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

In Hearing Loss by Dr. Arica Black, AuD

Dr. Arica Black, AuD
Latest posts by Dr. Arica Black, AuD (see all)

Two of the most common treatments for hearing loss are cochlear implants and hearing aids. Both of these devices help a wearer to hear and communicate better. While they serve a similar function, there are some key differences between hearing aids and cochlear implants.

How do hearing aids and cochlear implants work?

Hearing Aids

Hearing aids are external devices that sit in or on the ear. They are most often inserted each morning and removed each evening. Hearing aids use a microphone to collect sounds and a processor to detect useful sounds (such as speech) and amplify these. Depending on your environment, hearing aids also filter out unwanted sounds to help you focus on the ones you want to hear. Hearing aids make it easier for a person’s inner ear to collect sounds and for the auditory system to function properly.

Cochlear Implants

Cochlear implants consist of two distinct parts. The first is an external portion that sits behind the outer ear and the second is an internal portion that is implanted under the skin. At the onset, a cochlear implant works similarly to a hearing aid in that a microphone picks up sounds from the environment. Then, a speech processor selects and arranges these sounds.

This next step is where cochlear devices differ from hearing aids. The processor then sends these signals to a transmitter and receiver that is implanted inside the skin. The receiver then converts these signals into electric impulses. The impulses are then collected by an electrode array and are sent to the appropriate region of the auditory nerve. Unlike hearing aids, cochlear bypass a damaged inner ear system and directly stimulate the auditory nerve.

Cochlear implants do not restore normal hearing; instead, they give the user a useful representation of sound to help them to better understand speech.

Who would benefit from each type of treatment?

When determining whether a person is better suited to hearing aids or cochlear implants, it is important to consider the type and degree of hearing loss they experience.

Hearing Aids – Hearing aids are suitable for people with mild to severe hearing loss that is either conductive (stems from outer or middle ear) or sensorineural (stems from inner ear or hearing nerve). People who would benefit from using hearing aids over cochlear implants typically also have higher speech intelligibility. They can usually understand 50% or more of speech during a hearing assessment.

Cochlear Implants – Those who would benefit from the use of cochlear implants tend to have a much more severe degree of hearing loss. The type of hearing loss is also usually sensorineural rather than conductive. Speech intelligibility is usually at 50% of less for cochlear implant users.

Risk and cost of cochlear implants and hearing aids

Hearing aids and cochlear implants also vary greatly in terms of the risk, cost, and time needed to adjust.

Hearing Aids – Hearing aids are extremely low-risk, since they do not require any type of surgery or implantation. The cost of hearing aids is usually a couple thousand dollars, depending on the type, features, manufacturer as well as the user’s insurance.

Cochlear Implants – Because cochlear implants require surgery, there is inherently more risk than hearing aids in this treatment option. Although riskier than hearing aids, cochlear implant surgery usually holds a low risk – and are often implanted on children. Cochlear implants are much pricier than hearing aids, costing up to $100,000.

The Hearing Doctor

Questions about your hearing treatment options? If you’re wondering what hearing loss treatment might be best for you or your loved one, reach out to our friendly team today. We will happily schedule an initial appointment to assess your current hearing needs. Once we know the specifics of your hearing profile, we will determine a unique hearing treatment plan that meets you right where you are.