Both the hearing aid and the cochlear implant help people with hearing loss better communicate with the world, but which is better? A hearing aid is typically more suited for patients who have mild, moderate, or severe hearing loss with a good level of speech understanding. As long as your cochlea, the organ of hearing, can discriminate speech well, then a hearing aid will benefit. Cochlear implants are typically for people with more severe forms of hearing loss and limited to no understanding of human speech. When your cochlea has lost its ability to discriminate speech, then a cochlear implant will restore the cochlea’s ability to hear and understand speech

Approximately 48 million Americans are living with some form of hearing loss. While the experience of lost hearing affects everyone differently, the data shows it can have a negative impact on quality of life. Even a mild form of hearing loss can make it challenging to communicate with the outside world. Treatments include hearing aids and cochlear implants. What are these treatments and is one better than the other?

What is Hearing Loss?

senior suffering from hearing loss

Hearing loss or hearing impairment occurs when there is a problem with one or several parts of the ear: the eardrum, the hearing bones, the cochlea, the hearing nerve, or the brain. Aging and exposure to chronic high levels of noise as well as genetic issues or even excessive amounts of earwax can cause temporary or chronic hearing loss.

The inner ear (cochlea and semicircular canals) is a delicate, fluid-filled organ responsible for hearing and balance. There are three primary parts of the ear, including the external, middle, and inner structures. Any of these structures can be damaged, so the type of hearing loss you experience can vary. The type of hearing loss diagnosed can vary depending on the part of your hearing pathway that is damaged. 

There are four primary types of hearing loss:

  • Conductive hearing loss occurs when sounds cannot pass from the outer and middle ear to the inner ear
  • Sensorineural hearing loss occurs when the structures of the inner ear and hearing nerve have weakened or been damaged
  • Mixed hearing loss includes both conductive and sensorineural symptoms
  • Auditory neuropathy spectrum disorder occurs when sound enters the ear normally but isn’t organized in a way the brain understands. The hearing nerve pathways and the brain aren’t able to process the sound signals it receives properly

The type and degree of hearing loss (from mild to complete) can vary by person.

Some of the causes of hearing loss can include:

  • Hearing nerve tumors
  • Damage to the inner ear caused by exposure to loud sounds or natural aging
  • Ear infections
  • Ear tumors
  • Malfunction of the hearing bones
  • Earwax buildup and ear canal growths
  • Genetic causes
  • Ruptured eardrums

What Treatments Can Help Hearing Loss?

Depending upon the type and severity of the hearing loss, your hearing expert will select from four primary types of treatment:

  • Removing blockages caused by excessive earwax
  • Surgical procedures to correct outer ear, middle ear, or hearing bone problems
  • Hearing aids can be used to amplify sound so the cochlea can hear
  • Cochlear implants bypass the damaged parts of the inner ear to stimulate the hearing nerve

What is a Hearing Aid?

what is a hearing aid

Hearing aids are small electronic devices that amplify the sounds going into the ears. Hearing aids contain a tiny microphone and a computer chip that amplifies the sound to a speaker. The unit is powered by a battery. 

There are two primary types of hearing aids: in-the-ear (ITE) and behind-the-ear (BTE). Within both types are a variety of colors, shapes, sizes, and styles to choose from. Today’s hearing aids are improving all the time; these sophisticated little tools have a big impact on the lives of people living with hearing loss.  

Hearing aid devices are typically prescribed by a provider (audiologist, otolaryngologist) after an evaluation of the hearing problem. Hearing aids are most often prescribed for children and adults who have mild or moderate sensorineural hearing loss.

What is a Cochlear Implant?

what is a cochlear implant

Cochlear implant is a medical device designed to help you hear. But unlike a hearing aid, the cochlear implant is surgically placed under the skin to directly stimulate the hearing nerve that transmits sound and speech signals to the brain. The implant has a wire that is delicately placed within the cochlea. Unlike a hearing aid, which can be taken in and out of the ear canal, the cochlear implant is placed into the body surgically. 

The internal cochlear implants work with an outside the ear sound processor that fits behind the patient’s ear. The processor captures sound in the form of a digital signal, sending it to the internal implant receiver. The receiver sends that signal to electrodes implanted in the inner ear. This, in turn, stimulates the auditory nerve leading to the brain. The brain interprets this as sound and speech. In the beginning, this sound is not the same as what a hearing person experiences. People using cochlear implants are trained to interpret these signals as speech and sound. Your brain will quickly learn to hear these new sounds and get useful speech understanding. As with most things, some people will hear very quickly after a cochlear implant whereas others will require training. 

Cochlear implant technology has advanced rapidly over the past decade. Cochlear implants can connect to people’s phones and music devices. Today, these implants can be placed in one or both ears to help people with severe hearing loss that a hearing aid cannot help.

Hearing Aid Versus Cochlear Implants – Which is Better?

is a hearing aid or cochlear implant better for hearing loss?

Hearing aids are still the most commonly prescribed cure for hearing impairment. Unlike a hearing aid, which amplifies sounds, a cochlear implant electrically stimulates the hearing nerve to activate hearing. The cochlear implant is designed for severe hearing losses and it is not generally used when a patient has only partial hearing loss. However if your surgical team determines you are a candidate for a cochlear implant, then children as young as one year of age along with adults of all ages can benefit.

People with cochlear implants report improvements in:

  • The ability to hear speech without reading lips
  • Hearing environmental sounds such as music, telephone sounds, or television
  • The ability to know where environmental sounds are coming from
  • The ability to concentrate on speech when in a crowd

Your provider will evaluate which is better, the hearing aid or cochlear implant. Typically, the cochlear implant is recommended when the patient has:

  • Severe hearing loss or total deafness
  • Limited benefits from the hearing aid devices
  • No medical conditions that increase the risk for cochlear surgery
  • Strong motivation to be a part of the hearing world
  • An understanding of the technology’s limitations 

Because the cochlear implant can eradicate any remaining natural hearing in the ear, patients should carefully consult with their provider about their options. 

The expert hearing team at The Ear, Nose, Throat & Plastic Surgery Associates can help diagnose hearing loss and prescribe the best treatment option for your situation. Click here to set up an appointment today and hear the difference tomorrow.