Cochlear implants for children and adults

Cochlear implants can greatly improve quality of life for people with severe hearing loss. While hearing aids help many people hear better, some individuals continue to struggle understanding conversations, especially in noisy environments. Cochlear implants may be an option when hearing aids no longer provide enough benefit.

Prevea was the first in Northeast Wisconsin to bring cochlear implants to our community and we haven't slowed down. Since 2018, our team has performed more than 250 life-changing surgeries, helping hundreds of adults and children hear the voices, music and moments they thought they'd lost.

The program is built around a collaborative, patient-centered approach to hearing healthcare. Our cochlear implant program brings together an experienced surgeon and three audiologists who work as one team to support you at every stage. From your first evaluation through activation, programming, and ongoing follow-up, your care is shaped around your hearing needs and goals.

Below are answers to some of the most frequently asked questions about cochlear implants, including who may be a candidate, how they work, and what to expect during cochlear implant evaluation, surgery and treatment. 

Is a cochlear implant right for you

Am I a candidate for a cochlear implant?

If hearing aids no longer provide enough benefit, you may be a candidate for a cochlear implant. Cochlear implants are designed for children and adults with severe hearing loss who continue to have difficulty understanding speech, even when using properly fitted hearing aids. 

You may benefit from a cochlear implant evaluation if the following apply to you:

• Moderate to profound sensorineural hearing loss in one or both ears.
• Speech does not sound clear even while wearing hearing aids.
• Rely on lipreading to help with communication.
• Ask people to repeat themselves often.
• Have a hard time using the phone.
• Are dependent on closed captioning when watching TV.
• Feel your hearing aids are no longer helping.
• Feel your hearing loss is keeping you from doing the things you want to do or you are withdrawing socially.
• For children, the child
  • was diagnosed with severe to profound sensorineural hearing loss at birth.
  • has been using hearing aids but is struggling in school or asking people to repeat themselves even with hearing aids on.

How do I know if hearing aids are no longer enough? 

Hearing aids are often the first treatment for hearing loss, but they may not provide enough benefit for everyone. If you continue to struggle hearing conversations, especially in noisy environments, or have difficulty understanding speech despite wearing hearing aids, it may be time to ask about a cochlear implant evaluation.  

A Prevea audiologist can perform specialized hearing tests and work with an ENT specialist to determine whether hearing aids remain the best option or if a cochlear implant may provide greater benefit.

Who gets cochlear implants?

Children and adults who are deaf or severely hard-of-hearing can be fitted for cochlear implants. 

Cochlear implants are FDA-approved for use in children beginning at 12 months of age. For young children who are deaf or severely hard-of-hearing, using a cochlear implant while they are young exposes them to sounds during an optimal period to develop speech and language skills. 
 
Some adults who have lost all or most of their hearing later in life can also benefit from cochlear implants. They learn to associate the signals from the implant with sounds they remember, including speech, without requiring any visual cues such as those provided by lip reading or sign language. 

What you need to know

What is a cochlear implant?

A cochlear implant is an electronic hearing device that is surgically placed inside the ear. It is designed for people with significant sensorineural hearing loss (damage to the inner ear or hearing nerve). Unlike hearing aids, which amplify sound, cochlear implants bypass damaged parts of the inner ear and directly stimulate the auditory nerve. 

A cochlear implant does not restore normal hearing and often sounds different than natural hearing. However, many people experience improved speech understanding and communication with a cochlear implant. With improved access to sound, cochlear implants can also help people feel more connected to their families, friends and the world around them. 

How does a cochlear implant work?

A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so they can be detected by the remaining functioning parts of a damaged ear. Cochlear implants work differently by converting sounds into electrical signals that are sent directly to the auditory nerve. The auditory nerve carries these signals to the brain, where they are recognized as sound. Hearing through a cochlear implant takes time to learn. 

An implant has two main parts:

• External sound processor: The processor sits behind the ear and uses a microphone to pick up sounds around you. It processes sounds and sends the information across the skin to the internal implant via a magnet. 
• Internal implant: The internal portion is placed under the skin during surgery. It receives information from the sound processor and sends electrical signals to an electrode array inside the cochlea (inner ear). The electrical signals stimulate the hearing nerve, which carriers information to the brain. The brain then intreprets these signals as sound.  

How does a cochlear implant sound?

Hearing with a cochlear implant can sound very different at first. Many people describe early sounds as electronic, robotic or unusual. This is a normal part of adjusting as your brain learns to interpret the new signals.

Everyone’s experience is different. Some people understand speech on the first day. Others hear mostly noise or unfamiliar sounds at first. Voices may sound high-pitched or cartoon-like, and music and familiar sounds may not sound the way you remember.

The good news: sound quality typically improves with time and practice. For some people, speech and everyday sounds begin to sound more natural within a few months. For others, it can take up to a year.

Your audiologist will work with you through programming and follow-up appointments to fine-tune your implant as your brain adapts.

The process

What happens during a cochlear implant evaluation?

The evaluation takes place over a few appointments. Here’s what to expect:

1. Meet your care team
You’ll meet with our cochlear implant surgeon to talk about the process, whether an implant may be right for you, and any medical considerations or surgical risks. You’ll also see an audiologist for an updated hearing test and a check of your hearing aids.

2. Complete your hearing evaluation
With your hearing aids on, you’ll complete several speech-understanding tests. These help your audiologist determine whether you’re a candidate for a cochlear implant. Your audiologist will also explain how cochlear implants work and answer your questions. Afterward, you’ll meet with the surgeon again to discuss any other surgical considerations.

3. Get a CT scan
A CT scan provides detailed images of your inner ear (cochlea) and other hearing structures. This helps your surgeon plan the procedure.

What happens during cochlear implant surgery?

Cochlear implant surgery takes place in a hospital operating room. You’ll be under general anesthesia, so you’ll be asleep and comfortable the whole time. The procedure usually takes about two hours. Most people go home the same day.

What happens after surgery?

1. Fit your sound processor. Your audiologist will choose the right magnet strength to hold your external sound processor in place.
2. Program your implant. Using special computer software, your audiologist will play sounds, like beeps, and ask you how loud they seem. Children are programmed using different, age-appropriate methods.
3. Turn on your implant. Your audiologist will talk with you and adjust the volume so sounds are comfortable enough to wear your implant all day.
4. Show you how to use it. You’ll learn how to use and care for your sound processor at home.

• 2 weeks after activation
• 1 month after activation
• 3 months after activation
• 6 months after activation
• 9 months after activation
• 1 year after activation
• Every 1 to 2 years after that

Get started

With help from a cochlear implant, the world can open up for those who are deaf or hard-of-hearing. If you think that cochlear implants could be right for you, schedule an appointment to talk to a Prevea audiologist. And, as with any medical procedure, you'll want to connect with your insurance company to understand your insurance coverage.