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Cochlear Implants: What You Need to Know

Your elderly uncle is hard of hearing and has a difficult time understanding conversation — so much so that he’s feeling frustrated and left out. His hearing aids aren’t helping much.

Your one-year-old daughter was diagnosed with severe hearing loss in both ears, and you’re worried about her ability to learn and understand speech. How will she learn to communicate?

For both of these cases, a cochlear implant may be an option.

What are cochlear implants? Who uses them and why? And how does the U.S. Food and Drug Administration (FDA) play a role?

The cochlea is the part of the inner ear that contains the endings of the nerve that carries sound to the brain. A cochlear implant is a small, electronic device that when surgically placed under the skin, stimulates the nerve endings in the cochlea to provide a sense of sound to a person who is profoundly deaf or severely hard of hearing.

“A severe to profound hearing loss in both ears prevents a person from understanding speech and communicating in everyday conversations. Cochlear implants can increase hearing and communication abilities for people who don’t receive enough benefit from traditional hearing aids,” says Srinivas Nandkumar, Ph.D., chief of the Ear, Nose and Throat (ENT) Devices Branch at FDA.

How Does It Work?

A cochlear implant consists of an external part that sits behind the ear and an internal part that is surgically placed under the skin. Usually, a magnet holds the external system in place next to the implanted internal system. The FDA has approved cochlear implants for use by individuals aged one year and older.

A surgeon places the cochlear implant under the skin next to the ear.     The cochlear implant receives sound from the outside environment, processes it, and sends small electric currents near the auditory nerve.     These electric currents activate the nerve, which then sends a signal to the brain.     The brain learns to recognize this signal and the wearer experiences this as “hearing.”

“A cochlear implant is quite different from a typical hearing aid, which simply amplifies sound,” says Nandkumar. “Using one is not just a matter of turning up the volume; the nerves are being electrically stimulated to send signals and the brain translates and does the rest of the work.” Moreover, cochlear implant wearers need to undergo intensive speech therapy to understand how to process what they are hearing.

Cochlear implants don’t restore normal hearing, says Nandkumar. But depending on the individual, they can help the wearer recognize words and better understand speech, including when using a telephone.

Does Age Matter?

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