Top 3 Pros and Cons of Cochlear Implants
January 28, 2022

Hearing is an important sense, and as such, there are a number of different innovations that have been created throughout the years. These aim to allow individuals to retain their sense of hearing in the face of hearing difficulties and disorders.

The most well-known and popular hearing assistive device is the hearing aid. A hearing aid is considered an acoustic hearing assistive device. It works by amplifying the sounds that enter the ear.

Acoustic-based hearing devices have been around for hundreds of years. While devices are immensely useful for a wide range of people, it is not particularly helpful to those that are effectively deaf. 

Cochlear implants are a very different approach to the same problem of allowing individuals to hear. Below is a closer look at what a cochlear implant is as well as the pros and cons of this medical device.

What Is a Cochlear Implant?

The cochlear implant is one of many alternative forms of hearing assistive devices available. Other than hearing aids, cochlear implants are one of the more popular options. But, they are a much more invasive approach that involves the surgical implantation of the device.

Below is a detailed look at what a cochlear implant looks like and how it helps individuals to hear.

Cochlear Implant

The cochlear implant consists of two distinct components. The first component is the internal component that is implanted into the inner ear. This part of the device consists of electrodes that are placed into the inner ear and a receiver to communicate with the external device. This component of a cochlear implant is built to last a lifetime. 

The second component to the cochlear implant is the external unit and this can be thought of as the replacement ears and the brains of the operation. The external unit contains microphones in addition to a processor and a transmitter.

The microphones take in the sounds in your environment, and the processor takes this info and transforms it into the correct format. Then, the signal is sent from the transmitter to the receiver located within the body. There, the electrical impulse is discharged in the specific region of the inner ear. 

How the Cochlear Implant Works in the Body

Normal, natural hearing is quite complex, but it can fall into two separate categories: sensorineural and conductive.

Those that are eligible for a cochlear implant tend to have a severe form of sensorineural hearing loss. This is a form of hearing loss where the inner ear, also known as the cochlea, doesn’t function as it should.

Under normal conditions, the cochlea works thanks to the sensory hairs that line the inside walls of the snail-like structure. Each hair is finely tuned to a specific sound.

When the cochlea vibrates, the corresponding sensory hair bends and sends an impulse out of the ear. With severe sensorineural hearing loss, the sensory hairs don’t function as they should; this is where the implant comes in. 

The most crucial part of the cochlear implant is the internal electrode array. The electrode array is inserted into the snail-like structure of the cochlea. The electrode is a thin ribbon-like structure with a number of different outputs. These different outputs allow for signals to be sent to different parts of the cochlea, just like what is experienced when the sensory hairs would normally bend. 

The outer unit has microphones and a processor. The processor analyzes the sound and maps out where electrical signals should be sent in the cochlea. All of these components work together to effectively replace your ears with a bionic counterpart. 

Pros of Cochlear Implants

The choice of whether or not you should get cochlear implants can be a difficult choice to make. There are a number of factors that you need to consider. Creating a pro and con list is a great way to help you decide.

This is a closer look at the top pros of getting cochlear implants and what they can add back to your life. While these may not be your top reasons, they can provide you with some beneficial aspects of getting cochlear implants. 

Restore Some Level of Hearing

The most obvious benefit of getting cochlear implants is that they can provide you with a level of hearing that is simply not possible with standard hearing aids if you are profoundly hearing impaired. When you are at the stage of hearing loss that borders on deafness, you can either accept the hearing loss or attempt a procedure like a cochlear implant. 

Oftentimes, those that are profoundly hearing impaired have experienced a gradual and steady decline in hearing. While hearing aids may have allowed them to hold onto their hearing for a little while longer, at some point, they are not able to amplify sounds loud enough. Cochlear implants offer these individuals a real chance of being able to perceive the sounds around them and regain a sense that was seemingly lost without the implant. 

Increase Social Interaction

Another benefit of cochlear implants is that they can allow the profoundly hearing impaired a heightened ability to converse with others and engage in conversation. One aspect of hearing loss that isn’t discussed as frequently as it should is that hearing loss can cause individuals to withdraw themselves socially. This can have negative implications on mental health. 

Reading lips can only take an individual so far. By having auditory cues in addition to reading lips, many individuals can find it easier to converse with others after getting their cochlear implant. 

Volume Discrimination

Another pro to come from cochlear implants is they can allow individuals the ability to distinguish different sound levels of noise. When individuals begin to get into the higher degrees of hearing loss, it can be difficult to distinguish loud sounds from softer sounds.

In these cases, the hearing aids will be outputting noises at the upper limit of their capability. So, essentially, all sounds will be at approximately the same level. 

Once an individual has undergone the initial adjustment period, they may be able to regain their ability to distinguish between soft sounds and loud ones. This may seem like a small win but, in day-to-day life, it can be incredibly helpful.

Being able to tell the difference between someone walking versus knocking on the door is a great example of how this aspect of cochlear implants can be helpful. 

Cons of Cochlear Implants

While cochlear implants can sometimes just seem like the next logical choice after you are done with hearing aids, there are potential reasons as to why you may not want cochlear implants. Understanding the potential downsides can ensure that you are making an educated decision and that you are fully aware of what could come. 

Read on for a closer look at the cons of cochlear implants. 

Surgery Risk

One of the largest cons that makes many people think twice about cochlear implants is that it requires surgery and that surgery has surgical risks. Any time you are placed under anesthesia, and there is an incision, you run the risk for a number of different surgical complications. Some potential risks that are specific to the cochlear implant are the potential damage to facial nerves, a CSF leak, vertigo, tinnitus, and potentially meningitis. 

This is not a full list of potential complications but you can further discuss with your doctor the potential complications for your specific situation. While each cochlear implant is similar, people’s situations aren't, and what may be a low-risk surgery for one person may be considered a high-risk surgery for another. 

Sound Distortion 

Another aspect to consider is that even when you become fully adjusted to your cochlear implants, it won’t be a replacement for the full normal hearing you had before. When you first turn on the unit following the recovery after surgery, sounds will sound quite different from what you remembered.

This is because there is some level of distortion that will always be present. You are no longer utilizing the acoustics of the ear but rather the programming and stimulation of a computer. 

Commitment

The last con of cochlear implants is that once you choose a unit, you are strongly committed to that specific unit since half of it is implanted in your head. Many times you can upgrade the outer unit, but the internal unit is quite the commitment. 

Another way that you are committed is that a cochlear implant can reduce whatever remaining sense of natural hearing you had from before. For most cochlear implant candidates, however, this isn’t much of a commitment since the hearing loss tends to be quite severe. 

Hearing Solutions

Cochlear implants are assistive hearing devices that can allow the profoundly hearing impaired an opportunity to hear sounds again. If you are a candidate, the decision is a large one and being confident in your decision is essential. Hopefully, this article has helped to provide some education and information to help guide your own decision. 


Sources

Cochlear implant – state of the art | NCBI

Benefits and Risks of Cochlear Implants | FDA

Current indications for cochlear implantation in adults and children | NCBI

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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