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Cochlear vs present hearing aids

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I have been wearing hearing aids for about 20 years. I have low moderate loss in my right ear (60-70db) and severe loss in my left ear. The has recommended that I look at Cochlear implants. It looks like once the implant is in place regular hearing is mostly gone and cannot be reversed. It then takes up to a year before you to begin to be able to hear. I am concerned about not being able to hear without the implant receiver. This could be a safety concern at night. It seems like most of the recipients have severe to profound loss in both ears. Also the year of not being able to hear properly is a concern. At this point the hearing aids are able to amplify sounds but like most folks here I have a problem in noise and in speech recognition.

At this point I have very mixed feelings. I would like to be able to hear and understand but I am concerned that I will lose what I have and not really have much to gain.

Any others here who have similar conditions and have received the implants? Good or bad experience?

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@Gordon_L said:

t then takes up to a year before you to begin to be able to hear. I am concerned about not being able to hear without the implant receiver.

This statement is wrong for probably 95% of the implants, just an educated guess.

Most people getting implants can understand speech within 4-8 weeks or less. There are exceptions.

You are correct about losing residual hearing in that implanted ear. Most people do eventually lose that residual hearing but not all. My right ear is completely deaf but my left still has just a touch of hearing low frequencies.

@Gordon_L said:

The ENT has recommended that I look at Cochlear implants. It looks like once the implant is in place regular hearing is mostly gone and cannot be reversed.

Hello @Gordon_L For your “bad” left side it would be useful to get an Implant. Wheather you hear or not without the receiver is in my opinion no decision point, because you are able to hear more than nothing with your right side.

I hear your concerns and can address them as someone who went forward with a on the early side of qualification. The “year to hear” thing is more of an issue for people who are born deaf or completely deaf, or have not aided their ears for a long time. Since you are an active hearing aid wearer, and still do have some hearing left, research says you will more than likely have a better result at “activation”. You have the CI surgery and then a couple of weeks later they activate it (turn it on) and adjust the volumes of each tone according to your needs. I was able to understand speech on activation day, although all voices sounded like Darth Vader in a tunnel. From activation it takes your brain a while to learn how to interpret the new sound input - our brains are amazing thought and do this pretty quickly. I noticed improvements weekly and felt it was already better than with my . There are many “rehab” apps available to use to encourage the new brain connections - but basically all things you hear is rehab. Keep sound coming - audio books, TV, music, outdoor natural sounds - the more exposure the better. If you put your CI on in the morning and don’t take it off til you sleep, you will be better off than just wearing it a few hours at a time. As for losing your (residual) hearing - yes, you often do and I did. However not everyone loses it all and some CI brands have attachments for the CI to help also amplify the residual hearing you have. The reality is that our ears get worse with time anyway, so it’s not like it doing a lot for you. You also have your other ear that will help for nighttime. There are adaptive fire alarms etc if it is a concern. I have a CI left and a HA right and I hear much more with this combination than I did prior to implantation - take a look at my . I chose the Advanced Bionics brand because it has the Marvel Link HA that directly pairs with the CI and they work with one phone app. As for “most recipients have profound loss” - that is outdated information. There have been great advances in CIs over the last dozen years and studies show early implantation yields better results. It’s a scary decision and one that most say they wish they did sooner. You might be one of them someday!

In addition - a evaluation and conversation with a CI audiologist is very helpful in giving you more data to make your decision. You are not obligated to get the surgery at any point, but it does give you time to explore and learn more so you feel more comfortable making a decision.

In reply to @joanhawsey

So how does it work for you when you have a on the right and a on the left. Presently my right ear is similar to yours and when I am in a noisy environment or several people are talking everything is just overwhelming and I can’t understand anything. With a HA in that ear it would seem like I would still have that problem.

I had an Advanced Bionics implanted in my almost totally deaf ear plus a Link in the slightly better ear. After surgery I relied on my old HA in the better ear until I was activated.

I could just barely understand speech, in a quiet room, at activation. It sounded funny, but was understandable. I progressed quickly and reached 90% word understanding at 4 weeks (with the linked hearing aid). I did go through a lot of adjustments to the program (called the map) in the first few months. I also spent a bunch of time working on training my brain using a few of the apps available online for that purpose.

The question about loosing residual hearing bothered me too. I have retained a very tiny amount of hearing in my CI ear. My better ear with the Linked HA helps balance the sound. For me they work together to create a full, almost normal, sound.

I do worry about how I’ll manage if I loose more hearing in the better ear. But that would have been no different if I didn’t have the CI implanted. In fact, that is why I had the operation. I lost some more hearing in my better ear and realized I would be totally deaf if that ear tanked.

Now I can understand speech. I’m back in the world again.

It’s wonderful to hear again! Is it perfect? No. Noisy places are sometimes difficult. Is it better than not hearing at all? YES!

Hi Gordon,

I have an Advanced Bionics in L ear plus a Phonak Naida Link M in R. Implant surgery was in Jan & CI was activated in Feb. Residual hearing in the implanted ear is very much weaker than before the surgery.

I had been using HA’s for ~10 years. Last year I tried upgrading from KS10 to Phillips Hearlink 9040. They were not as good as the KS10’s. I also briefly tried two other Costco HA’’s in the store but they were no better. So I returned the Phillips and had the CI surgery.

My hearing comprehension is still not good – speech is distorted but the implant helps, especially with higher freqs. I often hear birds that my wife can’t hear. Streaming from my computer is much better than listening via the microphone, Most mornings I listen with only the implant to NY Times articles “read by an automated voice”. These voices are rather clear so they aren’t much of a challenge.

Many people on the forum like Cochlear implants. Perhaps they would have been a better choice. I find the app is primitive. For example, it has only 4 battery levels: 100, 75, 50% and discharged. One time, after seeing 50% charge, I went out for a walk and the implant shut down ~15 minutes later. I put it on the charger for 10 min. and the app reported 50% charge.

Edited

What percentage of (Word Recognition Score) you have in left and right ear separately and then in condition? Perhaps your left ear doesn’t contribute much to speech understanding?

@FredO said:

For example, it has only 4 battery levels: 100, 75, 50% and discharged

Cochlear isn’t much better in that issue: there is, accordingly 100, 80, 50 and 20% in which is better to charge immediately to extend battery life in good condition.

@Gordon_L said:

It then takes up to a year before you to begin to be able to hear.

This is not true. I could understand speech the day I was activated. One week later at my first mapping I could understand most spoken conversations. At 3 month evaluation I had 58% and Phenome score of 80%.

I’m and . I still have a small amount of residual hearing in my CI ear. You don’t have to go bilateral CI. You could well find being bimodal is sufficient for you

I’m assuming you’re in the US. Do your research on surgeons. Some surgeons are good at preserving residual hearing. Some aren’t also. Research until you find one who can. Then travel to that clinic. Just because you travel to a surgeons clinic doesn’t mean you have to keep traveling for your mappings. You can find a CI a lot closer to home. You will lose some residual but if you find the right surgeon you won’t lose the lot of it.

You will find plenty of of accessories very suitable for the deaf and community. Eg sonic smoke detectors and alarm systems.

My overall experience has been nothing short of life changing. The best thing I’ve ever done. Absolutely no regrets at all. I couldn’t answer the phone, I had isolated myself from friends, phone call are a breeze and I’m back out socializing again. It’s not an easy road to walk post surgery. You will need to put in a concerted effort in rehab

Good luck on your decision make.

My word recognition is about 75% in my right ear and 50% in the left. I do fairly well in a one on one situation in a quiet environment. My main problem is in a noisy environment and with several people talking at once. When I am in a noisy environment it is just completely overwhelming and I understand almost nothing. The problem is if I receive a in the left ear which is now pretty much useless I still have the problem with the right ear being completely overwhelmed in noise.

I work alone for most of the day and do not talk to anyone and I spend most of the evening reading in a room by myself. The main problem is supper time when I have a problem hearing my wife. I usually kick up the volume a couple of notches when I am with my wife. I would not watch TV even if my hearing was normal. What got me started on this was I went to the right after Thanksgiving where I was at the table with six other people and I had no idea what anyone said. I am not convinced that putting a CI in my left ear is going to improve my situation.

In reply to @Bimodal_user

@Bimodal_user said:

What percentage of WRS (Word Recognition Score) you have in left and right ear separately and then in binaural condition?

This is also my question @FredO . I am wondering if his rehabilitation is counter productive with the hearing aid in use. For some people it’s important to rehab the new CI by itself without the hearing aid in the other ear.

Cochlear battery indication on the app is shown in 1 percent incriminates. It’s actually a pretty nice and useful app.

You are above 80 except 8khz, I would never consider in that situation. you are grounded after surgery and have to relearn hearing. and you don’t really need them.

CI isn’t an option for me, it a plan B kind of thing if nothing works anymore.

very bad advice.

In reply to @Gordon_L

@Gordon_L said:

The problem is if I receive a CI in the left ear which is now pretty much useless I still have the problem with the right ear being completely overwhelmed in noise.

This statement is incorrect. Your brain typically hears from two ears. It takes two ears to hear localization and it takes two ears to understand in noisy environments. The truth is you would hear better in these environments with two hearing ears.

In reply to @Gordon_L

@Gordon_L said:

My word recognition is about 75% in my right ear and 50% in the left

And in condition e. g. two ears are checked concurrently?

@Gerhard_R said:

You are above 80 except 8khz, I would never consider CI in that situation. you are grounded after surgery and have to relearn hearing. and you don’t really need them.

It is not completely true. The more important test is Word Recognition Score. Relatively good not necessarily indicate good hearing of words.

Of course it is paramount to check possible less invasive options, like newest hearing aids (like Phonak Audeo Spheres 90, Oticon Intent, Starkey Omega, etc.). Maybe it will be enough, but the chances are lower when left ear have less than 60% of .

Keep in mind that it is possible that new generation of Oticon will be released in February (2 years after previous Intent) and in Phonak case - in August 2026.

However, I don’t know you financial situation, because hearing aid is often not reimbursed.

It can’t hurt to be evaluated for a . You can always say no. And if you decide against CI, there are other devices that may help you hear better in more situations. Your Audi can help you consider all your possibilities.

I used a instead of a hearing aid in my bad ear for many years. “A CROS (Contralateral Routing of Signal) hearing device is a system for people with single-sided deafness (unilateral hearing loss) that wirelessly transmits sounds from the poor-hearing ear to a hearing aid worn on the better ear, overcoming the “head shadow” effect to improve awareness and understanding of sounds from all directions, like someone talking from your deaf side. It involves two parts: a microphone/transmitter on the poor ear and a hearing aid on the good ear, working together to provide a complete sound picture.”

Get a Roger. “A Roger hearing device is a wireless microphone system by Phonak1 that transmits speech directly to hearing aids, cochlear implants, or specialized receivers, overcoming background noise and distance to improve speech understanding for people with hearing loss in challenging environments like classrooms or noisy restaurants. It functions like a “third ear” by sending clear audio signals, reducing listening effort and aiding communication for better learning, working, and socializing.”

@db4art said:

Get a Roger. “A Roger hearing device is a wireless microphone system by Phonak that transmits speech directly to hearing aids, cochlear implants, or specialized receivers, overcoming background noise and distance to improve speech understanding for people with hearing loss in challenging environments like classrooms or noisy restaurants. It functions like a “third ear” by sending clear audio signals, reducing listening effort and aiding communication for better learning, working, and socializing.”

It is very reasonable advice, especially before feature introductions, but from my point of view I barely use RogerOn after getting my Phonak Audeo Infinio Sphere 90 with AI Spheric Speech in Noise program.

Perhaps @raylock1 could write his though about that option.

In reply to @db4art

@Gordon_L said:

My word recognition is about 75% in my right ear and 50% in the left. I do fairly well in a one on one situation in a quiet environment. My main problem is in a noisy environment and with several people talking at once. When I am in a noisy environment it is just completely overwhelming and I understand almost nothing. The problem is if I receive a CI in the left ear which is now pretty much useless I still have the problem with the right ear being completely overwhelmed in noise.

I work alone for most of the day and do not talk to anyone and I spend most of the evening reading in a room by myself. The main problem is supper time when I have a problem hearing my wife. I usually kick up the volume a couple of notches when I am with my wife. I would not watch TV even if my hearing was normal. What got me started on this was I went to the ENT right after Thanksgiving where I was at the table with six other people and I had no idea what anyone said. I am not convinced that putting a CI in my left ear is going to improve my situation.

I agree. After over and year and a half of binaurality (is this a word?) there has been no improvement in noisy situations, so now I use the Roger all the time in noise. btw, I have been faithfully doing rehab every day for an hour or two, but now I wonder if I should continue, or at least spend less time.

At this point I am scheduled for evaluation with my on December 22 so at this point everything is pretty much speculation. I am relatively sure that I will qualify for my left ear and I certainly do not want to get two implants at this point. My main question or concern at this point is how will an implant in one ear and a hearing aid in the other interact in my situation. At this point there seems to be a split of opinions where some have good luck with that and others do not.

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