But you need to be absolutely certain it's a road you want to go down. Because although they have certain advantages compared to traditional hearing aids, they're also a huge commitment — and they aren't without drawbacks, too. 

How Do Cochlear Implants Work?

A cochlear implant consists of three components.

  • A receiver implanted under the skin behind the ear and connected to the cochlea via a combination of a small wire and a series of electrodes.
  • An external transmitter that clips onto the internal receiver. 
  • An external processor with a microphone that detects and transmits sound from the wearer's surroundings. 

When the implant's processor picks up soundwaves, it converts them to electrical impulses. Those impulses are then sent directly to the cochlea, stimulating the auditory nerve and giving the wearer a sensation of hearing. 

What's the Difference Between a Hearing Aid and a Cochlear Implant?

Whereas cochlear implants typically directly stimulate the auditory nerve, hearing aids at their most basic are little more than amplifiers. They pick up environmental noise, boost it, and then transmit it through the ear canal. The main drawback, of course, is that if structures within the inner ear are damaged enough, no amount of amplification will be enough.

That aside, modern cochlear implants have many of the same functions and features as hearing aids, including control via companion apps and Bluetooth connectivity. 

Who Should Use a Cochlear Implant?

Contrary to popular belief, you don't actually need to be experiencing total hearing loss to be a suitable candidate for cochlear implant surgery. The only real qualifier is that you must have a hearing impairment that is not improved in any noticeable fashion by traditional hearing aids. In some cases of asymmetrical hearing loss, you might even get a cochlear implant in one ear and use a hearing aid in the other. 

Benefits of Cochlear Implants

  • Restored functionality. In cases of severe hearing impairment, particularly if it involves catastrophic damage to the structures of the ear, a cochlear implant can at least partially restore hearing. This is the case even with completely deaf individuals, though the Deaf community is quite divided about the technology.
  • Improved perception of sound. Compared to hearing aids, users of cochlear implants typically report that they are able to perceive and differentiate different pitches and frequencies of sound more accurately. 
  • Helpful for early childhood development. In scenarios where parents, educators, and peers are unable or unwilling to learn sign language, a cochlear implant can play a crucial role in the development of speech and language comprehension. That said, there's a great deal of controversy around the ethics of performing CI surgery on a young child, and there's no guarantee it will succeed. 
  • Better directional awareness. Improved capacity to recognize environmental noise and discern its origin point has the side benefit of allowing a wearer to recognize and avoid potential dangers such as construction sites and emergency vehicles, which might not always be discernible with a typical hearing aid. 

Drawbacks of Cochlear Implants

  • More conspicuous. While some hearing aids are so small they're nearly unnoticeable, the nature of cochlear implants means it's generally obvious when someone has one. This can lead to feelings of self-consciousness in some wearers. 
  • Requires surgery. A cochlear implant must be surgically installed in the wearer, and the procedure tends to be quite complex. Risks may include facial paralysis, meningitis, cerebrospinal fluid leakage, vertigo, and bodily rejection of the implant. The implant must also be surgically removed if the patient no longer wants it. 
  • Inconsistent performance. Cochlear implants do not work for everyone. While some patients may find their hearing almost completely restored, others might see little to no improvement. 
  • Device failure. Certain injuries or incidents may damage the internal components of the implant, requiring further surgery to fix. 
  • Issues with medical testing. Certain procedures, such as MRIs and radiation therapy, cannot be safely performed with cochlear implants. 
  • Requires rehabilitation. The sound transmitted by a cochlear implant is fundamentally different from that transmitted by a traditional hearing aid. Most wearers will need speech therapy and coaching to learn how to interpret them.
  • Cost. Without insurance, a cochlear implant can cost upwards of $30,00 or even $50,000 USD.

When In Doubt, Consult With Your Audiologist

Cochlear implants aren't for everyone. Whether or not you choose to get one is entirely up to you. That said, it's not a decision that should be taken lightly, and even if you feel that your mind is made up, you should still at least discuss your options with a specialist.