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About Cochlear Implants

Frequently asked questions about about about cochlear implants:

The cochlea is the organ of hearing. This pea-sized structure, located deep inside the ear, sends sound information to the brain where it is heard as sound. Inside the cochlea are very delicate hair cells, which enable the individual to hear different pitches and rhythms of sound. If the hair cells are damaged, the individual has severe to profound sensorineural hearing loss.

A cochlear implant is a safe, FDA-approved medical device that transmits sound past the damaged hair cells of the ear, enabling deaf children to hear electronically. The internal portion–the implant–is positioned in the cochlea of the ear. The external portion–the processor–is positioned close to the child’s outer ear. The processor picks up sounds with microphones and sends them to the implant, which stimulates the hearing nerve directly.

How natural hearing works

How cochlear implant hearing works

Ear canal: Sound moves through the ear canal and strikes the ear drum

Sound processor: External sound processor captures sound and coverts it into digital signals

Eardrum and bones: Sound waves cause the eardrum to vibrate, sending the bones in the middle ear into motion

Digital signals: Processor sends digital signals to internal implant

Inner ear: The motion causes the fluid inside the inner ear (cochlea) to move the hair cells inside the inner ear

Electrode array: Internal implant converts signals into electrical energy, sending it to an electrode array inside the cochlea

Hearing nerve: Hair cells change the movement into electric impulses, which are sent to the hearing nerve in the brain, enabling the person to hear.

Hearing nerve: Electrodes stimulate the hearing nerve, bypassing damaged hair cells. The brain perceives the signals as sound, enabling the person to hear.

For some children, a hearing aid is simply not enough. Hearing aids only amplify sound. For children with severe to profound hearing loss making sounds louder does not make them clearer. For these children, even the finest, most advanced hearing aids will not work effectively. While hearing aids may provide minimal benefit to some, what they hear will not be clear. They will find it difficult to understand speech and other sounds. With even the best hearing aid, children with severe to profound hearing loss are unable to interpret sounds well enough to learn to understand the spoken word and to develop the ability to speak.

In contrast to a hearing aid, a cochlear implant does not make sounds louder--instead it bypasses the damaged part of the ear, sending sounds directly to the auditory (hearing) nerve, mirroring the intricacies of natural hearing for the child.

Cochlear implants are not for everyone. To know whether a cochlear implant may be right for your child, you first need to know the extent of the hearing loss. Children with mild to moderate hearing loss are not candidates for cochlear implants. Hearing aids and other forms of amplification can usually help them. Cochlear implants are most likely to help children who have severe to profound sensorineural hearing loss (nerve deafness). Children with this type of hearing loss get little or no benefit from hearing aids.

The earlier a child receives an implant, the greater the potential to develop listening/speaking skills at the same level as peers who have no hearing loss. The multidisciplinary cochlear implant team at the University of Chicago Medicine Comer Children’s Hospital, as well as audiologists and specially trained teachers in the educational system in your community, have the ability and resources to help your child make as much progress as possible with listening/speaking skills.

Finally, for your child to be successful with a cochlear implant, your family must have a strong commitment. You are the most important part of the process!

There are many families whose children have had cochlear implants at Comer Children’s. They would be happy to share their experiences with you to help you while you are in the decision-making process.

The cochlea is fully formed at birth, so your child will not outgrow the implant. The skull is almost full-grown by the time a child is two years old, and the electrode array is designed to accommodate this skull growth in children under two.

The cochlear implant is designed to last a lifetime. Its design has changed relatively little since it was first created over 30 years ago. Conversely, the methods that deliver the signal to the receiver have changed significantly over time. However, the external speech processor, which stores this programming, is designed to accept new programming as it is developed. And the speech processor itself can be easily replaced if technology improves.

What is more important is that the cochlear implant be received as soon as possible. To learn to communicate verbally, your child must learn to interpret the sounds received. The longer your child goes without hearing these sounds or hearing them clearly, the more difficult it will be to interpret these sounds.