10 Factors That Influence Hearing With a Cochlear Implant for Adults

Cochlear implants are one of the most effective ways to help restore a sense of hearing for someone with significant sensorineural hearing loss. However, hearing with a cochlear implant is different for each and every recipient. This is because hearing with a cochlear implant is different from “normal” hearing: it takes time for someone’s ears to adjust to the new sound stimulations from a cochlear implant and for the brain to learn what these sounds and sensations mean. And each person’s cochlea is different, which means it may receive the cochlear implant’s signals differently.

There are many factors that influence how much benefit a cochlear implant can provide someone who receives one as an adult. Here are some of those factors:

What’s Your Hearing History?

A recipient’s hearing loss history can influence how they hear once they receive a cochlear implant.

1. Age when the hearing loss first occurred. Recipients who lost their hearing later in life will have more memories and neural connections for sound in their brain. After they receive a cochlear implant, these memories can support them as they re-learn to hear with a cochlear implant.
2. Age at the time of implantation. There is no age limit for when someone can receive a cochlear implant. Even individuals over 90 years old have been able to enjoy sound with a cochlear implant.
   If an individual’s hearing loss happens after they’ve developed language skills through listening—this is called post-lingual hearing loss—they’ll be learning to hear the spoken language which they already established before receiving a cochlear implant.
   For someone who has not heard before receiving a cochlear implant, the journey will look pretty different. It may take more time for them to develop an understanding of sound. And although they may be able to understand some sounds in their environment, they may continue to communicate, listen, and speak in a way similar to how they did before receiving a cochlear implant.
3. Time between hearing loss and implantation. Having long-term hearing loss isn’t a reason not to get a cochlear implant. However, learning to adjust to hearing with a cochlear implant may take longer if there’s been a significant length of time between the start of the significant hearing loss and implantation.
4. Residual hearing. Having residual hearing means that some of the delicate hair cells in the cochlea are still intact and able to perceive sounds. The more residual hearing someone has, the more opportunities their brain has had to listen, learn, and retain sounds they can hear. This hearing can help the brain interpret and understand the meaning of new sounds they will hear with a cochlear implant.
   That’s why preserving residual hearing is so important and why MED-EL’s electrode arrays are so uniquely soft and flexible.
5. The cause of the hearing loss. It’s not always possible to identify the cause of someone’s hearing loss. However, when it can be identified, this information can guide a potential recipient and the professionals working with them and help them achieve the best hearing outcome with their cochlear implant.
6. Hearing aid use before implantation. Using hearing aids, especially for someone with good residual hearing, can help the brain receive sound during the time before a cochlear implantation. This keeps the auditory (hearing) part of their brain stimulated and prepares it to interpret the meaning of sound.

Hearing With a Cochlear Implant

Hearing with a cochlear implant doesn’t necessarily happen automatically. After the implant and audio processor are activated, a recipient is likely to hear sounds right away. But it can take some recipients months or years of hard work to interpret and give meaning to sounds and hear their very best.

1. Setting appropriate expectations. It’s important to take all of the abovementioned factors in to account when setting expectations for hearing outcomes with a cochlear implant. The best way to set appropriate expectations is pre-operative counseling with specialized professionals, including audiologists, surgeons, hearing implant therapists, rehabilitation specialists, and other trained medical professionals.
2. Family support. A motivated and supportive family has been shown to lead to a more positive experience for the recipient.
3. Rehabilitation is the key to success. Rehabilitation exercises begin on the first day of hearing. A motivated recipient who attends rehabilitation sessions with a well-trained professional and practices these exercises in their everyday life tends to perform better than recipients who do not.
4. Processor mapping. A cochlear implant MAP is the specific program which tells a cochlear implant’s audio processor how to process sounds. Each recipient will have a different MAP that’s customized to their hearing. Changes in its settings will directly affect the recipient’s hearing. It’s normal for MAPs to be adjusted frequently in the first months after implantation. If a recipient feels that their hearing has changed since their last mapping, they should tell their audiologist: adjusting the MAP might improve sound quality.

Are you or a loved one considering a cochlear implant? Let us know in the comments below and we can get you in touch with a MED-EL representative!