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Cochlear Implants

Sometimes hearing aids just can’t provide enough help. We make the sound as loud and clear as possible, but the hearing loss is too severe. And so the sound is just perceived as distortion. Or the amplified sound is still not audible. If this sounds like you, cochlear implants might be the right option for you.

Cochlear implants don’t make sounds louder. Instead, they convert sounds into an electrical signal. This signal is then sent to the auditory nerve via an implanted electrode. The nerve senses the electrical impulses and treats them just like input from the hair cells that normally sense sound.

Getting cochlear implants is a process. You need to find out whether you’re a candidate first. Then the internal part is surgically implanted. And after a short recovery and healing of the surgical site, the implant is finally activated. We’ve laid out the process step-by-step below, and we’re always available to answer questions.

Cochlear Implant Evaluation Process

Cochlear implants aren’t for everyone. They’re meant for people with severe hearing loss whose hearing aids no longer help. So to see whether you might be a candidate, trying asking yourself…

  • Are you currently using hearing aids? How long have you been using them?
  • Do you feel like your hearing aids are helping you? Try Cochlear Americas’ interactive self-assessment tool online.
  • Do you want to hear better? Implantation is a process that requires regular follow up even after the surgery. So motivation is an important factor.

If you think you might be a candidate, come see us for a cochlear implant evaluation. This evaluation is meant to assess whether your hearing status qualifies you to move forward with a medical evaluation. The cochlear implant evaluation consists of…

  • Questionnaires about your medical and hearing health history.
  • A standard hearing test.
  • Hearing aid adjustment and verification.
  • Speech recognition tasks while using your hearing aids.

If you’re found to be a candidate, you’ll be referred for a medical evaluation with an implant surgical team.

Medical Evaluation

You might be a candidate for cochlear implants audiometrically. But you also need to be assessed medically to move forward with surgery. There are questions that need to be answered by a physician before undergoing surgery.

  • Can the hearing loss be treated with a cochlear implant? Cochlear implants work by stimulating the auditory nerve. But if the auditory nerve isn’t intact, they won’t be able to help. Your physician may do some imaging studies, like a CT scan or MRI, to make sure the nerve is intact before scheduling surgery.
  • Are you healthy enough to have surgery? Your physician will get a detailed health history and run some tests to make sure you’re healthy enough to have surgery.
  • Are you aware of the process? We have a lot of information available about the implantation process. But the physician will still want to make sure you’re aware of what you’re getting into.

Once you’ve gone through the medical evaluation and everything checks out, you’ll be scheduled for surgery.

Cochlear implants adult recipients
Cochlear implants illustration

Implant Surgery

Your implant surgery will usually be performed as an outpatient procedure.

  • Someone might shave or clean your scalp around the future site of your implant.
  • Your doctor or hospital staff may insert an IV to administer drugs (ex: anesthesia).
  • You might wear a mask to provide oxygen.
  • You might have cables, monitors, or patches attached to you so your vital signs can be monitored.

Your doctor will create a small incision behind your ear. He or she will then drill out a portion of the bone underneath. This is where the internal magnet will be secured. Your doctor will then drill a small hole through the bone and down into your cochlea. Your doctor may choose one of a few different routes into the cochlea.

  • Cochleostomy: your doctor creates a new opening into the cochlea through which the electrode is inserted.
  • Round window: your doctor inserts the electrode through the round window. The round window is a membrane separating the cochlea from the middle ear.


Your doctor ultimately makes the choice on which route to use. But he or she will consider which route is best to use for you based on well established criteria. For example: can some of your hearing be preserved? Is your cochlea ossifying (hardening that may happen will certain medical problems like meningitis)? What did your doctor find with the imaging studies during the medical evaluation?

Your doctor will check to make sure the electrode is inserted properly and the internal magnet is secured. Then he or she will close up the incision. The entire procedure usually takes about an hour.


You should be aware of the risks of cochlear implant surgery. You may or may not experience some of the side effects and complications listed on the FDA website. Your surgeon should review the risks before your surgery.

After your surgery, there will be a short recovery period. You’ll want to make sure that the incision heals well during this period. So your physician will probably give you some instructions for checking and cleaning it regularly. The length of the recovery period varies. Just follow your physician’s instructions and return to have the incision site checked. Once you’ve been cleared, it’s time for activation!


Activations are when we attach the external part and activate the implant for the first time. They are some of the most exciting appointments in audiology. We get to watch someone hear sounds they’ve never heard before, or haven’t heard in a long time. It’s a special moment, and you may want to share it with someone special. So think about the first voice you want to hear and who you’d like to share the moment with.

We’ll start by running some tests on the internal part. These tests will check the integrity of the electrodes and how powerful the electrical pulses have to be for you to hear sounds. This process is called “mapping.”

After the mapping has been completed, your cochlear implant will be activated for the first time. It’s always important to have realistic expectations for the activation. Because we’re stimulating the nerve with electrical impulses instead of acoustic sound, it’s going to sound different than how you heard before. Some people say voices sound like robots or cartoons at first. But the longer you use the implant, the more natural it will sound as your brain adapts to the new input.

Cochlear has an array of resources to help you adapt to your new implant. After your activation, they can help you get in touch with other cochlear implants recipients and support groups. They also have an aural rehabilitation program available so you can exercise your new ears. The most important thing to remember is that receiving implants is a process that requires work, regular follow-up, and time to adapt. But with the proper mapping and patient motivation, we’ll be with you every step of the way to help you hear the best you can.