Many people have questions about cochlear implants, how they work and what to expect from the surgery. Here are some common questions and answers.

Hearing with an implant

How is a cochlear implant different from a hearing aid?

1.      Hearing aids amplify sounds so that the residual part of the ear can use it to hear. A cochlear implant transforms sounds into electrical current that is used to stimulate the hearing nerve directly.

2.      Cochlear implants have internal (under the skin) and external parts (behind or off the ear).

Are cochlear implants experimental devices?

No. Cochlear implants are approved by the Food & Drug Administration (FDA) in the USA and the rest of the world and have been used successfully at this clinic and in the rest of the world since 1986.

What does a cochlear implant sound like?

Because everyone’s hearing system is different, everyone’s experience with a cochlear implant is different. Generally adults report that initially the sound is quite high pitched and electronic but becomes ordinary over time. Young children often only know the sound they hear with a cochlear implant, so it sounds “normal” to them. It is just not the “normal” that a person with normal hearing experiences.

Can people with cochlear implants identify environmental noises as well as speech?

Cochlear implants provide a wide range of sound information. Performance in speech perception testing and in the real world varies among individuals. With time and training, most patients understand more speech than with hearing aids and many communicate by telephone and enjoy music.

What sounds can be heard with a cochlear implant?

You will probably hear most sounds from soft to loud sounds. Patients report that they can hear footsteps, doors closing, ringing telephones, car engines, barking dogs, lawn mowers, birds and various other environmental sounds.

Does a cochlear implant provide normal hearing?

No. A cochlear implant provides a limited sense of hearing in the implanted ear. However, most individuals with good language abilities can learn to use this sound to understand spoken language and having improved quality of life. Most cochlear implant users can learn to understand spoken sentences without looking at the person who is talking, particularly if there is no background noise. Many can also learn to use the telephone. An important factor determining the possibility of understanding speech without lipreading is duration of deafness and prior use of hearing aids.

How long does it take me to get maximum benefit from a cochlear implant?

It depends a lot on you and your listening therapy (rehabilitation), as well as how long you have been without hearing. Usually, there is a rapid rise in your ability to interpret sounds after receiving an implant. This rapid rise slows after about 3 – 6 months but your benefit gained often continues to improve for several years.

Will the cochlear implant help me control the loudness of my voice?

Yes. The cochlear implant usually helps you control the loudness of voice better because you can hear your own voice in relation to background sounds.

What can I expect if my child has a cochlear implant?

We cannot predict how well any child will progress with a cochlear implant.  A child’s progress depends on many factors, including:

  • the age at which the child became deaf
  • the length of time the child has been deaf
  • family and educational support
  • family’s and child’s motivation
  • child’s level of speech language development
  • child’s cognitive development and learning style
  • presence of a cochlear abnormality
  • consistency of use of the device

The cochlear implant:

  • will NOT provide normal hearing
  • will NOT guarantee intelligible speech or age appropriate language skills
  • will NOT guarantee educational success

However, with consistent use of the cochlear implant and ongoing training, the sound the child hears through the implant should become more meaningful and should enhance the child’s ability to communicate.


Are there risks in cochlear implant surgery?

Risk is inherent to any surgery requiring general anaesthesia. However, the surgical risks for cochlear implantation are minimal and most patients require only an overnight hospital stay and have no surgical complications.

Will I need more surgery as new technology becomes available?

The implanted unit is designed to last a lifetime and require only the initial surgery. The externally worn speech processor, which is responsible for sending information to the internal electrode, is dependent on software and hardware that can be upgraded as technology improves.

Will my child outgrow the internal device and require a new one?

No. The cochlea is fully formed at birth and the skull structures achieve almost full growth by the age of two. The electrode array is designed to accommodate skull growth in children.

How soon after the surgery can I start listening with my cochlear implant?

The sound processor is fitted two to four weeks after surgery. Generally the implant works from the day the sound processor is fitted, however, the time required for your brain to adjust to the new sound will vary from person to person.

Making the decision

What are the benefits and risks of a cochlear implant?

An implant can offer people with moderate to profound hearing loss increased awareness of sounds, and generally, greater understanding of speech. The benefit ultimately depends on pre-existing factors in each person’s case, e.g. duration of hearing loss, type of hearing loss and additional difficulties. Each person undergoes a thorough investigation that includes hearing tests, balance assessments, medical checks, MRI and CT scans to determine the relative risks and benefits of undergoing the implant procedure.

Should I wait for new cochlear implant technology?

No. The design of the surgically implanted unit has changed relatively little during the history of cochlear implants. Significant improvements have however been noted in the way in which the processor makes sense of speech (speech coding strategies), and delivers the signal to the internal unit. The speech processor can incorporate new technology when available. It is more important to deliver stimulation to the hearing nerve and centres of the brain. The longer the duration of deafness the more time it takes to achieve optimal results and learn to hear again.

Should we wait until our child can decide for herself if she wants a cochlear implant?

We know from widely published research that when there is little to no benefit from hearing aids, the earlier we can do cochlear implantation, the better the outcome is likely to be. Your child may be a good candidate for a cochlear implant when she is a baby or toddler, but if you wait until she is school aged or older the outcome may be poorer. If you are in favour of implantation and your child is deemed to be a good candidate, we recommend you proceed right away.

The process

Should my child try hearing aids before we investigate a cochlear implant?

All children need to use hearing aids for a trial period before cochlear implant/while investigating implantation. The audiologist who diagnosed the hearing loss will fit your child with hearing aids and refer your family to an appropriate intervention team including a speech and language therapist. All families with children with moderate to profound hearing loss are encouraged to contact the Cochlear Implant clinic as soon as the hearing loss is identified. The investigation to determine if your child will benefit from a cochlear implant(s) takes place over several months and the earlier you attend the Clinic, the greater the opportunity to provide your child with a cochlear implant at a young age.

Is a referral required to obtain an appointment at the Cochlear Implant Clinic?

No, you can contact us directly.

Living life

Can people with cochlear implants swim, shower and participate in sports?

Yes, people with cochlear implants can swim, shower and participate in virtually all types of sport activities when they are not wearing the external equipment (or if the speech processor is water resistant). The only restriction relates to skydiving and scuba diving (>25m) because significant changes in air pressure are not advised. Some processors are waterproof when used with their respective Aqua+ or WaterWear accessories. Participation in all other activities is unrestricted, although protective headgear is always recommended during contact sports.

Can the sound processor be removed at night?

Yes, but you should turn it off to save the battery. Some users wear the sound processor all night so that they can hear. it should be placed in a dry-store overnight


How is the external transmitter held in place correctly?

The internal part has a magnet that connects with the external coil which also has a magnet. They attract each other to stay aligned.

Can I go through the security gates at an airport?

Yes. People with cochlear implants can go through the gates, but it could trigger the alarms. It is advised that you carry a card provided by your audiologist which will identify you as a cochlear implant recipient.

Do I need to turn off the speech processor while flying?

No. It can be used consistently during take-off and landing as well as flying.

Is there a battery under the skin?

No. The implant itself does not have a battery. The power is fed to the implant from the external part, the processor, which is on the outside of the ear and has a rechargeable/disposable battery.


Do medical aids pay for the cochlear implant?

Because cochlear implants are recognized as standard treatment for moderate to profound deafness, most medical aids cover/partially cover them. TH-US-CIU will help you to obtain prior authorization from the appropriate medical aid company before proceeding with surgery.

Do I pay for the repairs?

You will have to pay for repairs that are not covered by the initial warranty or covered by insurance.


Who can benefit from a cochlear implant?

People with moderate to profound hearing loss. Children who were born without hearing and children who lose their hearing can benefit from an implant if implanted early enough. Adults and  older children who once had enough hearing to perceive the sounds of speech have an easier time learning to use the new sound through an implant.

At what age can surgery be done?

Children as young as 6 months of age can receive cochlear implants. Outcomes are better for children born deaf who receive their cochlear implant (s) before 18m of age.

Am I too old?

As long as you are medically fit, no one is too old.

What if I live outside South Africa?

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