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Cochlear Implants

For Some, a Miracle. For Others, a Tool.

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Updated June 22, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Cochlear implants have been around since the 1960s, but they really began to catch on in the early 1990s. At that time, many in the deaf community reacted with alarm. There were unfounded fears that the technology would negatively affect deaf culture and countless debates in deaf forums and even public protests.

Today, deaf people with cochlear implants are largely accepted in the deaf community. Parents are routinely getting them for their deaf children. Bilateral cochlear implants are standard for young children.

What Is a Cochlear Implant

Cochlear implants are not hearing aids. Hearing aids amplify sound. Cochlear implants are classified as medical devices by the U.S. Food and Drug Administration (FDA). Even so, some people refer to the implants as "internal hearing aids."

Cochlear implants function differently from hearing aids. A cochlear implant uses electrical signals to stimulate the auditory nerve. This allows sound to skip around damaged hair cells in the cochlea and go directly to the brain.

The user has a speech processor that collects sound and converts it into electrical signals. The processor then sends those signals to the coil on the user's head (held in place by a magnet under the skin). The coil in turn transmits the electrical signals to the cochlear implant electrodes inside the cochlea. The electrodes stimulate the auditory nerve, and the auditory nerve sends the signals to the person's brain to be interpreted into sound.

Qualifying for a Cochlear Implant

Not everyone qualifies for a cochlear implant. A candidate can be rejected if he has too much residual hearing for an implant. This is because a cochlear implant destroys whatever natural hearing remains in the implanted ear.

People who receive cochlear implants are still deaf. When the cochlear implant is not in use, the person cannot hear. This isn't much different from what I experienced wearing a hearing aid. I was either "on the air" or "off the air."

The decision to implant a child or to get one yourself is very personal. I faced this same issue myself. There are risks (including risks associated with any surgery), however minimal. These risks include facial nerve injury and infection in the surgical area. About.com has an animated video on cochlear implant surgery.

Furthermore, if a patient does not strive to develop good auditory skills, the implant may not produce good results.

Hearing Aids No More

Here's my story. Until the mid-1990s, I was able to get some limited benefit from hearing aids. After buying my last hearing aids, I told the audiologist that if I lost more hearing, that was it. I could not afford another $1,000 for new hearing aids every time I lost more hearing (insurance would not cover it). The doctors told me I could expect to be totally deaf by the time I was 40. They were wrong. It happened when I was 30.

The day finally came when I realized I could no longer benefit from hearing aids. One day I put them on as usual, but the sound was incredibly faint. Could it be the battery? I tried some new batteries. No improvement. Bought another pack of batteries. Tried every battery in the pack. Still no improvement. Conclusion -- I could no longer benefit from hearing aids.

Should I get a cochlear implant? I pondered this as I considered living as a totally deaf person. I knew this day would come someday and had been preparing myself for it by going to work without hearing aids now and then, to force myself to function without relying on sound. At that time, I decided not to get a cochlear implant.

Reason for a Cochlear Implant?

Then I had a near-disaster in my house. I had been washing the dishes. When I finished the dishes, I went downstairs to use the computer. About 3 1/2 hours later, I needed to use the bathroom. The bathroom floor was a little wet. I thought it was my child, who had recently played with toys in the bathtub. I started mopping it up. Soon it became a flood I couldn't control. I looked around for the source. Tested the toilet and the sink. No leaks.

As the flood got worse, I sought a neighbor's help. The neighbor came into my house, looked around the basement bathroom, and suddenly stopped in her tracks. "I hear something!" She went into the playroom, flicked on the light, and showed me what she had heard -- the water was cascading down the wall next to the bathroom and flooding into the bathroom! The source was upstairs. We raced upstairs, and she immediately found the source -- the kitchen sink faucet had not been turned off after I did the dishes!

If I had gotten a cochlear implant years earlier, maybe I would have been able to hear the water running down the wall. As I mopped up the water, the thought, "Should I get a cochlear implant?" again crossed my mind.

I now have a cochlear implant. You can read my cochlear implant story. I ended up getting it for reasons that had nothing to do with the near-disaster in the house.

Sources:

Benefits and Risks of Cochlear Implants. U.S. Food and Drug Administration. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/default.htm. Accessed June 2011.

Cochlear Implants. American Academy of Otolaryngology-Head and Neck Surgery. http://www.entnet.org/HealthInformation/cochlearImplants.cfm. Accessed June 2011.

How Do Cochlear Implants Work? University of Miami School of Medicine. http://cochlearimplants.med.miami.edu/implants/04_How%20do%20Cochlear%20Implants%20Work.asp. Accessed June 2011.

Related on About.com: Inventors.About.Com: Cochlear Implants

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