Cochlear Implant Program
Few hearing centers around the country can marshal the level of expertise and resources available at the Cochlear Implant Program run by the Ear Institute at New York Eye and Ear Infirmary of Mount Sinai (NYEE). As an academic teaching institution, we surround each individual—adult or child—with an experienced team of otolaryngologists (ear, nose, and throat doctors), audiologists, speech-language pathologists, social workers, and in the case of children, an educational consultant. Because of the large volume of cases we handle—many of them referrals from other states and internationally—we’ve been able to assemble under one roof a team of professionals whose day-to-day focus is evaluating, treating, and supporting individuals with cochlear implants. Many of our specialists are also actively involved in research and clinical trials.
We offer cochlear implants from all three of the FDA-approved implant manufacturers. Our knowledgeable professionals sit down with each cochlear implant candidate and their family to discuss in detail the benefits of the surgery and the device.
There are no age restrictions on cochlear implants. They can help infants and toddlers as well as people in their seventies and older to improve their hearing experience and increase their awareness of sounds.
What is a Cochlear Implant?
A cochlear implant is a small electronic device that helps to partially restore hearing to people with severe to profound hearing loss, who receive only limited benefit from hearing aids. While cochlear implants do not return hearing to normal levels, the majority of people who receive them are able to hear well enough to understand speech. Most young children will be able to hear well enough to learn spoken language and to be successfully mainstreamed for school and play.
How Does a Cochlear Implant Work?
Most people suffer hearing loss because the microscopic hair cells in the inner ear that convert mechanical sound to electrical energy are damaged. The cochlear implant bypasses those damaged hair cells and directly stimulates the nerve endings under the cells that enable you to hear. It uses two basic components:
- An external part that is similar to a hearing aid that rests behind the ear
- An internal part (known as the receiver-stimulator) that is surgically implanted in the bone behind the ear.
The external part contains a battery-powered processor with a microphone that captures sound and turns it into digital code. The processor then converts that digitally-coded sound to electrical impulses which are transmitted to the internal receiver. The receiver in turn sends these signals to an electrode array that’s been implanted in the snail-shaped cochlea in the inner ear. The electrodes stimulate the cochlea’s hearing nerve endings, and send the impulses to the brain where they are interpreted as sound.
Who is a Candidate for a Cochlear Implant?
A cochlear implant is not right for everyone. The Ear Institute’s multidisciplinary team of specialists will help determine through an extensive evaluation if you or your child is a candidate. Among the factors they consider are:
- Hearing loss that is not helped by hearing aids
- Severe to profound hearing loss in both ears
- Difficulty understanding speech, even with hearing aids
- Heavy dependence on lip reading, even with hearing aids
What is the Process for Getting a Cochlear Implant?
The Ear Institute divides the evaluation process into two parts: medical and audiological.
Under the medical part, one of our otolaryngologists will examine the anatomy of your ear to make sure there is no infection, tumor, or other abnormality that would prevent successful cochlear implantation and use. This evaluation may include a CT scan or MRI of the inner ear.
The audiologic part draws on the extensive resources of our collaborative cochlear implant team, and includes:
- Hearing tests: Every patient will have a thorough hearing evaluation with a licensed audiologist to confirm the degree of hearing loss. Patients will be tested with their hearing aids, and if it is determined they are not performing as well as possible, different hearing aids may be tried. Once it is determined that hearing aids are not providing sufficient benefit, cochlear implants are discussed.
- Speech-language pathologists: All children are evaluated by a speech language pathologist. This allows us to better understand the child's skills and plan for rehabilitation after implantation. The speech-language evaluation assesses all aspects of a child's ability to comprehend and formulate verbal communication.
- Educational consultation: Our education consultant meets with the parents of hearing impaired children to explain to them and help them secure government-funded educational services and placements that are most appropriate for their child.
- Social Worker: Patients and families of children considering implantation will meet with a social worker who is prepared to answer their questions and discuss their concerns.
At the conclusion of these evaluations, members of the cochlear implant team meet to discuss the test results and the best way to meet your hearing needs. If it is determined that a cochlear implant is appropriate, we’ll make an appointment with you and your family to discuss and demonstrate the available devices. Unlike many hearing centers, we offer cochlear implants from all three of the FDA-approved manufacturers. You will also get a chance to meet with your cochlear implant surgeon prior to the procedure.
What Does Cochlear Implant Surgery Involve?
Cochlear implant surgery is performed in the hospital under a general anesthetic. It usually takes about two hours, and after recovery and observation you’ll be discharged the same day.
The surgeon makes an incision behind the ear and gains access to the inner ear by creating a small opening in the mastoid bone. A series of tiny electrodes are then inserted into the cochlea. These electrodes connect to the internal receiver, which is implanted by the surgeon under the skin above the ear.
The overriding goal of our surgeons during this procedure is hearing preservation. This is accomplished by taking a series of steps during surgery to minimize trauma to the inner ear when implanting the electrodes. By preserving some or all of your residual hearing during cochlear implant surgery, you may be able to use a hearing aid together with the cochlear implant in the same ear, a technique known as electroacoustic stimulation. This helps to optimize your hearing by allowing the hearing aid to acoustically amplify low frequencies while the cochlear implant electrically stimulates the middle and high frequencies.
Another option for some patients is a cochlear implant in one ear and a hearing aid in the other. This is known as bimodal hearing.
What Happens After Cochlear Implant Surgery?
About three weeks after surgery you will be seen by your audiologist at the Ear Institute to activate and program the cochlear implant. This means customizing it to your needs based on your auditory perceptions in response to electrical stimuli.
Just as important as the surgery is the care that is provided in the months and years that follow. That is why the relationship you form with your audiologist is so important. You will continue to see that professional at regular intervals to reprogram your cochlear implant and ensure maximum performance. In cases of children who have received cochlear implants, they also benefit from ongoing speech therapy.
At the Ear Institute, we take great pride in the long-term relationships our dedicated specialists have built with patients and their families—relationships based on the confidence and trust they have in us.