear implant make him lose that skill? 
Absolutely not. Your child can continue using sign language and work on building their hearing skills. More skills the better.

Going into Cochlear Implant surgery,
suggestions and good tips from the experts
Cochlear implant surgery are now done on an outpatient basis. You go in and out the same day, unless you have a need for additional help after surgery. You will probably need about 1 1/2 to 2 weeks to rest and heal up well after surgery.
Here are some tips that can be useful before, day of and after cochlear implant surgery. 


​Before surgery:
  • Make some meals ahead of time, freeze them so they are available when you come home.
  • If you live alone, see if someone can come around and check on you once you are home.
  • If you live with others, have them around when you take your first shower in case you need a hand.
  • If there are items you will need after surgery that are on high to reach areas, put them lower or on the counter so you don't have to get up on a stool or ladder after surgery. Your balance might not be the greatest after surgery.
  • You might need to sleep in a recliner after surgery, so get one set up before hand. 
  • Have some movies or good books around in case you would like to break up your time while recovering.
Things to bring and to ask for at the hospital the day of surgery:
  • ​Make sure your doctor prescribes pain medication for after surgery that will be appropriate for you.
  • Bring / wear a button down shirt so you don't have to pull anything over your head after surgery. You will have a bandage and a large cup over your ear afterwards. Button down shirts are easier to handle.
  • If you are having surgery only on one side and you wear glasses, take off the footy of your glasses on that side. It will be easier to put your glasses on afterwards.
  • Bring slip-on shoes so you don't have to bend over to tie your shoes after surgery. Bending over or down is a really bad idea after cochlear surgery.​ There is a high chance you will get very dizzy. NO BENDING OVER AFTER SURGERY.​
After surgery:
  • Rest all you need. Don't rush it. Take your time.
  • You will probably be laid up about 1-2 weeks, depending on you and your doctor's instructions.
  • Don't bend over. Have a reacher available or have someone else do the bending. You could lose your balance or become very dizzy and fall over. 
  • You can probably take the bandages off 24 hours after surgery. Follow your doctor's instructions on that.
  • 24-48 hours after you can take a shower. Also follow your doctor's instructions.
  • Any swelling, rashes, out of the ordinary pain, contact your doctor ASAP.
  • If you are home alone, have someone check in on you from time to time. 

Videos:

More info to come....

Disclaimer: Hearing Loss Association of America does not promote one cochlear implant company over another. The choice of implant company is completely up to the candidate.
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