by Neil Bauman, Ph.D.
A man explained,
I have very severe hearing loss in both ears. My doctor says I need to have cochlear implants.
He then requested,
Could you shed some light on how successful they are, and what I should expect as a result of the surgery.
Cochlear implants (CIs) are typically very successful. I know hundreds of people that have cochlear implants. With a handful of exceptions, all now hear better than they ever did with their hearing aids.
Yes, there are some failures. Of these, some have been re-implanted and have achieved success the second or third time round. For some reason, the odd person just doesn’t have any success with a CI—but as I said, they are only a handful.
Having a CI doesn’t give you normal hearing to be sure— although some people think they come pretty close. Thus, the proper way to look at it is that you will have better hearing than you have now with your hearing aids—but keep your expectations low. Then if you have much better hearing, you will be happy. If you go into it with high expectations, even if you only just hear a bit better than you do now, you likely will be disappointed.
It takes time for your brain to rewire itself to hearing with a cochlear implant. Some people can understand speech the same day they are turned on. For others it takes weeks or months of effort. A few people can actually hear on the phone the day they are turned on. For others, this never happens. You need to know that your hearing will keep on improving for 3 to 5 years or longer after you are turned on, so don’t get discouraged if you don’t hear everything all at once in the beginning. Take the long-term view and measure your success after 5 years of wearing your CI. By then, your brain will have rewired its auditory circuits, and you’ll realize just how much better you hear now than you did before.
Almost everyone that has gotten a CI has said that knowing what they know now, if they had it to do over again, they’d do it over again in a heartbeat. That tells you how much they love their CIs, and how much benefit they get from them. Another phrase CI recipients often use is, “My CIs gave me my life back.”
There are a few side effects from the CI surgery that some people experience. Many people have bad tinnitus right after the surgery—but it typically goes away in a few days, or after they get “turned on” about a month later. Some find they have dizziness in the days or week after the surgery, but that usually goes away in a few days. Some people have taste problems— food tastes different or they have a metallic taste. This is because the facial nerve that includes servicing the taste buds lies close to the auditory nerve and may have been nicked or become inflamed during the surgery. Typically, taste returns to normal within a couple of months or so.
Before you have CI surgery, you would do well to join an on- line list for people with CIs. That way you will get first-hand information from a variety of people. The best CI list—friendly, supportive and one with no CI ‘wars’—is the CI list in the SayWhatClub. You can join the SayWhatClub CI list here and follow the instructions. If you do join, I’ll see you there.
You say “Almost everyone that has gotten a CI has said that knowing what they know now, if they had it to do over again, they’d do it over again in a heartbeat,” but after 3 years with a CI I wish I had never gotten one. One reason is that my ability to understand speech changes dramatically from day to day, for no reason anyone can find. One day my husband sounds like Darth Vader, and the next he sounds like he sounds like Darth Mickey Mouse. One day the default volume is too soft and several days later the same setting is so loud it is painful. The second reason is that after the CI surgery, my Musical Ear Syndrome changed to what I would call Musical Noise Syndrome. After a very sudden ALMOST total hearing loss in my only hearing ear, I had non-stop Christmas music playing in my head which I thought would drive me crazy, but after a few weeks I actually learned to enjoy the music and could sometimes control which tune was “playing.” After the CI surgery the music changed to noise … an out of tune choir repeating a monstrous two or three notes which increases in volume in proportion the level of sound around me. With the CI both real and phantom music is nothing more than painful noise and I cannot even remember the tune to “Happy Birthday.” So would I do it again? Hell NO.
Hi Leah:
Sorry that you are having troubles with your CI. You are one of the rare ones I have heard from out of the hundreds and hundreds of success stories I’ve heard that have had trouble.
Have you been evaluated by a different surgeon than the one that did your implant? Have you had an MRI or CT scan to see whether anything has moved out of place? Have you had a second opinion by another audiologist to be sure it was programmed the best it can be? If you haven’t, you should. A fresh pair of eyes may be able to find the problem. One or more electrodes may be acting up and your processor may need to be replaced, or the implanted part taken out and replaced. There are a lot of possibilities that could be causing your problems.
Cordially,
Neil
I have profound hearing loss and I have been declared a candidate for C.I. surgery. I have some reservations. First, I fear that I will lose what residual hearing I currently have. Second, I also fear that I will be one of the rare few who is unsuccessful and I will have to live with that for the rest of my life. I envision myself being like the deaf, dumb, mutes you see in the old western movies. I couldn’t bare that kind of life and humiliation. I am also turning 62 in a few months and I fear that my ability to learn new sounds will be ineffective because of age and current hearing loss. If I have the surgery sometime in January 2026 I am afraid I wont be able to hear adequately at my daughters wedding in May 2026.
Hi James:
If you have profound hearing loss, a CI should most likely help you. However, you do not give any details of your hearing loss history which are important in order to address your concerns.
For example, was your hearing loss profound from birth? Have you successfully worn hearing aids since your hearing loss?
If you had a profound hearing loss from birth and did NOT wear hearing aids or use assistive devices to help you hear, then the chances of a successful CI experience is much lower than if you wore hearing aids so your brain could develop the necessary hearing circuitry.
If you suddenly lost most of your hearing as an adult, you have then developed good hearing circuitry and thus you have an excellent chance of having success with a CI. The shorter the interval between losing your hearing and getting a CI makes a difference too.
Having said that. I’ll address your concerns now.
If you have relatively good low frequency residual hearing, that could be a valid concern. You could do what numbers of people have done and wait until your residual hearing is basically useless to helping you understand speech–then you have nothing to lose so that concern goes away. Another tactic is to only have your worse ear implanted. That way you’ll not lose the residual hearing in your better ear. Numbers of people do that and wear a CI in their worse ear and a hearing aid in their better ear with very good results. The CI gives you the higher frequency hearing you don’t have, and the other ear lets you hear the low frequency sounds you still currently hear.
Yet another tactic is to have the worse ear implanted and see how well it works. If it works well and you hear much better than you ever did with your hearing aid, then you can consider getting your other ear implanted.
Incidentally, you may still retain some/all your residual hearing in your implanted ear. If so, that is a bonus. Just don’t expect that will be the case. It may be, or may not happen.
You can put the odds in your favor so you have a good chance of success if you choose an implant surgeon who does many CI implants each year and thus has the experience that leads to success. And in the evaluation process before the implant have that surgeon determine whether you have any abnormalities that would reduce your chances of success and explain his ideas of your chances of success. This can help you make up your mind whether to go ahead or not.
Again, if you only have one ear done, you have not put all your eggs in one basket. You’ll still have the residual hearing you now have in one ear.
Just because you lose your remaining hearing does not make you a “deaf and dumb mute”. There are lots of things you can still do to communicate even with no hearing. For example, you can speechread. It isn’t perfect, but I’ve been speechreading since birth and would never want to be without it. It’s that important to me for success in communicating.
It is true that no everyone is good a speechreading, but every little helps. And you will learn to use your eyes in place of your ears. For example, a hearing person may step out to cross a street without looking because they can hear cars coming. I NEVER do that. In fact I often double check both ways before crossing a street because I seldom hear traffic.
Furthermore, there is wonderful technology available that captions speech in real time so you can read what a person is saying to you. The accuracy is amazing. I have one such device called the “Caption Companion”. And both my landline and cell phones are captioned so I can read what the person on the other end says. In like manner, my TV is captioned so I can read the dialogue while I watch the action and speechread the actors as well.
Your concern about being too old to learn isn’t really valid. What makes the biggest difference is the amount of time you spend in practicing listening with your new CI. The more you practice, the better you become. And don’t forget to have a positive attitude that you WILL succeed. If you keep thinking that you’ll never be able to do something, it will just become a self-fulfilling prophecy.
And to your last point about not being able to hear at your daughter’s wedding, my question to you is, “How are you going to hear at her wedding if you don’t get a CI? You’ll miss a lot I dare say. With the CI, just one mind you, while not perfect, should still let you hear better than you do now. Besides, you’ll still will have your residual hearing in your other ear.
I hope I’ve helped relieve your concerns and anxiety about getting a CI. Carefully consider what I have said, and then make up your own mind. There is no right or wrong answer. You will be able to live a relatively normal life whichever way you choose if you use all the available technology that is out there.
Cordially,
Neil