Cochlear implant pros and cons

7 cochlear implant pros and cons that will make you think

Many people assume that when you get a cochlear implant, you are “cured” of deafness. This is complete nonsense. It just doesn’t work that way. A deaf person receiving a cochlear implant remains a deaf person; they don’t miraculously become a hearing person. There are many cochlear implant pros and cons to consider before committing to the operation.

Being deaf is not an illness that needs to be cured. It’s true that cochlear implants (CIs) can help some severe or profoundly deaf individuals improve their way of communicating in the hearing world. However, not everyone has positive experiences; some deaf people actively protest the use of CIs.

Many people in the deaf community resent cochlear implants for the effect it has on the hearing people in their lives. When a deaf person gets a CI, and it works to a certain degree, their friends and family assume they can stop putting in the effort to effectively communicating with them, because you can hear now right?

It’s important that you understand how much work and dedication goes into effectively using a CI. You don’t simply flip a switch and boom you can hear. Also, it doesn’t work for everyone.

Having said that, a hearing person who suddenly becomes deafened after decades of normal hearing will have a different experience from someone who was born deaf. A CI candidate with a memory of sound, knowing what things are supposed to sound like, will make those connections more easily, and is likely to be more successful, more quickly, than a person who was born deaf with no memory of sound.

Tom was a hearing person and became a CI candidate when he suddenly lost his hearing as an adult. After getting his CI, he says;

I struggled with getting my sound processors to “create” that same sound as close as possible. I wanted my dog to bark again but not like a sick duck, and I wanted my wind chimes to tinkle instead of clack. And after eight months of program adjustments we (my AuD and me) were finally able to give me a new bionic hearing “normal”, what I’ve since called a facsimile of “normal” sound.

How does a normal cochlea work?

The ear is made up of three primary parts, the outer ear, the middle ear and the inner ear. The cochlea is the inner organ of the inner ear. It is a fluid-filled snail-like structure with tiny little hair cells which bend when the fluid is disrupted by sound waves.

Each tiny hair responds to a specific frequency or pitch. The bending of these hair cells sends electrical signals to the brain for interpretation, allowing us to understand what we’re hearing.

The human ear is truly magnificently designed. However, we were not all meant to experience its wonders in the same way.

Due to CIs being such a controversial subject, I’ll keep the focus of this article to cochlear implants for adults and the pros and cons associated with it.

What does the cochlear implant do?

Cochlear implants are surgically implanted electrical devices that allow people with a severe-to-profound hearing loss to process sound. Referred to as an auditory prosthesis it provides a sensation of hearing, and some implantees achieve near-to-normal speech understanding in quiet acoustic conditions.

The implant works by transforming sound into electrical stimulation. A microphone-like device, or sound processor, picks up external sounds and digitises it. These digital signals are then sent to a tiny wire, with many electrodes, which is implanted into your cochlea. Each electrode corresponds to a different signal frequency. Your brain then receives the signal through the auditory nerve.

The problem comes in when two electrodes stimulate the same neural population or overlapping neural populations, thus confusing the sounds, reducing your understanding of what you might have ‘heard’.

How well does the cochlear implant work?

A cochlear implant doesn’t work for everybody, and not everyone is a candidate to receive a CI.

The audiology team try to give candidates realistic expectations of how successful they will be with a CI, and they will only offer a CI if they think a candidate will benefit from having one. Of course, they can’t predict how well someone will do. Statistically most people will do relatively well, those who have been recently deafened tend to do better than those who were profoundly deaf all their lives. Recipients can push the envelope, as I did, by practising listening to a variety of sounds on a daily basis to get the best out of their CI.

Being born profoundly deaf, my audiologist said I should not expect to do as well as most recipients – I will always have to lip read. By focussing on Auditory Verbal Therapy, listening to music and audio books when I was working or doing housework, asking people what I was hearing, I improved well enough that I can sometimes use the telephone or have a conversation with someone in the next room. It really depends on how they talk and it’s still difficult for me. With my hearing aids, I had NO hope of being able to understand speech. With the CI, I had some hope, and with lots of practice, determination and patience, pushed it as far as I could. It’s like training for a marathon – you tend to get out what you put in. It’s important to remember that everyone is different and can get very different results at activation. The CI won’t cure your deafness, but it sure is a heck of a lot better than a hearing aid.

There are many factors that contribute to your CI outcome, including:

  • The amount of residual hearing you have.
  • How long you’ve been deaf for.
  • Your age, overall health and other medical information.
  • If you have a functioning auditory nerve.
  • The type of device implanted.
  • The experience of your surgeon.
  • Postoperative complications.



Increases your level of hearing, making it easier for you to communicate with your friends and family and follow conversations.

Speech perception

CI development has improved a lot, allowing recipients better speech perception in quiet environments.


A CI can expand your career opportunities, setting potential employers concerns at ease.


Increased opportunities to learn and participate in a learning environment without outside assistance.


Being more alert to potential dangers, for example hearing sirens and thunder.

Music & telephone

Many recipients enjoy the beautiful melodies of music and even use the phone.

Confidence & independence

Many recipients experience a boost in confidence, being able to hold their own in a conversation.


Background noise

Background noises, like many people talking or environmental sounds, can affect a CI recipient’s understanding of speech. Technological advances are rapidly improving this.


All surgery carries an element of risk.

Sport risks

You must be careful participating in certain physical activities, including high contact sports and water related activities.


A CI does require maintenance, for example replacing wires, changing batteries or remapping of the sound processor.

Side effects

It does take some time getting used to the CI device. It might irritate your skin, or you may experience muscle spasms, numbness and even facial paralysis. Fortunately this is rare.


Sounds are translated via the device and might sound unnatural at first. You need extensive training to perceive and comprehend the sounds more effectively.

No guarantees

There is no guarantee that the implant will work well. You could lose any remaining or residual hearing.

The cochlear controversy

If you’re a hearing person reading this article, you might be surprised to find out that many deaf people don’t like CIs and believe them to be a threat to deaf culture.

The controversy about cochlear implants are primarily directed to the definition of deafness as a disability. Many deaf people argue that they should not be seen as disabled, but rather as members of a minority cultural group.

They do not see deafness as an illness to be cured or a problem to be solved. For them, being deaf is part of their identity and getting a CI would destroy their identity, effectively betraying their cultural values.

In my opinion, this is pure rubbish. I have two cochlear implants, and I am still deaf. What I mean is I still require communication support when dealing with noisy environments and multi-person conversations. I will never be able to be a fully hearing person, and that’s ok. I’ve accepted I am deaf – but now I really do have the luxury of selective hearing!

I understand that deaf people against CIs believe they’re fighting for the preservation of their culture, and that’s great, but change cannot be stopped, especially with technology. Every person should have a right to their decision and not have to defend it.

How much does a cochlear implant cost?

UK residents wanting a CI can usually get one on the NHS if over the age of 18, and two if younger than 18. Very few people in the UK need to pay for a cochlear implant.  An adult might get a second CI if they are blind as well as deaf, or have another qualifying disability.

In the UK, the cost of assessments, surgery, and aftercare is around £20,000 to the NHS. The CI device costs upwards of £20,000. Paying privately for the CI will easily double the cost.

In the USA, the cost of a CI, including all add-ons, is around $150,000.

Cochlear implant pros and cons

A cochlear implant will not give you ‘normal’ hearing, but it will enable you to hear better. When I say ‘hear better’ I’m comparing CIs to the standard hearing aid.

Today, cochlear implants are more sophisticated, and they help many more people with severe to profound hearing loss than ever before. Still, a CI cannot replace natural hearing. The cochlear implant pros and cons should be carefully weighed before you make your decision.

That being said, the decision to receive a cochlear implant, if you are eligible, is yours and yours alone. I encourage you to respect every adult’s decision and not judge them. The best impartial website to help you to make an informed decision is Cochlear Implant Help. There you will find a very useful comparison chart.

You can read my personal cochlear implant story and how I went from rejecting the very idea of having a “thing” implanted into my head, to acceptance and learning to live with a new way of hearing. Cochlear implants and hearing aids are so very different. I now understand why hearing people find it so hard to understand hearing loss, and why deaf people can’t really comprehend what it’s like to hear. It’s like night and day. I’ve lived through the shock of going from almost zero hearing to a full-on Take-Me-With-You-World rollercoaster ride at ninety miles an hour – and lived to tell the tale – and I’d do it all over again!

If you feel you need additional communication support after getting a CI, feel free to browse our range of services and find your perfect fit.

11 replies
  1. Yong
    Yong says:

    Friend of mine who got CI and after being recovery and able to go back to work at office. All her co-workers all suddenly talk to her as they thought she can understood of everything they said. Good grief.

  2. Tina Lannin
    Tina Lannin says:

    I had my manager say to me, when I explained I still can’t hear like a hearing person and need to lip read, he said “What’s the point in getting a CI?” – this was AFTER I had given them training. It is hard to get hearing people to understand that a CI doesn’t always mean we can automatically hear like they do.

  3. Marty
    Marty says:

    I’ve been bilateral for 3.5 years and hear pretty well for a deaf old guy. While it can be frustrating explaining again and again that I don’t hear like a normal person, I have no regrets. CIs gave my my life back!

  4. Patricia Foy
    Patricia Foy says:

    I have been told the need to recharge the battery each night means taking it out to do this leaves the person totally deaf. I find thye idea frightening especially if I were to be on my own and unable to hear warnings , not that I hear smoke alarms currently. Is there a spare battery for recharging?

    • Tina Lannin
      Tina Lannin says:

      Hi Patricia, you can get a rechargeable battery. It is just like taking out hearing aids at night. You can install a smoke alarm that vibrates a pad under your pillow, and there is a similar pager system for sounds around the house which can connect to a pad under your pillow.

  5. Vicki
    Vicki says:

    I have had the CI for a year now, they are still programming it in. I hear beeps, buzzes, hums and noises that sound like Morris Code! Surgeon questioned the Audiologist on why I cant hear people speak yet. Their response was: We are stimulating the inner ear. Are you kidding me! One year later and they are milking me and insurance company dry.

    • Terri
      Terri says:

      This is happening to a dear friend of mine. He is almost to the point of not trying anymore.

      If you changed audiologist, did it help?

  6. sandra shields
    sandra shields says:

    i think anything is better then none if it does not work at lest you have given it a go there is more to gain when first had hearing aids a car when past and could hear wind water running now am getting bad told cochlear implant next if you are hard of hearing people talk around you not to you never mind the bad looks plus i cannot sign so you are on your own think want you may hear next its more exciting to open your world more hear the birds plus music if not at lest i tried

  7. Dawn
    Dawn says:

    I’m on my third and worst implant. I went almost completely deaf in December 2012. In the same week I found out I had breast cancer. They couldn’t do my implant until after my cancer surgery and treatment was over. That was the worst nine months of my life. I couldn’t understand anything anyone was saying all throughout my cancer treatment. The first implant went good but the doctor put it too low and over time it had slipped all the way behind my ear. When I told him about it he referred me to another doctor. He didn’t even look at it. I guess he didn’t want to do anything because of my insurance being Medicare and a supplement that paid for it but maybe not enough for him. Anyway the next doctor went in and moved it up higher but when I was in recovery he tested it and everything sounded distorted. I had to wait until the audiologist turned it on to see if it was still the same and it was. All distorted and couldn’t understand anything. They did a Ct scan and saw there was an electrode loose so back I go again but this time he had to put a whole new one in. They’re not aloud to use the same one three times. When they turned it on everyone sounded like Mickey Mouse which they said wasn’t uncommon and eventually it did get batter but not as good as the first one. The first one everyone sounded pretty normal. Then with the new one the rechargeable batteries started going dead before there time. They are supposed to last 20-30 hours. They were only lasting 7-8 hours so I contacted Cochlear and they sent new batteries but they didn’t work any better. They finally sent me a whole new unit but that didn’t help with the batteries either. I finally got in to see my audiologist and she said it was the program that was causing it and she changed it. Now the batteries last but the sound is terrible. Everything sounds like I’m going through a tunnel or kinda echoey. I don’t know if it’s the program or the implant that’s causing it. Sometimes the sound will go up and down in volume when I’m not touching my remote for it. It also hurts and itches a lot. I never had these problems with the first implant. If that doctor hadn’t been too lazy to put it up higher the first time I don’t think I would be writing this. If you are thinking about getting one which I do recommend make sure you ask a lot of questions about everything that they are going to do. Happy hearing


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