If you have permanent or severe hearing loss, you might have the option of getting a surgically implanted hearing device.
Hearing implants are placed inside or on your skull during an operation.
The most common types of hearing implant are cochlear implants, bone anchored hearing aids, middle ear implants and auditory brainstem implants.
Not everyone with hearing loss can or wants to wear hearing aids or implants. Whether or not you do is your personal choice.
On this page:
- Cochlear implants
- Bone anchored hearing aids
- Middle ear implants
- Auditory brainstem implants
What’s the difference between a hearing aid and a cochlear implant?
Hearing aids are devices that you wear in your ears to amplify sound. They support people with hearing loss to hear sounds more clearly.
Cohclear implants are devices that are placed inside or on your skull by a surgeon during an operation. They can help some people with severe or profound hearing loss to interpret sounds.
A cochlear implant is a hearing device that is surgically implanted. It may be an option for people with severe to profound hearing loss.
What is a cochlear implant?
A cochlear implant is a small device that can help some people who are D/deaf to hear sounds.
Unlike hearing aids, which amplify sound in your ear, a cochlear implant connects to the nerves inside your ear. This sends sound signals to the brain.
Cochlear implants don’t restore natural hearing, but they can give the person wearing them a useful idea of the sounds in their environment.
How do cochlear implants work?
A cochlear implant has a part worn outside the body (external), and a part placed under the skin during the implant operation (internal).
The external part contains:
- A microphone to pick up sound waves and pass them to the sound processor.
- A sound processor to convert the signals from the microphone into digital signals and pass them to the transmitter coil.
- A transmitter coil, which transmits the digital signals received from the sound processor to the internal parts of the implant.
The transmitter sits flat against the skin, a little behind the ear. The sound processor sits either behind the ear (in a device that looks like a hearing aid) or in a single unit with the transmitter coil.
The internal part contains:
- A receiver/stimulator with a magnet – fitted under the skin, behind and above the ear. The magnet holds the external transmitter coil directly over the implanted receiver.
- A set of electrodes – inside the cochlea (the spiral cavity of the inner ear).
The receiver picks up the digital signal from the transmitter coil and sends it to the electrodes inside the cochlea.
The electrodes do the job of the damaged or missing hair cells in the cochlea, sending electrical signals along the hearing nerve to the brain. The brain learns to recognise these signals as sounds.
Pros and cons of cochlear implants
Whether or not cochlear implants are right for you will be a totally personal decision.
Some people in the Deaf community believe that Deafness is not a condition to be “cured”, so they choose not to wear implants. They also argue that young children should not be implanted until they are old enough to decide for themselves.
This is a very complicated debate, and one that can only be summarised here. Before making the decision for yourself or your child, it’s best to do your own research. You might have conversations with professionals, people in the Deaf community and people who have experience of the implant.
Some pros of cochlear implants include:
- They can make it easier to understand speech, making it possible to have conversations and to make phone calls and even watch TV.
- Some people with cochlear implants can also enjoy other sounds such as music.
- Children implanted at an early age may have a chance to develop oral speech and listening skills.
- Some cochlear implants can connect to other assistive technology, such as specialist phones, to further assist with hearing.
Some disadvantages of cochlear implants include:
- The person with the implant has to learn how to interpret the new auditory signals they’re receiving. The sound won’t immediately make sense to them, and can be overwhelming. It might take a long time and a lot of effort to adjust. This is called “rehabilitation”.
- The surgery itself comes with some risks. Your doctor should tell you about any possible complications.
- Cochlear implants work differently for everyone. Depending on your specific hearing loss, the benefits of getting the implant might be limited. Some people with a cochlear implant, for example, can enjoy the sound of music, but others can’t.
- If you later decide you want the implant removed, you will need to have surgery again. This can be a complicated procedure.
How can I get cochlear implants?
Cochlear implants aren’t suitable for everyone. If you have severe or profound hearing loss and you’d like to know if implants are an option for you, you should start by speaking to a professional.
Your GP, audiologist or your ear, nose and throat (ENT) specialist can refer you to a cochlear implant centre for an assessment.
Can my child have cochlear implants?
Cochlear implants may be suitable if you have a child with severe to profound permanent deafness who gets little or no benefit from hearing aids.
Usually, the younger a child is when they receive a cochlear implant, the more likely they are to get the most benefit from it.
It’s now common for children to have a cochlear implant before they’re 12 months old.
Older children can also benefit from cochlear implants, such as those who become deaf after learning to speak (for example, following meningitis) and those with progressive or acquired hearing loss who get less benefit from their hearing aids.
If you think your child might benefit from a cochlear implant, speak to your ENT consultant, paediatrician or audiologist for a referral.
If your child is old enough to understand what is happening, it’s important to explain the cochlear implant process to them.
The National Deaf Children’s Society has a comic to help explain the process of getting cochlear implants to children under the age of eight.
Can cochlear implants get wet?
Most newer models of cochlear implant are water resistant. Many people choose to keep wearing their cochlear implants while swimming or showering.
You can also buy equipment and accessories to help you wear the outer part of your cochlear implant while you’re in water.
You should remove the outer part of your cochlear implant before showering or swimming if it is not waterproof.
Water will not affect the internal part of your cochlear implant. You can swim and shower as normal after you’ve healed from a cochlear implant operation.
Help and support with cochlear implants
The following organisations also offer further information, help and support:
Bone anchored hearing aids
Although it’s called a hearing aid, a bone anchored hearing aid (BAHA) is a type of hearing implant.
They are also known as bone conduction hearing devices.
What are bone anchored hearing aids?
Bone anchored hearing aids send sound to the inner ear through the bone of the skull.
There are two different types that you can have:
- Some BAHAs are worn on a soft band around the head. It’s a bit like a tight hairband with a box on it. This option is usually for children, whose hearing loss may be temporary, and whose skulls haven’t developed enough yet for surgery.
- Some BAHAs are surgically implanted. This involves either a small titanium screw (called a “connector”) or a magnet being placed behind the ear. Once you’ve healed from surgery, you can attach the BAHA to the connector or magnet.
BAHAs may be an option for people who have problems in their outer or middle ears, with sound unable to reach the inner ear, who don’t get much benefit from hearing aids.
How do bone anchored hearing aids work?
Instead of amplifying sound into your ear, like traditional hearing aids, BAHAs pick up on sound and transmit it to the inner ear.
They do this by sending the sound straight to the nerves in your ear via your skull bone.
A BAHA can be clipped on and off, so you can remove it at night and when you take a shower or go for a swim.
Types of bone anchored hearing aid
There are two types:
An abutment BAHA
This has the implant coming through the skin of your scalp. An abutment (a connecting piece) is attached to the implant, which attaches it to the sound processor – a small box.
A magnet BAHA
This contains an implant magnet in the shape of a flat disc, about the size of a two pence coin.
This sits completely under the skin. The sound processor and sound processor magnet sit on the skin of your scalp, held in place by magnetic attraction.
Middle ear implants
What are middle ear implants?
Middle ear implants (MEIs) are surgically implanted hearing devices, which bypass the middle ear and send sound signals to your inner ear.
MEIs might be suitable if you have mild to moderate:
- Conductive hearing loss – this is when sound cannot get through the outer and middle ear. For example, it could be caused by glue ear or a problem with your ear drum or the bones in your inner ear.
- Sensorineural hearing loss – this type of hearing loss involves damage to the inner ear, the nerve that runs from the ear to the brain (auditory nerve), or the brain. This damage could be caused by, for example, exposure to loud noises or ageing.
- Mixed hearing loss – a mixture of both of the above.
An MEI may also be an option if you cannot use a regular hearing aid because you have any of the following:
- Earmould allergies.
- Skin problems in your ears.
- Outer-ear infections.
- Narrow, collapsed or closed ear canals.
- Malformed ears.
An MEI could be an alternative to a BAHA if you have any of the above problems as well as healing issues, problems using your hands or difficulty keeping a BAHA clean.
How do middle ear implants work?
MEIs are relatively new technology. An MEI has two main parts:
- A device attached to the skin that picks up sound and turns it into an electrical signal.
- A device under the skin that picks up these signals and sends them along a wire to the inner ear.
This will not fully restore your hearing but it can help make sounds louder and clearer.
Auditory brainstem implants
If your auditory (hearing) nerve is damaged, hearing aids and cochlear implants can’t help you. You might be able to benefit from an auditory brainstem implant.
What are auditory brainstem implants?
Auditory brainstem implants (ABIs) bypass the ear and the hearing nerve, and stimulate your brainstem itself. This creates a sensation similar to hearing.
Your brainstem is the lower part of your brain connected to your spinal cord.
ABIs are new and still in development. They may work for children born without an auditory nerve, and people whose auditory nerve is damaged later in life.
How does an ABI work?
An ABI has two parts:
- The external part: a microphone and speech processor (which you can wear on your body or place behind your ear), a lead and a transmitter coil.
- The internal part: a receiver and electrodes that directly stimulate your brainstem to provide a sensation of hearing. This is surgically implanted directly onto your brainstem, bypassing the cochlea and auditory nerve.
A few weeks after the internal part has been implanted, the external parts are fitted and your implant is switched on.
Over a period of time, the speech processor is tuned to meet your needs.
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This content was last reviewed in September 2023. We’ll review it again in 2025.