Cochlear implants: Sorting out fact from fiction

December 9, 2015 by Nicolas Rouleau

implant cochléaire

Cochlear implants: Sorting out fact from fiction

A cochlear implant restores normal hearing.


For cochlear implant wearers, maintaining effective listening habits (communication strategies) and lip reading remain essential. The implant performs very well in quiet locations, but speech becomes a lot more difficult to understand without resorting to lip reading in noisy environments like restaurants. Poor speech understanding in noisy places is the implant’s main weak point.

Voices sound very high-pitched and “robotic” to people wearing a cochlear implant.

True…and false later on.

During the first months of wearing a cochlear implant, patients go through an intense period of adjustment. Patients begin to hear sounds that they have not heard for years or have never heard before! Sound is also perceived as very loud. Ambient sounds and voices do not seem natural at first, but they come to feel more and more natural over the following weeks and months as the brain gets used to them, and also thanks to both brain reorganization and hearing rehabilitation.

Everyone with a cochlear implant hears the same way, and the results are the same for everyone.

False, totally false!

It can be difficult to establish a prognosis for cochlear implants as it depends on numerous factors, with deafness duration being one of the most important: the longer patients have been deaf, the harder it will be to get used to new sounds they will be hearing. Theo‑
retically, people who receive an implant soon after losing their hearing will get better results than people who have lived with major hearing loss since birth and never worn hearing aids. Other important factors include age, motivation, hearing loss cause, and health condition.

Most people with hearing loss should receive a cochlear implant.


Cochlear implants are a last resort, as any residual hearing are usually destroyed during surgery. Therefore, ideal candidates for cochlear implantation are those with severe to profound deafness (deafness that makes speech almost impossible to hear without hearing aids). There is no age criterion for a first implant.

In Quebec, the youngest patient to be implanted was four months old, and the oldest was 90. Among other things, candidates must have realistic expectations of the implant (they won’t get “perfect” hearing), be motivated, have a clean bill of health allowing them to undergo surgery under general anesthesia, and show functional oral language. The most important criterion is the likelihood of significant improvement of auditory skills (the patient’s ability to use his hearing).

In Quebec, patients receive only one cochlear implant.

This was true…it is now false.

Previously, and in order to fit the most patients possible with this technology, each patient could receive only one cochlear implant (with some exceptions, e.g., deafblind patients). But since the summer of 2012, people with one implant have been allowed to apply for a second one to take advantage of the benefits of binaural hearing (both ears are stimulated), including sound localization and improved speech understanding in noisy environments. To be eligible, candidates must be reassessed by the team and meet given criteria.

The author: