An alarming number of Americans – 48 million – report some degree of hearing loss. And those figures are likely to skyrocket as the Baby Boomer generation reaches their golden years. The good news: People have more options than ever before to improve their hearing – and improve their quality of life, says Laura Brainard, M.D., an ear, nose and throat (ENT) specialist at Henry Ford Health.
Hearing can be vital to connecting to one’s community of friends and family. As hearing fails, many people find their worlds contracting, limiting social engagements, avoiding group activities and even giving up jobs. Fortunately, cochlear implants provide people with an alternative.
Hearing aids can tide people over when their hearing is faltering, but with significant or complete loss, cochlear implants are often a more useful technology. The FDA first approved cochlear implants in the mid-1980s to treat hearing loss in adults. Since 2000, cochlear implants have been FDA-approved for use in eligible children beginning at 12 months of age.
While the technology has been around for decades, the technology and surgical techniques have improved dramatically since they were first introduced. Initially, there was simply a focus on sound perception, then speech recognition. Now, the new frontiers of cochlear implants are hearing preservation and music appreciation.
Here, Dr. Brainard answers a few frequently asked questions about the technology – including what’s required to help you hear more naturally.
Q: What is a cochlear implant?
Dr. Brainard: It’s an electronic device that helps people who are hard of hearing sense sound. It is like a “bionic ear,” essentially replacing the inner ear. It is comprised of two parts — an internal electrode, surgically placed in the cochlea (the inner ear) and an external sound receiver/processor that sits either over the ear or behind the ear and connects to the internal part through a magnet.
Q: How do cochlear implants work?
Dr. Brainard: They work differently from hearing aids, which are essentially amplifiers, making sounds louder. While a hearing aid presents a stronger sound wave to the ear, it still relies on the inner ear to act as an energy transformer, turning that sound wave into an electrical signal. Cochlear implants, on the other hand, convert sound waves into electrical energy and present the electrical stimulus directly to the nerve of hearing. They essentially bypass the non-functional inner ear. The brain then recognizes those signals as sounds. In this way, a deaf or hard of hearing person can understand speech, even though their ear can no longer detect sound.
Q: What does the procedure entail?
Dr. Brainard: It’s an outpatient procedure performed under general anesthesia, during which the surgeon places an electrode into the inner ear and the internal receiver under the skin a couple of inches behind the ear. The surgery is done through a curved incision behind the ear, and tends to be very well tolerated, with many patients requiring only Tylenol or ibuprofen afterward. About a month after the surgery, the audiologist activates and programs (or “maps”) the device for the first time.
Q: Who is a good candidate?
Dr. Brainard: Cochlear implants are a solid option for people who are no longer able to get by with a hearing aid. In fact, the best candidates have severe to profound hearing loss in both ears. Some people with residual but inadequate hearing, are able to use a combination of a hearing aid and an implant to maximize their hearing. The cochlear implant is typically placed in the worse ear, leaving the hearing aid for the better ear. In some patients with residual hearing, both the hearing aid and the implant can be used in the same ear.
Q: How does using a cochlear implant compare to regular hearing?
Dr. Brainard: It’s electrical rather than auditory, so it can take a while for the brain to adjust to the different input. The time it takes to achieve maximal benefit varies. Most people hear something right away, and then experience improvements in their hearing over time, with the most improvement happening between 3 and 6 months after surgery. Their hearing may continue to improve for up to a year.
Q: How can I get adjusted to the device?
Dr. Brainard: Unfortunately, getting an implant and having it programmed isn’t like turning on a light switch. It’s sort of like learning to hear – the more you practice, the faster you’ll progress. If you take out your hearing aid, and use only the implant during your waking hours, you’ll adjust more quickly.
Before you decide to get an implant, get your hearing tested to ensure you really need one. Then, talk with an experienced cochlear implant surgeon and implant audiologist.
“The procedure is safe and well-tolerated, but learning to interpret the sounds created by the cochlear implant takes time,” says Dr. Brainard. “It requires commitment.”
Over time, and with regular use, patients begin to decode sounds in the environment and better understand speech – both in person and over the telephone. Most people are able to hear at normal sound levels and achieve word understanding around 75 percent, which is a huge improvement over the 0 to 40 percent that they start with before surgery.
It is estimated that only 5 percent of people who are cochlear implant candidates are currently benefiting from this technology. The first step is increasing awareness that there are excellent solutions for people whose hearing aids are no longer adequate.
“What I love most about cochlear implants is their capacity to transform people’s lives,” says Brainard. “They’re able to enjoy their friends and families again, participate in conversations and do the things they love to do.”
To find a doctor at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).
Dr. Laura Brainard specializes in otology and neurotology (diseases of the ear and lateral skullbase) and is a senior staff physician in the Henry Ford Department of Otolaryngology/Head & Neck Surgery, which was recently ranked among the top 25 in the nation by U.S. News & World Report on its 2017-18 Best Hospitals list. She sees patients at Henry Ford West Bloomfield Hospital and Henry Ford Medical Center – Fairlane.
