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Cochlear implantation is a life-changing event to many patients with hearing losses that are not effectively managed with well-fit hearing aids. With the experience most implant users are able to understand spoken speech in the everyday world. Some patients are able to enjoy music and/or hold conversations on the phone. The implant does not restore normal hearing, and many patients describe its sound as mechanical. However, with time and practice, the brain adapts to the new "sound" and speech signals and environmental sounds begin to sound more natural.
The primary benefits of a cochlear implant are:
- Aid in lip reading
- Perception of environment sounds
- Aid in monitoring the volume of one's own voice.
The ideal candidates for cochlear implantation are adults or children with recent hearing loss and young children whose hearing loss is identified very early. People with prior hearing experience adjust very well and often very quickly to hearing with a cochlear implant. They report significant satisfaction and improved quality of life. Deaf children implanted before the age of 5 also do very well. With time and rehabilitation, they develop very good speech understanding as well as speech production skills. The majority of these children are able to attend mainstream schools. Children who are implanted before the age of 2 seem to do even better than those implanted between 2 and 5 years old.
For adults and teens who have been deaf for most of their lives, were educated with manual language, and live in the deaf community, cochlear implantation has been very controversial. Not only are there medical issues, but more importantly social issues. Fortunately, the strong opposition to implantation from the deaf community is lessening. More and more prelingually deafened and long-term deafened patients are seeking information on cochlear implants. For those people who are good lip readers, who have some spoken language skills, and who are committed to learning and adapting to the use of the implant, cochlear implantation may provide significant benefit. Users like this report better communication with hearing family and friends, better use of environmental sounds, and improvement in quality of life.
This technology is continuing to improve thanks to the work of many scientists throughout the world. Current research includes improvement of speech processing technology, improving performance by implanting bilateral devices and preserving residual hearing, expanding the eligibility requirements by looking at patients with more residual hearing and prelingual deafness, improving the design of the device to one day be 100 percent implantable, and improving the function of the inner ear by preventing injury to the sensitive inner ear structures with new medications and potentially gene therapy.