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Cochlear Implant Frequently Asked Questions

Introduction to Cochlear Implantation

The Johns Hopkins Listening Center provides a comprehensive, team-oriented approach to cochlear implantation and rehabilitation. Our patients work with a team of cochlear implant experts, including surgeons, audiologists and auditory rehabilitation therapists.

In this video, Dr. Howard Francis, director of the Johns Hopkins Listening Center, answers the most commonly asked questions about cochlear implants.

Prospective Cochlear Implant Candidates

Can I take a shower or go swimming after I get a cochlear implant?

Yes. The surgically implanted internal processor is placed underneath the skin, making it waterproof. The external processor traditionally is NOT waterproof and should be removed (similar to a hearing aid). Some currently available models of external processors do have waterproofing options that can be used in the pool, bath or shower. You should discuss these options with your cochlear implant audiologist.

How much hair will be shaved off during surgery?

The surgeon will typically only need to shave a very small area of hair immediately behind the ear (1cm to 2 cm).

What does a cochlear implant sound like?

This is a tough question to answer, as it varies for all patients. Initially, the most commonly reported sound qualities are described as “mechanical,” “robotic,” “cartoonish” and like people are “talking with marbles in their mouth.” Some patients will only “feel” the stimulation when it is first turned on. It is very important to realize this is a process. Over time the sound quality will change as the brain re-learns the stimulation patterns provided by the cochlear implant. For the majority of patients, the sound quality will continually improve over the first six to twelve months.

How frequently do I need to come for appointments after I get a cochlear implant?

The cochlear implant is a lifelong commitment. You will be set up for three to four programming appointments starting approximately one month after surgery. These appointments are set up to provide you with a transitional period to help you acclimate to the new sounds you will hear through your cochlear implant. Following those initial appointments, you should expect to be seen every three to six months for the first two years and then AT LEAST every year after that.

I can’t understand things in a large group or noisy situation. Will the implant fix that?

The simple answer is no. You will likely still have a lot of frustration and difficulty when listening in large groups or noisy situations. However, you may find that over time your ability to communicate in those situations gets easier as you have greater access to information and your brain can ignore some of the noises you don’t want to hear.

Can I sleep with a cochlear implant on?

No. The implant is likely to come off during sleep, and it could get damaged. It is recommended that you remove the device prior to going to bed. If you live alone, please consider additional assistive listening devices for alerting purposes.

Can I use assistive listening devices such as an FM system or T-coil neckloop with a cochlear implant?

Yes. All cochlear implants have internal t-coils available for use and available connectivity to FM systems or Bluetooth.

Can I fly in an airplane?

Yes. You’ll need to carry your cochlear implant identification card with you to show security personnel, as you will set off the security detectors. Provided there are no surgical complications, most patients can resume airline travel within a week or two of surgery. However, it may be best to discuss this topic further with your implant surgeon.

What is the cost of a cochlear implant?

In order to determine the cost of a cochlear implant you will need to contact your health insurance provider. Your audiologist can assist you with the correct procedure and diagnosis codes to help.

Learn more about cochlear implant costs and resources.

How can the Outreach Program help me?

Collaboration between home, school and The Listening Center ensures a unified effort to optimize your child’s listening and communication potential. The Listening Center partners with teachers and support personnel to provide an optimal listening environment, promote language growth and maintain the function of the cochlear implant system. Services can include annual and/or supplemental speech-language and auditory skill assessments, in-service instruction for school professionals regarding specific equipment and auditory strategies, attendance to Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP) meetings, classroom observations and recommendations specific to the child and assistance in development of auditory skill goals for therapy and the classroom.

Outreach services for adults are provided indirectly according to the specific employment or community difficulties the patient may encounter.

 

Activating the Cochlear Implant

Steve Bowditch, an audiologist at the Johns Hopkins Listening Center, answers the most frequently asked questions about the cochlear implant activation process.

Rehab after Cochlear Implantation

Deborah Bervinchak, an auditory rehabilitation therapist at the Johns Hopkins Listening Center, answers the most commonly asked question about the rehabilitation process after receiving a cochlear implant.

Current Cochlear Implant Users

Can I get an MRI?

The simple answer is no. There are certain devices currently available that are FDA approved for MRI strengths up to 1.5 and 3.0 tesla. You should always contact your cochlear implant surgeon to discuss whether your device falls under this approval umbrella. In most cases, a high-resolution CT scan is an adequate substitute, which can be obtained with any cochlear implant at no risk.

Can I get an X-ray?

Yes, X-rays are fine. Just remove the external equipment.

My external speech processor doesn’t feel secure behind my ear and falls off frequently. How can I better secure it?

Depending upon the processor you are using, there may be options available. Some of these include:

Wig tape: This can be placed between your skin and the processor. The tape will adhere to both, keeping your processor secure against your head.
Ear mold: An earmold can be connected to your processor (like a hearing aid) and provide an anchoring point for the processor. This is also a good option to alleviate the weight of the processor pressing down on your ear.
Third party retention devices: There are a number of options available for purchase through online sources that can be used to hold onto the processor. You can search for “cochlear implant retention” to see what’s currently available.

My ear hurts from wearing the speech processor. Why and what can I do about it?

It isn’t uncommon for the ear to be sore, especially in the beginning. This is due to the fact that a speech processor is often heavier than a hearing aid. To ease the discomfort, we recommend getting some mole skin. This is located in the drug store in the foot section. Mole skin is used most commonly to prevent blisters on your feet but works great on the ear too. You simply need to trim it to the size you need, stick it to the processor and put it on. Typically, the ear will toughen up so that the mole skin won’t be needed all the time, but in the beginning it is very helpful.

Where can I get replacement batteries or parts for my cochlear implant?

Most parts for cochlear implants are manufacturer specific. You should contact your processor’s manufacturer to make sure you are getting the correct parts for your processor. All manufacturers have multiple ways to get in touch with them (phone/chat/email) and can even sometimes bill your insurance directly.

What do I do if my speech processor isn’t working?

If you are having difficulty with your speech processor, we would recommend performing whatever troubleshooting you can with your back up equipment at home first. There are troubleshooting guides available for all devices in the instruction manuals you originally got with your equipment, or they are available online at the manufacturer’s website. If you cannot determine the problem through troubleshooting, you should contact your manufacturer. The cochlear implant manufacturers all have resources in place to assist recipients and usually have a greater range of hours than your audiology clinic. Lastly, you can always contact your audiologist and make them aware of the problem. They may be able to suggest a repair strategy or they may request you come in for an appointment to further investigate the problem.

Is there a recommended cell phone for use with cochlear implants?

No ,there is not one particular device recommended. Cochlear implants can interact with a cell phone acoustically, electromagnetically and via Bluetooth streaming. The latter option is the most common with all current cochlear implant processors having some accessibility to a Bluetooth signal.

What do I do if I lose the speech processor?

There are warranties in place against loss for the speech processor. These warranties are not indefinite, however, so you should let your audiologist know immediately about the loss. They can assist you in determining if you are still under coverage or not. They can also assist you in completing any paperwork necessary to file a claim.