Tips & Tricks

Getting Your Own Bilateral Cochlear Implants

If you’ve got one implant, have you ever considered getting bilateral cochlear implants? Getting a second cochlear implant is like moving from a 2D world into a 3D world.

The experiences you have with a second implant can be a bit different than when you got your first one. Here we’ll take a brief look into why you’d want a second one and how you can get the most out of it.

Why Bilateral Cochlear Implants?

Basically, getting bilateral cochlear implants can mean coming closer to more normal hearing. Bilateral hearing is “normal” for the brain, and hearing with only one ear can be comparatively more difficult.

Doctors have a lot of fancy names for the different phenomena that come along with bilateral hearing, including “sound localization,” the “head shadow effect” and the “squelch effect.” If you’re interested in the science behind it you can read more in those blog links we’ve linked to, but if not they can basically be summed up into one sentence:

You can hear the sounds from all around you, and where they’re coming from, easier.

How fast can you expect this? The answer here is that there’s not a single answer. Everybody’s hearing is different, and there are many different factors that influence how well someone can hear. Some things that can suggest better hearing with a second implant are:

  • Receiving the second implant at a younger age, or with not a very long time in between receiving the first and second implant.
  • Having been able to hear sounds before receiving the second cochlear implant.
  • Being able to hear well with the first cochlear implant.

Rehabilitation for Bilateral Cochlear Implants

Just like rehabilitation exercises with your first cochlear implant, you’ll also need to do rehabilitation for your second cochlear implanted ear. But the exercises and way you rehabilitate won’t be identical. With your second cochlear implant, the goal is to build up your hearing and listening skills to match those of your first.

Because there will have been some time in between when you got your first implant and the second, you’ll have to focus specifically on your new cochlear implant ear to give it the chance to catch up.

The big question is how much time do you use spending with just your new ear, and how much with both ears?

Focussing on Your New Ear

Once you’ve got your second cochlear implant, we recommend that you spend some time hearing with just this new ear on its own. You could either set aside a time to do specific rehabilitation exercises, or just spend some time wearing only one audio processor. It’s best to spend this unstructured time when you’re doing something familiar, like interacting with family members in familiar routines, reading a book or on weekends when you’re doing normal day to day activities.The rehabilitation activities that you do with this ear will likely be the same as those you did with your first cochlear implant ear:

  • Start with closed-set word or sentence tests, and then move on to open-set sets.
  • Have someone speak in simple language, and then move on to more complex vocabulary.
  • Sit next to someone as they’re reading you a story or the newspaper, and then repeat each sentence after they’ve read it.
  • Do the Ling Six Sounds Test over and over.
  • Use a telecoil or Direct Audio Input to listen to music with just your cochlear implant. Bonus points if you print out the lyrics and read along as you listen.
  • Listen to audio books while reading along with a printed book.
  • Watch familiar movies, with or without closed captions.

Practicing with Both Ears

These are activities specifically intended to build up your bilateral hearing.

  • Practice localizing sounds. This means being able to tell where a sound is coming from and is only possible when you can hear with both ears.
    • Recognize and localize a known sound that occurs in a known spot (like the telephone at your house, where it normally sits).
    • Recognize and localize a known sound from an unknown spot (like the telephone in your house, except moved to somewhere new).
    • Recognize and localize an unknown sound from an unknown spot (have someone else pick out what, and where, the noise comes from).
    • Recognize and localize a known sound from a known spot, with background noise.
    • Recognize and localize an unknown sound from an unknown spot, with background noise.
    • Track a sound as it moves between different spots.
  • Improve your hearing when there’s background noise.
    • Background noise is anything that you don’t want to hear like a television when you’re not watching it, traffic outside, or a conversation at the next table over. Hearing with both ears can make it easier to listen in noise, but you need to practice. Basically, practice means building experience.
    • Start by turning on some background noise and have someone give you simple tasks, like following directions. As you start to understand them have them move on to more difficult directions, or read you some sentences and repeat them back.
    • Change up the different kinds of noises, and the volume of the noises. Music, radio, white noise, a clothes washer, a vacuum cleaner are all different kinds of noises you can use.


Curious what others are saying about bilateral implants? Check out these stories from real MED-EL recipients:

Want more tips for your first (or second) cochlear implant? Subscribe to the MED-EL blog!



This post was written by MaryKay Therres, a speech-language pathologist and Rehabilitation Specialist at MED-EL.


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