Written by Lydia Brekke, Taylor Graft, and Madisyn Plumhoff
“The number of people who use cochlear implants keeps growing. More than 324,200 people across the world have cochlear implants. In the United States, over 96,000 people have cochlear implants” (ASHA, 2019).
Two weeks after his birth, Patrick from St. Louis, Missouri was diagnosed with profound hearing loss. He was fitted for hearing aids, however with these he was still unable to hear many of the sounds crucial to language development. Patrick was given cochlear implants the week of his first birthday. In 2016 when he was seven years old, Patrick was already participating in a gifted program and was in the 99th percentile for reading at his school (Packer, 2016). What exactly is this cochlear implant, how does it work, and when does it work best in order to have a successful hearing experience such as Patrick’s?
What is a Cochlear Implant?
There are three parts of the ear, the outer, middle, and inner. Sound waves pass through the different parts of the ear causing vibrations that travel to the cochlea, a snail-shaped structure in the inner ear. In the cochlea are thousands of tiny hairs that translate sound vibrations into electrical signals that are sent to the brain from the auditory nerve. For most people who have hearing loss, the hairs in the cochlea are damaged or missing, so electrical signals cannot be transmitted to the brain. “A cochlear implant bypasses hair cells that don’t work anymore and gives the brain the ability to perceive sound once again” (Mayo Clinic, 2016). Essentially, people with extreme hearing loss can choose to have an implant placed under the skin with a magnetic transmitter on the outside of the skin. To place the implant, the surgeon makes an incision and creates a small hole in the cochlea, threading the internal portion of the device through the hole. Following surgery, an audiologist works to adjust the sound processor and to make sure the implant works. This complex electronic device works differently than hearing aids do. Hearing aids amplify sounds, whereas cochlear implants actually bypass damaged portions in the ear and send signals directly to the auditory nerve which clarifies sound making it more distinct. These signals are sent to the brain, and it may take some time for the recipient of the implant to be able to interpret these signals as they are not the same as “normal hearing.” The processor is not activated until 4-6 weeks after the implant is placed, and hearing for the first few months with a cochlear implant is often unstable and unpredictable, as new thresholds are established and the ears tune in to sound quality (Boswell). The implant is said to help users understand speech really well, but does not do a great job in relating information about pitch and timbre, or sound quality (Hamilton, 2015). Some people who have received cochlear implants describe the first sounds they hear as “robotic” or like ducks quacking.
Since the cochlear implant is most successful within the peak period of language acquisition, which is before the individual reaches puberty, this means it is not always equally effective per person. The cochlear implant is not meant to fully restore hearing, although there have been many successful cases of individuals improvement in hearing abilities due to the implant. People who have had the cochlear implants report improved ability to speak, recognition of environmental sounds, listening in an overwhelming and loud environment, as well as hearing telephone and television conversations (Mayo Clinic, 2019).
Concerns Regarding Cochlear Implants
Besides the fact that cochlear implants may not be as effective from person-to-person, there are also several other factors one must consider when deciding whether to receive the implant. One such factor is the cost, as cochlear implants can cost $30,000-$50,000, and that is just for the device itself. This does not include costs of rehabilitation, pre and post-operation, and any other expenses (Boys Town National Research Hospital, 2019). Another factor one must consider is the potential health risks. Although not extremely invasive, this procedure inherently carries risks. Some of these include: bleeding, swelling, tinnitus (ringing in the ears), injury to the facial nerve, dizziness or vertigo, and risks associated with general anesthesia (Johns Hopkins). When making this decision, one might also consider societal factors, as cochlear implants have been a divisive issue in the deaf community.
Controversy in the Deaf Community
Although there are other factors to consider when making one’s decision, there is an understandable amount of controversy within the deaf community regarding cochlear implants. Adults who have grown up deaf and feel as if deafness is a part of their identities, sometimes deny deafness as a disability. Deaf culture, including the use of sign language, is being compromised in the eyes of some of the deaf community. In the documentary Sound and Fury (Aronson, 2000), the Artinian family are a perfect example of individuals who truly value their identity within the deaf community. The parents of Heather Artinian, a four and a half year old candidate for the cochlear implant, struggle to release their daughter to the hearing community and feel that the implant will cause her to question her identity. Even though Heather is already fluent in sign language, her parents fear that Heather’s involvement in the hearing community will eventually cause her to retract from her family and other deaf people around her. Morality and ethics were often mentioned in the film, regarding Heather having a normal, hearing life.
Conclusion
The cochlear implant has improved the quality of life for many. With the continuous progression of technological advancements, hopefully someday the cochlear implant will be the gateway to hearing in full for those who desire it. Although there is much to consider when deciding whether to surgically place the implant, the possible outcome of hearing may be worth the potential risks for qualifying individuals.
References
Boswell, Susan (n.d.) The Mind Hears: Tuning In With a Cochlear Implant. Retrieved from https://www.asha.org/public/hearing/Tuning-In-With-a-Cochlear-Implant/
Boys Town National Research Hospital (2019). Cochlear Implant Cost. Retrieved from www.babyhearing.org/devices/cochlear-implant-cost
Cochlear implants. (2019, January 15). Retrieved from https://www.mayoclinic.org/tests-procedures/cochlear-implants/about/pac-20385021
Hamilton, J. (2015, May 18). Deaf Jam: Experiencing Music Through A Cochlear Implant. Retrieved from https://www.npr.org/sections/health-shots/2015/05/18/406838781/deaf-jam-experiencing-music-through-a-cochlear-implant
Johns Hopkins Medicine (n.d.) Cochlear Implant Surgery. Retrieved from www.hopkinsmedicine.org/healthlibrary/test_procedures/other/cochlear_implant_surgery_135,81
Mayo Clinic Q and A: Cochlear implants for advanced hearing loss. (n.d.). Retrieved from https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-cochlear-implants-for-advanced-hearing-loss/
Packer, L. (2016, August 16). Technology meets support: One family’s cochlear implant success story. Retrieved from https://www.healthyhearing.com/report/52673-Technology-meets-support-one-family-s-cochlear-implant-success-story