Most people with severe and profound sensorineural hearing loss don’t realize what they’re missing. The average hearing aid user waits for a decade before biting the bullet and getting hearing amplification. A cochlear implant candidate takes even longer—a dozen years before receiving an implant. Learn more about cochlear implants.

Dr. Ruffin’s Story

I (Dr. Ruffin) was fit with hearing aids as soon as I was diagnosed with severe hearing loss at age 3 years. I first learned of cochlear implants when I was in junior high school. Because I grew up with computers, I thought I should wait and let the technology mature.

Boy was I wrong. Read here for the medical reasons why this is a bad idea and for more info on cochlear implants. On a personal level, I grew up where there were no d/Deaf or sign language resources. Having better hearing would have made childhood and adolescence easier.

Here’s why: As a child and into my early 20s, I was socially awkward. Because I couldn’t hear well, I didn’t have a great “social blueprint” for how to interact with people. After receiving a cochlear implant, I was able to converse with many more people than I could with hearing aids. With more hearing came more “hearing experience” that gave me a better background of knowing what, how, and when to “say something.” Making friends and professional relationships was much easier with cochlear implants (see my 15 min talk).

In hearing science, we call these concepts “social cognition” and “theory of mind.” These concepts are of particular importance to people who experience hearing loss in childhood. Having bilateral implants makes it much easier to hear. This is because a more robust speech signal from the ears means that the brain has to do less work to “fill in the gaps.” That allows my brain to really focus on how a speaker is talking and what message they’re trying to get across.

In other words, bilateral cochlear implants give my brain room to process what’s being said and have room left over to really focus on the message that a speaker is trying to deliver. We will explore these issues more in upcoming blog posts.

Misconceptions about Cochlear Implants

COCHLEAR IMPLANTS ARE SAFE

There are lots of misconceptions about cochlear implants. Many implant candidates believe that surgery is complex, fraught with complications, and the risk is high for not receiving benefit from surgery. In reality, implant surgery is like any other outpatient surgery—the risk for surgical complications is very low. The surgery is actually not complex—because the ear is otherwise normal, there is no disease processes that make it difficult to navigate the structures of the ear. Finally, after activation, it is very unlikely that a patient will receive no benefit from their cochlear implant.

IT IS RARE TO NOT BENEFIT FROM A CI

Despite these facts, patients are often scared to undergo surgery for the implant. They often relate a story such as, “But my cousin had one and it didn’t work.” The specter of a surgery “not working” is pretty scary. Let’s unpack this. Does “lack of benefit” mean that the patient couldn’t lipread, talk on the phone, or had great difficulty in background noise? A young adult who had sudden onset hearing loss and quickly received a cochlear implant is not the same person as an 80 year old with a long history of progressive hearing loss.

The benefit that one can expect to receive from a cochlear implant changes based on several factors: Age at onset of hearing loss, duration of deafness, age at implantation, and the presence of other neurological problems (e.g. cognitive issues). All of these factors can affect the level of benefit that one might receive with a cochlear implant.

Stories of Cochlear Implant Recipients

In the comments section are stories that Dr. Ruffin solicited from a variety of other CI patients. These patients were selected because they represent a variety of different kinds of cochlear implant patients and the outcomes they experience. Below there are patients who…

• were deafened at birth and some who lost their hearing in adulthood
• mostly use oral and spoken language but a few who use American Sign Language
• feel that deafness is an annoyance or disability and others who proudly identify as Deaf
• lost their hearing suddenly versus progressively over a long period of time

In the stories below, you can see a wide spectrum of improvement with a CI and how “benefit” is personal to each patient. For some, it’s being able to lipread more easily. For others, the ability to hear on the telephone and in background noise is appreciated. When well fit hearing aids cannot improve speech perception above 60% correct, 95 out of 100 CI recipients will hear better with CIs than with their hearing aids. Those 5 who do not benefit usually perform similarly to their hearing aid.

Even if patients aren’t able to talk on the phone, they still appreciate having a cochlear implant. So, it is truly rare to have patients who either (1) perform worse with a cochlear implant than their hearing aid or (2) receive no quality of life benefit with a cochlear implant.

Check out cochlear implants and resources for cochlear implants to learn more about these devices. These links can educate you about the cochlear implant process, who is a candidate, and how to get evaluated.

Significant edits:

22 July 2021: Added headings

3 March 2020: Updated likelihood of benefit from 99% to 95%