PHOTO PROVIDED Pictured above is a chart to showcase the different parts of a cochlear implant.

A cochlear implant is an electronic medical device designed to restore the ability to perceive sounds and understand speech by individuals with moderate to profound hearing loss.

Children and adults who are not sufficiently helped by hearing aids may benefit from cochlear implants. Unlike a hearing aid, which delivers amplified sound acoustically, a cochlear implant is surgically implanted and bypasses damaged hair cells in the cochlea and stimulates the remaining nerve fibers through the application of electrical current directly to the auditory nerve.

A cochlear implant is a device for people whose hearing technology needs may be far beyond hearing aids. I am inserting a picture to help you visualize the implant.

Like last month’s article on genetic hearing loss in pediatric patients, cochlear implants are not part of my practice scope of service, but I like to use these monthly visits to talk about hearing health care. I have a friend in the industry that has a very significant background with cochlear implants, so I turned to that person for resource information on this topic.

Their company was uncomfortable with them being identified in this article so I submitted some questions to that friend who is a doctor of audiology and will unfold them to you without identifying them.

To that friend:

Q: What is your background with cochlear implants?

A: I have been an audiologist for 19 years. For seven of those years, I have evaluated, programmed, and managed patients with cochlear implants. I have also worked for a cochlear implant manufacturer as well.

Q: When were cochlear implants first used?

A: The first multi-channel cochlear implant was first implanted in a human in December of 1977. There are currently 3 manufacturers that are FDA approved in the U.S.

Q: Is there an upper or lower age that insurance will not fund implants?

A: The FDA guidelines for cochlear implants are as young as nine months old. The insurance companies may have some audiologic regulations, however if an individual is able to undergo surgery, there is no upper limit, to my knowledge.

Q: What is the average cost for implants?

A: According to experts, a cochlear implant can range from $50k-$100k. This may be also dependent on the facility where the surgery and services are completed.

Q: Why are they so expensive?

A: This may include devices, surgery and rehabilitation.

Q: I have heard they sound tinny. Is that true?

A: The outcome that the patients receive can vary patient to patient. This may depend on the length of hearing loss, amount of time wearing hearing aids prior to implant, reason for hearing loss, anatomy, surgical outcomes and device implanted.

Q: What challenges do patients face with implants?

A: Cochlear implants can improve speech recognition, but they are not perfect for everyone, especially in noisy environments. Sound quality may not be as natural as normal hearing or as natural as one may expect, however I will say that I have seen great outcomes as well. New CI users may experience a period where they need to adjust to the sound, especially if they’ve had hearing loss for a long time. The brain must adapt to the new auditory signals, which can take time and training. Many CI users report difficulties with music perception; however, this may be manufacturer and patient dependent. There are individuals that appreciate music. Cochlear implants require regular maintenance, just as hearing aids would. Cochlear implants can be expensive, and not all insurance plans cover the full cost of the device, surgery or therapy. This can make access to cochlear implants difficult for some people. There can be failure in the device, or a technical issue can result in a temporary loss of hearing, which can be stressful. This is a challenge with hearing aids; however, the degree of hearing loss may be more significant. While I have discussed the challenges, the amazing outcomes of cochlear implants have changed many lives. These are also the same challenges that those with other hearing devices face as well.

Q: What are the future features of implants? What new abilities or technology?

A: Unfortunately, the future of implants is somewhat kept under wraps. Manufacturers are consistently working on future technology and even technology that is many years in the future. There are some offerings from manufactures that may be more advanced than others at this time, however with the rate that technology changes, this could vary at any time.

As I said at the beginning, my practice does not deal directly with cochlear implants, but I have referred nearly a dozen patients out to ENTs and the Veterans Administration who now wear them.

Hearing better is a vital sense not to be taken for granted. If you have symptoms of hearing loss, schedule an appointment with a hearing care professional to find out what is really happening with your hearing.

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Jeffrey L. Bayliff is owner of Hear the Birds Hearing Aid Centers in Lock Haven.