A cochlear implant is an electronic device that partially restores hearing in people who have severe hearing loss due to damage of the inner ear and who don't benefit from hearing aids. A processor behind the ear captures and processes sound signals, which are transmitted to a receiver implanted behind the ear. The receiver sends the signals through wires to the snail-shaped inner ear (cochlea), then via the auditory nerve to the brain, which interprets them as a form of hearing. It takes time and training to learn to interpret the signals received from a cochlear implant.

Although results vary from person to person, most find that cochlear implants help them communicate better and improve their quality of life. They report:

  • Improved ability to hear speech without needing visual cues
  • Improved ability to recognize normal, everyday environmental sounds
  • Improved speech reading
  • The ability to hear soft sounds
  • The ability to find where sounds are coming from

Eligibility criteria

Criteria to be a candidate for a cochlear implant:

  • Severe-to-profound hearing loss in both ears caused by sensorineural damage to the inner ear
  • Limited benefit from hearing aids as determined by specialized audiologic testing
  • No medical or radiologic conditions or factors that increase the risks associated with cochlear implants
  • High motivation to participate in rehabilitation sessions and to be part of the hearing world
  • Clear understanding of what cochlear implants can and cannot do for hearing

Mayo Clinic has performed cochlear implants in children as young as 1 year of age and adults as old as 96.

Evaluation

You undergo many tests during several outpatient visits, including:

  • Hearing test
  • Hearing aid evaluation
  • Speech understanding with appropriate hearing aids
  • Balance assessment
  • MRI scan
  • Medical evaluation
  • Insurance consultation
  • Audiologic consultation
  • Psychology consultation
  • Speech pathology consultation

Surgery

Surgery is performed while you are under general anesthesia and takes approximately one to three hours. The ear, nose and throat surgeon makes an incision behind the ear and forms a slight depression in the mastoid bone, where the internal device rests. The surgeon then creates a small hole in the cochlea and threads the electrode array of the internal device through this hole. The incision is closed so that the internal device is beneath the skin. Most people feel well enough to return home the day of surgery.

Activation

Two to four weeks after surgery, the external components of the device can be programmed and activated. There's no hearing ability from the implant until this is done.

The activation comprises:

  1. Fitting the headset. An audiologist attaches a headset that consists of a transmitter and a microphone-speech processor. The transmitter sends sound signals across the skin to the internal receiver-stimulator.
  2. Cochlear implant check. Every component, including each electrode, is checked to make sure it's working properly.
  3. Programming the speech processor. An audiologist creates a "hearing map," an individually designed set of instructions that tells each electrode how to stimulate the nerve endings in the cochlea.
  4. Trying it out. The speech processor is turned on, and you hear through the cochlear implant for the first time. On this first day, speech usually sounds garbled or high-pitched. Environmental sounds may be difficult to identify. Over time, speech and environmental sounds become clearer and more natural. The audiologist will verify that you can tolerate a range of sounds, such as soft speech, conversational speech, loud speech, hand clapping, coughing or doors shutting.
  5. Instruction. The audiologist shows you how to wear and operate the speech processor and its accessories and how to maintain the device.
  6. Fine-tuning. You will return several times over a year to program the device for optimal performance.

Rehabilitation

Rehabilitation involves training the brain to understand sounds heard through the cochlear implant. Speech and everyday environmental noises will sound different from what you remember; the brain needs time to recognize what these sounds mean. This process is ongoing and is best achieved by wearing the speech processor continuously during waking hours.

You may be given listening exercises to do at home. The difficulty level of these exercises varies. Some people may need weekly rehabilitation therapy to help retrain the brain to hear. Speech therapy may be recommended for people whose speech has been significantly affected by hearing loss.

Bilateral cochlear implants

Bilateral cochlear implants are increasingly being accepted as standard care for the treatment of severe hearing loss. This is particularly true for infants and children who are acquiring speech and language.

Bilateral cochlear implants have been documented to provide significant hearing benefit for children and adults, related to quiet, noise, reverberation and localization of sounds. There's also evidence that bilateral cochlear implants significantly improve the quality of life in people with severe hearing loss and that the cost of the second implant is offset by its benefits.

  • Skilled teams. Each Mayo Clinic location has a specialized team for evaluating, treating and rehabilitating hearing loss. These teams include ear, nose and throat (ENT) specialists, audiologists and speech-language pathologists.
  • Experience. Each year, our cochlear implant teams implant more than 150 Food and Drug Administration-approved cochlear implant systems in adults and children.
  • Long-term support. Mayo Clinic providers are committed to the long-term support of people who receive a cochlear implant, from the initial fitting and programming of the device, through rehabilitation, to ongoing management of device performance.
  • Continuous improvement. Mayo researchers are continually trying to improve cochlear implant technology and care, with a special focus on hybrid devices that blend hearing aid and cochlear implant technologies.

Read more about cochlear implants at Mayo.

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Cochlear implants are available for children and adults. Care is provided by specialists in audiology and ENT (otorhinolaryngology). Cochlear implant surgery is performed at Mayo Clinic Hospital on the Phoenix campus.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in audiology offer cochlear implants for children (age 12 and older) and adults. Cochlear implant surgery is performed at Mayo Clinic's hospital. Pediatric specialists at Nemours Children's Clinic in Jacksonville, Fla., provide the pre-evaluation and postsurgical treatment of children with cochlear implants.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in audiology offer cochlear implants for children and adults. Cochlear implant surgery is done at Mayo Clinic Hospital, Saint Marys Campus. The contact number for the cochlear implant program is 507-266-1965.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Research on cochlear implants has focused on current and future implant technology, bilateral cochlear implantation in adults and children, and speech perception and psychoacoustic properties of hearing in cochlear implant recipients.

Mayo researchers are evaluating the effectiveness of a "hybrid" cochlear implant that stimulates the area at the base of the cochlea electrically, while also providing the acoustic amplification of a hearing aid. Hybrid devices preserve residual hearing in an ear as the patient uses both cochlear implant technology and a traditional hearing aid apparatus in the same ear.

Mayo Clinic publications

See a list of publications on cochlear implants published by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine.