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 lots of different factors which influence how much benefit a cochlear implant can provide to 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 the 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. Individuals over even 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—then 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, their journey will look pretty different. It may take more time for them to develop an understanding of sound. And, they may be able to understand some sounds in their environment, but may also continue to communicate, listen, and speak in a way like they did before receiving a cochlear implant.
3. Time between hearing loss and implantation. Having a long-term hearing loss isn’t a reason to not 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. 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 then support the brain to interpret and understand the meaning of sounds they will hear with a cochlear implant.
   That’s why preserving residual hearing is so important, and why MED-EL 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 help to guide a potential recipient and the professionals working with them to help achieve the best outcome for hearing with their cochlear implant.
6. Hearing aid use before implantation. Using hearing aids, especially for someone with good residual hearing, can help the brain to receive sound during the time before a cochlear implantation. This keeps the auditory, hearing, part of the individual’s brain stimulated and prepares it to interpret the meaning of sound.

Hearing With a Cochlear Implant

Hearing with a cochlear implant isn’t necessarily automatic. 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 these sounds they hear and give them meaning with meaning at their very best.

1. Setting appropriate expectations. It’s important to take all of the above mentioned factors in to account when setting expectations for outcomes of hearing with a cochlear implant. The best way to set appropriate expectations is pre-operative counseling with specialized professionals, including audiologists, surgeons, hearing implant therapists and rehabilitationists 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 and changes in its settings will directly affect the recipient’s hearing. It’s normal that MAPs will 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 because 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!

This post was written with help from R Sheetal, an speech language pathologist and clinical specialist at MED-EL.