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When hearing loss is severe, there may be significant damage to the inner ear or the cochlea. When there is substantial damage to the cochlea, a hearing aid may not be able to provide enough help with improving access to sound. If hearing aids are no longer beneficial, a cochlear implant may be considered as the next option.

While a traditional hearing aid sits on the outside of the ear and sends sound through the entire outer-, middle-, and inner-ear system, the cochlear implant is surgically placed within the inner ear, inside of the damaged cochlea. The implant then sends electrical sound signals directly to the hearing nerve. Sound is sent to the implant from a device that sits on the outside of the head, which stays in place with a magnet.

The cochlear implant surgery is typically an outpatient procedure and most patients go home the same day. After the surgery, the ear is given some time to heal. After about one month, the cochlear implant gets “activated,” which is when sound is turned on and the device is programmed with an audiologist.

On this day, sounds are not usually clear—some people say they hear beeps and squeaks, while others say they hear robotic or cartoon voices. Over time, listening performance improves1, but this process requires practice and effort. Within the first year of having the implant, one should return regularly to update the device settings, to ensure you are receiving the maximal benefit from the device.

It is important to remember that each person’s performance and experience can be different with a cochlear implant, depending on the cause of hearing loss2 and duration of hearing loss without hearing aid use3 for those who lose their hearing after they learn language. The audiologist will guide you through the entire process and can help establish realistic expectations and provide strategies for success for your situation.

Most insurance carriers, including Medicare and Medicaid, cover at least some costs associated with cochlear implants. However, each plan varies, so it is important to investigate the details of your policy for specific information. If you use hearing aids and have significant difficulty communicating, ask your audiologist about cochlear implants.


1 Wilson, BS and Dorman MF. (2008). Interfacing sensors with the nervous system: Lessons from the development and success of the cochlear implant.

2 Blamey et al. (2013). Factors affecting auditory performance of postlingually deaf adults using cochlear implants: An update with 2251 patients. Audiol Neurotol, 18:36-47.

3 Rubinstein JT, Parkinson WS, Tyler RS, Gantz BJ (1999). Residual speech recognition and cochlear implant performance: effects of implantation criteria. American Journal of Otology, 20 (3)445-452.

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