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If you or your child have hearing loss in one or both ears—and hearing aids provide little or no benefit—you may be eligible for a cochlear implant.
University of Iowa Health Care founded one of the country’s first cochlear implant programs in 1980. More than 40 years later, our neurotologists (ear disease experts) are still among the most experienced in the U.S. They perform around 200 adult and pediatric cochlear implant surgeries every year.
We’re also internationally recognized for our cochlear implant research.
During the last several decades, members of our team have helped create and refine safer, more effective cochlear implant devices. Our efforts have made it possible for more people—including children, teens, and adults of all ages—to hear better.
Understanding cochlear implants
Although cochlear implants can’t fully restore normal hearing, they can improve your ability to distinguish between different sounds and better understand speech.
What is a cochlear implant?
A cochlear implant is an electronic device that consists of two main parts:
- An external component that you wear on (or near) your ear. This removable piece contains a microphone and “sound processor.”
- An internal component (receiver) that is surgically implanted under the skin near your ear. It’s attached to electrodes (wires) that run through your inner ear to your cochlear nerve (your main hearing nerve).
How does a cochlear implant work?
The two main parts that make up the cochlear implant work together in the following ways:
- The external component picks up sound, digitizes it, and sends it to the implanted receiver.
- The receiver converts the sound signals into electrical pulses that travel along the electrodes to your cochlear nerve.
- Your cochlear nerve then sends the electrical pulses to your brain—and your brain interprets them as speech, music, or other sounds.
Why choose UI Health Care for cochlear implant surgery
People across Iowa—and beyond—trust us to perform their cochlear implant surgery because we have a long track record of safety and success.
Our clinical and research achievements include:
- Early adoption of better devices. In 1983, UI Health Care was the first in the United States to implant a “multi-channel” cochlear implant. Unlike earlier cochlear implants that struggled with sound quality, the multi-channel device was the first to help users understand speech.
- Laying the groundwork for pediatric cochlear implants. We were the first center in the world to launch a clinical trial evaluating cochlear implants in children. In 1990, the data gathered from this trial led the Food and Drug Administration (FDA) to approve the surgery for children who met eligibility criteria.
- Helping people preserve natural acoustic hearing. Members of our team led the development of “hybrid” cochlear implants. These devices are now an FDA-approved treatment option. They preserve low-frequency acoustic hearing and provide high-frequency sounds through the cochlear implant in the same ear.
- Testing new advances in technology. In 2020, one of our surgeons performed the world’s first robotic-assisted cochlear implant surgery as part of a clinical trial. This procedure is now FDA-approved and widely used at our facility.
What to expect
If hearing loss has affected your quality of life, you should consider scheduling a consultation at our cochlear implant clinic.
Even if you weren’t eligible for a cochlear implant in the past, you may be a candidate now because the FDA continues to expand its eligibility criteria.
For example, we can now perform cochlear implant surgery on certain babies as young as 9 months old. We can also offer cochlear implants to some people who have profound hearing loss in only one ear.
If you’re interested in getting a cochlear implant, the first step is to see if you’re a candidate.
We’ll start by reviewing your most recent hearing test results. If necessary, you can undergo a new hearing test with a UI Health Care audiologist.
If your results confirm you’re a candidate for a cochlear implant, we’ll verify whether your health insurance plan will cover your surgery. If so, we will schedule you for an in-person evaluation.
During this evaluation, which will take a couple of hours, you’ll take part in the following:
- A thorough review of your hearing history
- A hearing aid evaluation (if you have hearing aids, we’ll make sure they work properly)
- Speech testing, which measures your ability to hear and understand speech while wearing your hearing aids
- A discussion about cochlear implant usage. We’ll teach you how the device works and explain what types of rehabilitation you’ll need after surgery. We also want to make sure you have realistic expectations about your hearing improvement after receiving a cochlear implant.
- A consultation with one of our surgeons, who will examine your ears and help you understand the surgery process
In most cases, you’ll find out whether you’re a candidate for cochlear implant surgery at the end of your evaluation.
If you are a candidate, you’ll come back in one or two weeks for a CT scan and/or MRI scan of your inner ear. These imaging tests show us the quality of your cochlea and cochlear nerve.
Finally, we’ll schedule your surgery. This will most likely take place within six weeks of your imaging tests.
Cochlear implant surgery is usually an outpatient procedure. This means you or your child will probably return home the same day.
The procedure usually involves the following steps:
- First, you’ll receive general anesthesia (so you’re asleep during the procedure).
- Next, your surgeon will make a small incision behind your ear and open the mastoid bone (part of your skull). They’ll create a “bed” for the internal device to sit in, so you don’t have a visible lump once it’s implanted.
- Your surgeon will then open your cochlea (a snail-shaped bone inside your inner ear that’s attached to your cochlear nerve).
- They will gently guide the electrodes from the implanted receiver into your cochlea.
- Finally, they will close your incision with a few small stitches.
Between two and four weeks after your surgery, you will have your first follow-up appointment.
During this visit, you’ll have another imaging test. This lets us confirm that the electrodes are in the right place inside your cochlea.
You’ll also receive the wearable, external part of your device. We’ll turn it on and program some initial volume settings.
We’ll continue to adjust these settings—also known as your “dynamic range”—as your brain acclimates to the new sound over several visits. You’ll have another visit two weeks after your device activation and additional visits after three months, six months, and one year from your activation. More appointments can be scheduled if needed.
We’ll also perform speech perception and other hearing tests three months and six months after your device is activated—and then once every year. By keeping track of your results, we can make sure you’re continuing to benefit from your cochlear implant.
Who can benefit from a cochlear implant
Although cochlear implantation isn’t for everyone, the number of children and adults who qualify for this treatment continues to grow.
If you are considering a cochlear implant for yourself or your child, you must meet certain candidacy criteria. For example, you (or your child) must:
- Have a fully formed cochlea and intact cochlear nerve
- Have sensorineural hearing loss (hearing loss caused by a problem with your inner ear or cochlear nerve)
- Receive little or no benefit from hearing aids
- Be healthy enough to have general anesthesia and surgery
There are also additional criteria specific to children and adults.
Our Care Team