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The Cochlear Implant Option

Better Hearing for Severe Loss

Hearing loss affects you gradually and can often worsen over time. An audiologist can help determine the best treatment for your experience and for many, if not most, people, that will be a hearing aid. However, hearing aids work through the “normal” auditory pathway and they rely on the inner ear (cochlea) to transmit sound to the auditory nerve. Unfortunately, some sensory cells in the inner ear are simply not able to transmit clear sound.

“In cases of significant hearing loss where there is little or no benefit from traditional hearing aids, audiologists and otologists may recommend a cochlear implant to provide the perception of sound,” says Alan G. Micco, MD, an otolaryngologist at Northwestern Memorial Hospital. “A cochlear implant can be thought of as a cochlear bypass. It replaces the function of the sensory cells in the inner ear and sends auditory information up the auditory pathway beyond the distortions of the cochlea. The implant changes sounds into electrical pulses that directly stimulate the auditory nerve.”

In general, someone who cannot understand speech well enough to use the telephone or someone who uses the phone with difficulty is likely to be a good cochlear implant candidate. The telephone transmits only auditory information and does not provide access to visual cues, so it is a quick estimate of someone’s speech understanding.

Evaluation and Surgery

Getting evaluated for a cochlear implant involves a few steps. First, the care team will perform a CT or MRI scan to determine if a cochlear implant can be easily inserted. If there is narrowing in the inner ear channels, a special electrode array may be necessary. The surgeon needs to know if there is anything unique about an individual’s ear that would affect the surgery or possible outcomes.

Then, an audiologist will do special hearing tests in a sound-treated room while hearing aids are worn. This can often be very frustrating to cochlear implant candidates, but the testing is necessary to determine for sure that test scores meet the candidacy requirements for a cochlear implant.

If you’re a good candidate for a cochlear implant, your team will schedule you for a 90-minute surgery with an otologist, after which you can go home. There is some time between surgery and when the device is fully activated with the externally worn sound processor. At that point, results can vary. Most people report speech is not clear on the first day, but these perceptions change quickly as the brain becomes used to the new source.

Real Experiences, Real Impacts


Liz, 57, has had bilateral cochlear implants for close to 10 years now and hears much of what she needs to hear. People are almost always surprised to learn she has any hearing impairment. She credits much of this to the different programs, or settings, the cochlear implant offers for different noise environments.

“The audio zoom program is incredible for noisy environments,” says Liz. “My family has noticed that, with my bionic ears, I can sometimes hear better in noise than they can!”

“People may ask, how well do the cochlear implants work for you,” Liz continues. “Well, just the fact I can answer someone’s question at all is amazing. Before my implants, I had only 4 percent comprehension and my CIs have given me back the joy of relationships. Perhaps the best thing I can say is that sometimes I forget I have any hearing impairment at all.”


Cochlear implants also gave Patrick back a sense of intimacy that was missing from his life. Since he began to lose his natural hearing at age 14, Patrick was at the mercy of hearing aids and progressively worsening hearing loss. But with cochlear implants, he could see a future, both personal and professional.

“Although the hearing from my bilateral cochlear implants is less than perfect, I have welcomed back to my life the intimacy that only stress free communication can provide,” says Patrick. “The cochlear implant team at Northwestern Medicine provided care and comfort every step of the way from the pre-surgical tests and consults through the surgery and follow-up programming, some of which will continue for the rest of my life. Relearning to hear with a cochlear implant is not easy. But, every day that you do so is elating.”

Learn more about cochlear implants.