What is a cochlear implant?

A cochlear implant is a small electronic device that is surgically inserted into the cochlea, a part of your inner ear, to help you hear better. The implant stimulates your hearing nerve to provide sound signals directly to your brain. Cochlear implants are also known as 'bionic ears'.

If you have hearing loss, a cochlear implant may help you:

• understand speech and communicate better
• sense which direction sound is coming from
• hear despite loud background noise

How does a cochlear implant work?

The cochlear implant has 2 parts: external and internal.

The external part is a sound processor that is worn behind your ear. It looks like a hearing aid and is powered by batteries. It contains small microphones that capture sounds and send them through your skin to the internal part of the implant.

The internal part is an implant, which needs to be fitted by a surgeon. It picks up signals from the sound processor and stimulates the nerve fibres in your inner ear. The nerve signals travel to your brain, where they are turned into sound.

Who can benefit from a cochlear implant?

A cochlear implant can help adults and children who have sensorineural deafness. This means that part of the inner ear doesn't work properly. The cochlear implant bypasses the damaged part of the inner ear.

It is suitable for people who:

• have severe or profound hearing loss
• have hearing nerves that work
• can't overcome their hearing loss with hearing aids
• are able to participate in speech therapy after the implant is inserted

If your child was born with severe hearing loss, having a cochlear implant fitted at a young age helps them develop language skills. The implants can be inserted into babies as young as 6 months old. The younger your child receives treatment, the better they can pick up language and learn to speak. Language skills will help them learn at school and interact socially.

What's the difference between a cochlear implant and a hearing aid?

A hearing aid makes sounds louder, so you can hear them better through your ear. However, this may not be enough if your inner ear is badly damaged. A cochlear implant bypasses the damaged area and sends sound signals directly to your hearing nerve.

How do I prepare for the procedure?

If you are having a cochlear implant fitted, you will need to see a team of specialists. They might include:

• an ear, nose and throat surgeon (also called an ENT or otolaryngologist)
• an audiologist
• a speech pathologist
• a social worker
• a psychologist
• a teacher for people with hearing loss

The specialist team will examine you. Tests may include:

• specialist hearing tests with and without your hearing aids
• medical examination of your ear
• speech and language assessment
• CT and/or MRI scans to check whether your ear is suitable for a cochlear implant

The team might recommend a cochlear implant in one or both ears.

You might want to talk to people who already have a cochlear implant, so ask your team to suggest a support group in your local area.

Learn more about how to prepare for surgery here.

What happens during the procedure?

When you have a cochlear implant fitted, you will have a general anaesthetic. The surgeon will make a small cut behind your ear and insert the implant. When it is in position, your health team will check the implant is working. The procedure can take 1 to 3 hours.

You will probably need to stay in hospital overnight.

What can I expect after the procedure?

Most people have minor discomfort only. You might have some vertigo or ringing in your ears.

The cochlear implant will be switched on once your wound has healed, which could be any time between one day and 6 weeks after surgery. An audiologist will fine tune the device to improve your hearing. This usually takes several sessions.

It can take time until you can hear clearly. Rehabilitation will involve an audiologist and/or speech therapist. This helps train your brain to interpret and recognise what sounds mean. If you have used hearing aids in the past, things might sound different with a cochlear implant. Hearing gets better and easier over time and with practice.

What can go wrong?

It's important to discuss the benefits and risks with your surgeon before deciding to have the procedure. Most of the time there are no complications, but the risks can include:

• infection at the site where the implant is inserted
• meningitis (a serious infection of the membranes around the brain)
• damage to the facial nerve, which can cause paralysis of facial muscles
• failure of the implant and needing another procedure to replace it

There are vaccines available, which lower your risk of meningitis. You will be advised to have these vaccines if you haven't already received them.

How do I take care of my cochlear implant?

There are some things can do to look after your implant:

• The sound processor is not waterproof, so you will need to keep it dry. If you go swimming, you can take it off or cover it with a special cover.
• You will need to recharge or replace the batteries regularly.
• Avoid contact sports so your implant isn't damaged.

Your treating team will give you safety instructions for a range of situations that might affect your implant.

Resources and support

• Visit Aussie Deaf Kids for more information about cochlear implants for your child.
• The Department of Health Hearing Services Program can help you check if you are eligible and help you apply for hearing support services.
• You should talk to your health professional about the benefits and risks of getting a medical implant. Use the Therapeutic Goods Administration's guide on what to ask. The information is in English, Arabic, Croatian, Farsi, Greek, Italian, Korean, Mandarin, Spanish, Turkish and Vietnamese.