Hearing Preservation in Cochlear Implants

Cochlear implants are an amazing technology and have become the routine for rehabilitating hearing loss in patients with sensorineural (nerve-type) deafness. When hearing aids are no longer working well, cochlear implants can be considered to restore some hearing benefit to the patient. Traditionally, when cochlear implants are placed, there is very little hearing in the ear remaining, and the implant placement would result in loss of any residual “natural” hearing.

Patients with more and more residual “natural” hearing are being considered for cochlear implants as candidacy criteria expand.  In these patients, some hearing remains, but often their speech understanding is very compromised due to mid-to-high frequency hearing loss. With small cochlear implant electrodes, the residual low-frequency hearing that the patient has can often be preserved, allowing the patient to hear natural pitch perception with their normal hearing, while having the rest of the frequency spectrum restored by the cochlear implant. In this situation, the patient can wear their cochlear implant processor and a hearing aid on the same ear, and the brain will “combine” the natural and cochlear implant hearing together. Patients who use this type of system report that their hearing is more robust and that pitch perception can help with tasks such as music appreciation, identifying who exactly is speaking, and other sounds where the “bass” is an important component of the sound information.