A cochlear implant – for the hearing impaired and the deaf

A cochlear implant, also called CI, is an electronic hearing aid that helps severely hearing impaired and deaf people to hear better. For many people, a cochlear implant is a major improvement in their quality of life. Many implanted patients experience better hearing and can communicate better with others.

What is a cochlear implant?

A cochlear implant (CI) is an electronic implant that converts sound into electrical impulses, which are then received by the cochlea. The many cilia are replaced by 24 electrodes of the cochlear implant (CI). Depending on the user, they can be partially or all activated.
A cochlear implant (CI) consists of two parts: an external headpiece and an internal implant. The microphone captures the sound and sends this information to a speech processor that converts it into an electronic and digitized code. This code is ultimately forwarded to the internal implant. Each electrode has its own function. A hearing-impaired person with little residual hearing has a good chance of losing it, but the CI provides better results compared to a hearing aid.
Some differences between a hearing aid and a CI


Hearing aid

Cochlear implant

Aftercare and rehabilitation

Not reimbursed



Not necessary


Residual hearing

Low risk of loss of residual hearing

High risk of loss of residual hearing


1 battery that lasts a long time (several weeks)

3 batteries (several days) or rechargeable battery (about 8 hours)


Who is eligible for a cochlear implant?

In adults, the hearing loss must be 80 dB or more, residual hearing may be lost due to the procedure.
Nowadays there is an alternative: Electronic Acoustic Stimulation (EAS) uses residual hearing to preserve the low tones. This way no losses
are possible. In children, it is first necessary to strive for maximum speech stimulation with a hearing aid. You can then proceed to a CI. In a small child, one must be extra alert for damage to the external part as children can sometimes be boisterous . Special boxes have been designed on the market for this purpose, where a battery can be placed and worn on the child’s chest. The CI is attached to this box by means of a long cable , so that it cannot be lost.
Before the operation, it is determined whether one is eligible for the operation. This is discussed in a medical team of speech therapists, ENT surgeon, ENT rehabilitation doctor and his team, audiologist and psychologist. Beforehand , scans and an MRI are made to see whether the auditory nerve is intact and whether the petrous bone is not fossilized. It must always be remembered that there can be no guarantee that the operation will be successful and the CI will work. Even though the studies show no abnormalities.

During the operation

The operation is performed under general anesthesia and takes approximately 3-4 hours. When the patient is under anesthesia, a small incision is made behind the ear. The cochlea can be reached via the skull bone, into which the electrode can be inserted.
After a small test, the wound is sutured and a bandage is applied around the head. You will have to stay in the hospital for about two days. Complications are rare with today’s technology. It will only be determined during the first fitting whether the cochlear implant actually works.

After the operation

The first test (fitting) will be given approximately 3 to 4 weeks after the operation. The CI is used there for the first time.
Don’t expect too much, mainly unrecognizable sounds will be heard. Voices sound mechanical.
As people get used to the CI and learn to separate the sounds, it will become easier to recognize voices. The disadvantage of a CI is that the mechanical voices remain for a long time and diminish over time.

Finally – living with a CI

A persistent misunderstanding is that people with a CI are suddenly regarded as hearing. Unfortunately, this is not the case: they can hear better, but not as well as hearing people. After all, without a CI you can no longer hear anything on that side
(or both sides, if you have had bilateral surgery).
Some tips for living with a CI:

  • With a CI you cannot just swim or shower, take off the external part or ask the audiologist for a special ‘water set’.
  • Place it in a drying box with a drying tablet every evening so that the moisture can be drawn out.
  • It is better not to sleep with a CI, there is a real chance that you will damage it.
  • Always provide spare parts, especially a headpiece breaks quickly.


read more

  • Hearing impairment: possible solutions thanks to aids
  • Hearing impairment: causes, consequences and treatment