Choosing a cochlear implant

In a hurry? Check out the Cochlear Implant Comparison Chart, the most frequently updated and technically accurate cochlear implant manufacturer comparison chart.  But do take the time to read this page to better understand some of the terminology used in the Guide.

Three factors contribute to your success with a cochlear implant.

  • Your hearing history
  • Practice and rehabilitation
  • The implant itself

You can’t do anything about your hearing history.  Some of us were born deaf, others lost our hearing later in life.  The hearing loss may have been gradual or sudden.

Generally the best candidates for cochlear implants are babies and very young children.  Because their brains are wired to acquire language, they will start out learning to hear with an implant (or two).  These children usually grow up to achieve things far beyond what we may have imagined when we learned that they were deaf.

Adults who grew up with normal hearing and have a good auditory memory generally do quite well also.

People who had little auditory stimulation growing up, either not having worn hearing aids, or with a severe enough loss that hearing aids did not provide much benefit, have a wide range of responses.  This group of candidates benefits from more intensive and longer duration rehabilitation therapy.

Some people with stable long-term low-frequency hearing may benefit from a combined cochlear implant / hearing aid system.  However, loss of residual hearing after implant surgery is common, so it is important to choose a system that will operate well in either mode.

Rehabilitation is important for all implant recipients.  Children need extra practice during their early years.  Practice can be anything from formal therapy sessions with a speech and language pathologist to bedtime stories used to reinforce language learning.

It is impossible to predict how well an individual user will do with an implant, even when you take the above factors into account.  Most users fall into a normal distribution.  But there are some users who do far better than average.  And there are others who don’t do nearly as well as the average.  There is always some uncertainty in the eventual outcome.  It is the job of your cochlear implant team to assess your case, and to determine whether it is likely that you will be better off with an implant than with any other available technology.

We would like to hope that once we make the decision once to get an implant, it will stay with us for the rest of our lives.  For babies and young children, that means that the electronics will have to stay relevant and functional for many, many decades.  But there aren’t many pieces of electronics 60 or 70 years old that are commonly found useful and in good repair.  When a baby is implanted today, chances are pretty good that far superior technology or medical treatments will be available at some point in his or her life.  Still, the internal part of the system, the implant itself, should be chosen with a strong focus on reliability and upgradeability. The implant is the part of the system that requires surgery to replace if it can no longer be upgraded via software.  External processors may always be replaced with newer technology.

Some say that all implants work equally well, and that hearing history and rehabilitation are the only aspects that affect the outcome. But that does a disservice to the engineers and scientists at all cochlear implant companies who dedicate their careers to improving the technology so that we may all hear better.  Cochlear implants are marvels of modern medicine and technology, and it would be naive to consider them indistinguishable commodities.

When choosing a cochlear implant, you have access to the materials made available to you by the manufacturers, each highlighting the advantages of their particular system.  And there are sources on the web such as this one, created by individuals, which attempt to simplify the task by presenting the information in a concise format. Comparing the relative merits of the available systems can be a sensitive topic for some people.  But as you start on your journey, this is precisely what you must do.

Cochlear implants can be a more personal topic than your favorite sports team or which car you drive, because they involve surgery and a long-term commitment.  When you have an implant, you should expect a feeling of inclusion in the global cochlear implant community.  Nobody should tell you that you have made the wrong choice just because it was different from theirs. Just as automotive enthusiasts can discuss differences between their vehicles in a civil manner, so should you be comfortable talking about your implant.

Does the implant contribute 10% to the overall result?  20%, or 50%?  Nobody knows.  And they all do work well, as far as it is possible to determine by testing subjects in sound booths. So do your homework, make a choice, then relax.

With this in mind, please take a look at the Cochlear Implant Comparison Chart.

Points to Consider

The implant contains a fixed number of channels, each of which drives one or two electrodes.  The electrodes stimulate the fibers of the auditory nerve.

This is the difference between the loudest and softest sounds that can be heard at any one time. Imagine you have a pair of curtains, they can be opened wider or drawn closer to let in more or less light – so it is with IDR and sound.


The T-mic from Advanced Bionics is situated at the entrance to the ear canal, blocking noise naturally, and allowing the wearer to use a phone or headphones in a natural manner. All other cochlear implant processors have one or two mikes positioned elsewhere.  Multiple mikes can be useful in some situations to focus the sensitivity towards the speaker.


How serious is each company about bringing new products to the market? Check out the US Patent and Trademark Office search engine and fill in the search box for a company name. You’ll need to make sure to select ‘Assignee Name’ for the field. Or you can try Google Patents.

Occasionally issues occur that may prompt a manufacturer to temporarily halt production of an implant due to safety concerns. These may involve recalling unimplanted devices.

How do you feel about carrying a remote control?  Would you like to fine tune your hearing for different listening situations?


Multiple stimulation circuits allow unique speech processing strategies. Some people prefer one type of sound over another. One type can sound sharper, softer, or just ‘different’. These may be used to create virtual electrodes, increasing pitch resolution.


Faster stimulation rates enable more accurate timing of sound.


Consider how much unused hardware and software capability is available on your implant for upgrades without surgery.


Issues to be aware of

Warnings and Precautions

Cochlear implant problems