Status: 06/12/2023 09:04 a.m
Hearing implants often bring benefits for deaf and severely hard of hearing people. The operation is possible at any age, disadvantages are rare. In many cases, health insurance companies cover the costs.
The cochlear implant, or CI for short, is now part of the standard care for people with severe hearing impairments in Germany. The hearing implant can help when the strongest hearing aids are not enough and the affected person is threatened with exclusion from social life or losing their job.
What is the difference between a hearing aid and a hearing implant?
With healthy hearing, the sound waves from the outside, after being amplified in the middle ear, cause the fine hairs of the sensory cells in the cochlea of the inner ear to vibrate. These movements are converted into electrical impulses and travel to the brain via the auditory nerve.
A hearing aid can only amplify sound and works as long as there are enough intact hair cells. Unlike a hearing aid, a cochlear implant does not amplify the sound, but sends it directly to the auditory nerve as an electrical signal. The technology thus replaces the function of the sensory cells if they are too severely damaged. That is why one also speaks of a real hearing prosthesis.
How does a cochlear implant work?
The outer, detachable part of the hearing prosthesis consists of a microphone, the battery and a sound processor, which converts the sound into an electrical signal and transmits it to the outer coil behind the ear. This is where the signals are transmitted to the inner implanted part, to the inner coil in the skull. From there, a thin cable leads to the inner ear and fine electrodes in the cochlea can stimulate the auditory nerve directly with the electrical signals.
Who is a hearing implant suitable for?
Cochlear implants are suitable for children born deaf and profoundly hard of hearing, as well as for people who lose their hearing later in life due to damage to the inner ear. Even with advanced inner ear hearing loss in old age, the hearing prosthesis can replace the declining function of the fine hair sensory cells in the inner ear if the amplification of the sound with a hearing aid is no longer sufficient.
There is no age limit for implanting a hearing prosthesis. Prerequisites, however, are an intact auditory nerve and the willingness to train hearing with the prosthesis. An estimated 5,000 people in Germany receive a cochlear implant every year – on the other hand, around a million people affected could also benefit from the artificial sensory organ.
Possible disadvantages and side effects
But many are afraid of complications. They fear losing their residual hearing or shy away from the operation per se. Some are afraid of pain or have heard of bad experiences. Since the procedure is standardized and routinely performed at the centers that use cochlear implants, the likelihood of risky complications is very low compared to many other surgical procedures. In rare cases, wound healing disorders can occur. The prospect of having to relearn how to hear can also speak against a hearing prosthesis, and there is no guarantee that hearing will be possible again with satisfactory quality.
In addition, deaf people often make a conscious decision not to have implants and instead campaign for the social conditions for barrier-free participation to be further improved. This also includes the general recognition and promotion of German sign language and the maintenance of it Deaf culture that connects many of the approximately 80,000 deaf people in Germany.
What are the advantages of a cochlear implant?
From about the age of 65, most people are hard of hearing in both ears. Hearing deteriorates with age, but not equally in both ears. With a cochlear implant, which usually lasts for life, different combinations are possible:
- an implant
- an implant and a hearing aid
- two implants for both ears –
- implant and residual hearing
- With the cochlear implant, those affected can participate more in social life again. In addition, the risk of dementia threatening hearing loss is reduced.
OP: How is a cochlear implant inserted?
Today, the operation is micro-invasive using the “keyhole technique”. General anesthesia is no longer necessary for the implantation and those affected only have to stay in the hospital for a few days. In the approximately two-hour operation, a cavity for the inner part of the hearing prosthesis is milled into the skullcap behind the ear. From there, a thin cable with fine electrodes is advanced into the cochlea in the inner ear and the flat implant is again covered with scalp. The outer part of the prosthesis then adheres magnetically directly over the hollow and sends electrical signals to the inner part via the shortest possible route. Even if both ears are to be treated with a CI, the two operations are carried out individually with a time interval.
After the operation: when will you be able to hear again?
In most cases, those affected only gradually get used to hearing with the prosthesis. The first sound impression after switching on the cochlear implant is different: it is not uncommon for spoken words to be recognized immediately – in other cases, those affected only hear noises or tones at first. The brain analyzes the new hearing impressions and compares them with known sound patterns. This happens automatically, but can be supported with audiological exercises. Noises and tones can sound artificial or tinny at first. It can take six months or more for everything to sound natural and beautiful.
Who pays for a cochlear implant?
The health insurance companies usually cover the costs for the operation and the adjustment of a cochlear implant if, despite an optimally adjusted hearing aid, the speech understanding at normal speech volume is below 60 percent.
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