A cochlear implant is a medically advanced electronic device that restores hearing in patients with severe to profound hearing loss. It consists of two main components: an internal part implanted surgically and an external sound processor that attaches via a magnet. The external component picks up sound from the environment through a microphone, converts it into electrical signals, and transmits them to the internal part, which stimulates the auditory nerve.
What Is a Cochlear Implant?
Core Components
- External Sound Processor: This part usually sits behind the ear, though some models are worn differently. It has microphones to pick up sound, a processor to analyze and code the sound, and a coil held in place by a magnet.
- Internal Implant (Receiver-Stimulator and Electrode Array): This part is placed under the skin behind the ear during surgery, and its electrode array goes into the cochlea. It receives coded signals from the external processor and sends electrical signals to the auditory nerve fibers.
How Signal Flow Works ?
- Sound Capture: The microphones on the external processor pick up sounds from the environment and speech.
- Signal Processing: The processor converts acoustic signals into a digital code optimized for speech understanding.
- Transmission: The coded signals travel through the skin using a radio frequency link and a coil held in place by a magnet.
- Electrical Stimulation: The internal receiver-stimulator reads the signal and sends small electrical pulses through the electrode array inside the cochlea.
- Auditory Perception: The auditory nerve carries these signals to the brain, which then understands them as sound.
Who Can Benefit ? Age and Candidacy
Candidate Categories
- Prelingual Hearing Loss: Individuals born with hearing loss or who lost their hearing in early infancy, before developing speech. Early diagnosis and timely implantation are associated with better speech and language outcomes, supported by structured auditory-verbal therapy and consistent device use.
- Postlingual hearing loss happens when someone learns to speak and then loses their hearing later. People in this group often adjust to cochlear implants faster because their brains already know how to connect sounds with meaning.
Age Considerations
- In Türkiye, children can get a cochlear implant starting at 12 months old. In some other countries, the procedure is done as early as 9 months if the child’s health and local guidelines allow it.
- There is no set upper age limit for cochlear implants. As long as a person is healthy enough for surgery, doctors look at their hearing needs, overall health, and how much the implant could help them communicate day to day.
Additional Factors Reviewed
- Degree and configuration of hearing loss
- Cochlear nerve integrity and inner ear anatomy
- Duration of deafness and age at onset
- Realistic expectations and commitment to rehabilitation
- Family support for pediatric candidates
- Speech-language development and educational environment for children
How is the surgery performed ?
Before surgery, all patients undergo thorough audiological assessments and radiological imaging to confirm their candidacy. Once confirmed, anesthesia planning and surgical preparation are undertaken.
The surgery is performed under general anesthesia with an incision made behind the ear. The electrode array of the implant's internal component is carefully inserted into the cochlea (inner ear), while the receiver stimulator is placed under the skin, behind and slightly above the ear. The implant's functionality is verified during the procedure using various assessment methods.
After surgery, patients typically remain in the hospital for 1-2 days for observation. The external sound processor is fitted and activated about 3-4 weeks after the operation, once the surgical site has healed and swelling has reduced.
Adaptation, Outcomes, and Quality of Life
- For children, getting an implant early and working closely with speech and listening therapy can help many develop speech and language skills at the same pace as their peers. This often allows them to join regular classes at school.
- For adults who lost their hearing after learning to speak, progress is often quick because they already have experience with sound. Many say they get better at using the phone, talking with others, and communicating at work as time goes on.
Will the patient hear immediately after the external processor is activated?
Yes, once the external processor is connected, the implant begins to stimulate the auditory nerve and the brain receives sound signals. However, the sounds perceived through a cochlear implant are initially quite different from natural hearing.
Over time, the brain gradually learns to interpret these signals as meaningful sounds. This adaptation period varies for each individual and depends on several factors, including whether the hearing loss is prelingual or postlingual, the duration of deafness, and the amount of auditory rehabilitation received.
* Liv Hospital Editorial Board has contributed to the publication of this content .
* Contents of this page is for informational purposes only. Please consult your doctor for diagnosis and treatment. The content of this page does not include information on medicinal health care at Liv Hospital .
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Frequently Asked Questions
What does a cochlear implant do?
A cochlear implant bypasses the damaged inner ear and sends electrical signals directly to the auditory nerve, allowing people with severe hearing loss to perceive sound.
How is a cochlear implant different from a hearing aid?
A hearing aid amplifies sound, while a cochlear implant converts sound into electrical signals and delivers them to the auditory nerve, helping when hearing aids are no longer effective.
Who is a good candidate for a cochlear implant?
Candidates usually have severe to profound hearing loss, limited benefit from hearing aids, healthy cochlear nerve function, and realistic expectations about rehabilitation.
At what age can children receive a cochlear implant?
In Türkiye, implantation typically starts at 12 months of age. Younger implantation supports better speech and language development.
Will the patient hear normally right after activation?
No. Sound begins immediately, but it may seem unclear or unusual at first. Hearing improves gradually as the brain adapts.
How long does it take to adjust to a cochlear implant?
Adaptation varies by person. Many adults adjust within weeks to months, while children progress gradually with continuous auditory therapy.
Is cochlear implant surgery safe?
The surgery is considered safe and routine, with low complication rates. Patients are monitored closely before and after the procedure.
Can someone with a cochlear implant swim or shower?
Yes. The internal implant is fully implanted under the skin. The external processor must be removed before water exposure unless using a waterproof accessory.
Do cochlear implants work for older adults?
Yes. There is no upper age limit as long as the patient is medically suitable for surgery and can participate in rehabilitation.
Will the implant restore normal hearing?
It does not restore natural hearing, but it provides meaningful sound perception that improves communication, speech understanding, and overall quality of life.
