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Cochlear implant

4-minute read

A cochlear implant is a small electronic device that is surgically inserted into a person's inner ear - the cochlea - to help them hear better. The implant stimulates the hearing nerve and provides sound signals directly to the brain. Cochlear implants are also known as 'bionic ears'.

Why is the procedure performed?

The surgery is done to allow people with certain types of deafness to hear better. The cochlear implant bypasses the damaged part of the inner ear.

It is suitable for people who:

  • have severe or profound hearing loss
  • have hearing (auditory) nerves that work
  • can't overcome their hearing loss with hearing aids

The implant doesn't replace normal hearing. After the operation, the person will need training to learn how to recognise sounds, which may have changed.

For children born deaf or with severe hearing loss, having a cochlear implant fitted before the age of 18 months can be vital for developing normal language skills. The implants can be inserted into babies as young as one year old, allowing them to:

  • hear and pick up language
  • learn to speak
  • communicate better
  • attend mainstream school classes

How to prepare for the procedure

If you or your child are having a cochlear implant fitted, you will need to see a team of specialists. They might include:

  • an ear, nose and throat surgeon (otolaryngologist)
  • an audiologist
  • a speech pathologist
  • an occupational therapist

The specialist team will examine you or your child. Tests may include:

They might recommend a cochlear implant in one or both ears.

Before the procedure you or your child might be advised to stop taking certain medicines.

Learn more about how to prepare for surgery here.

What is the cochlear implant?

The cochlear implant has both external and internal parts.

Externally, a battery-powered sound processor is worn behind the ear. It looks like a hearing aid. Small microphones capture sounds and send electrical signals towards the inner ear.

In the inner ear is an implant, which needs to be fitted by a surgeon. It picks up signals from the sound processor and stimulates the nerve fibres in the inner ear. The nerve signals travel to the brain, where they are interpreted as sound.

Illustration of a cochlear implant showing the sound processor, transmitter, receiver and the cochlear with implant electrodes
The sound processor captures sound and sends electrical signals through the transmitter to the implant, which then stimulate the cochlea's hearing nerve, sending the impulses to the brain.

What happens during the procedure

When you have a cochlear implant fitted, you or your child will have a general anaesthetic. The surgeon will make a small cut behind the ear before inserting the implant. The doctor will then thread the electrical array into the snail-like spiral of the cochlea. This takes 2 to 3 hours.

You or your child will probably need to stay in hospital overnight.

What to expect after the procedure

Most people have minor discomfort only. You or your child might feel some:

The stitches will be removed after about a week. The cochlear implant will be switched on any time between one day and 6 weeks after surgery. Over several sessions, an audiologist will adjust or fine tune the device to help improve your or your child's hearing.

As soon as the cochlear implant is switched on, auditory rehabilitation starts. This involves training the brain to interpret and recognise what the sounds mean. Children and adults who have been profoundly deaf might need speech therapy, which can take months or years. Hearing gets better and easier over time.

What can go wrong?

Discuss the benefits and risks with your surgeon before deciding to have the operation. The procedure usually goes smoothly but the risks include:

  • losing the remaining ability to hear in the ear that had surgery
  • infection
  • meningitis or inflammation of the membranes of the brain and spinal cord in children
  • facial paralysis

More information

Visit the following website for more information about cochlear implants:

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Last reviewed: March 2020

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