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Cochlear implants vs. hearing aids

Which option is best for you?

Profile picture of Tom Rains
by Tom Rains ConsumerAffairs Research Team
woman wearing cochlear implant

Choosing between cochlear implants and hearing aids

Approximately 12 million Americans wear hearing aids, while only about 50,000 Americans have cochlear implants. If you or your child has severe to profound hearing loss, cochlear implant surgery might be a good option. If your hearing loss is not severe, then a hearing aid may be the right choice for you.

The difference between cochlear implants and hearing aids

Although cochlear implants and hearing aids might seem to do similar things at first glance, they are two very different instruments. Hearing aids are removable devices while cochlear implants require surgery. A hearing aid magnifies certain sounds and reduces ambient noise and other unwanted sounds. A cochlear implant is surgically implanted and sends electrical impulses through the auditory nerve. The brain recognizes these impulses as sound. While a hearing aid can totally or nearly restore hearing, a cochlear implant can only simulate hearing. A hearing aid works best when fitted by an audiologist. A cochlear implant requires surgery and therapy afterward to learn how to use it and understand how it works.

Cochlear ImplantsHearing Aids
Can cost up to $100,000Typically cost between $1,000—$4,000 each
Require care when performing sports, especially water sports and contact sportsCan be worn during most sports, though some care is required
Waterproof versions are available; otherwise, the outer portion must be removed before going in waterAvailable as waterproof, or waterproof covers can be used
Using one is different from traditional hearing and requires therapy to learn or relearn hearingWorks for those with mild to moderate hearing loss
Side effects include dizziness, paralysis and additional loss of any hearingNot permanent and can be removed if causing irritation or discomfort
Cochlear implants can affect MRI scansRemovable for medical procedures

Cochlear implants

Cochlear implants are small electronic devices that provide sound to people with significant or profound hearing loss. Like hearing aids, cochlear implants can help you hear better. The main difference is they are surgically implanted under the skin behind the ear instead of being removable. The implants do not restore hearing; instead, they directly stimulate the auditory nerve, which can help the wearer better understand speech. A cochlear implant might be the right option for children or adults who cannot be helped by hearing aids.

A cochlear implant works as a prosthetic for the damaged portions of the inner ear. The implant consists of two parts: an outer section with a microphone and processor, and an internal element that transmits electric pulses to the auditory nerve. A cochlear implant receives sounds through the outer component, processes the information and sends it to the internal element, which transmits data as electric pulses to the brain.

Cochlear implant pros and cons

Benefits of cochlear implants
Cochlear implants can be life-changing and come with several benefits. They make communication and social interaction with peers easier. A person may be able to listen to music. For babies and children, cochlear implants are less likely to be pulled out and lost. Medicare and most insurance plans cover cochlear implants.

Disadvantages of cochlear implants
Cochlear implants may also have negative effects. They require surgery, which is a strong consideration for medically fragile individuals. The price for the implantation surgery alone can run up to $50,000, and initial consultations and follow-up therapies can cost an additional $30,000 to $50,000.

Cochlear implant risks

The surgery for cochlear implants involves anesthesia, which always carries some risks. If the device doesn’t work or needs to be repaired, additional surgery might be required. In addition, the recipient will have to avoid getting the cochlear implant wet. This can damage the implant, requiring expensive repairs.

young girl getting new hearing aids

Hearing aids

Hearing aids are small devices worn in or around the ear that help users hear better. In the past, most hearing aids were analog, but today most are digital. They are equipped with complex technology that allows wearers to customize their hearing experience. The hearing aid market today is vast and rapidly increasing in technological ability. Hearing aids come in a wide range of prices.

Traditional analog hearing aids turn sound waves into electrical signals. These signals, in turn, are amplified. Digital hearing aids are highly advanced pieces of technology that convert sound waves into numerical codes. These numerical codes contain information about the sound’s pitch and volume. The hearing aid uses this information to amplify certain frequencies and diminish others. This all happens in an instant. The digital nature of these types of hearing aids allows for a highly customizable experience.

Hearing aid pros and cons

Benefits of hearing aids
Hearing aids cost less than cochlear implants. For a cost that breaks down to just a few dollars a day, hearing aids allow people to hear the sounds of the world around them. This can help them at work, in social settings and at play. Hearing aids can help relieve symptoms of tinnitus, or ringing in the ears. For most hearing aid users, the price is well worth the ability to better hear music, the sounds of nature and their loved ones. The intangible benefits of hearing aids are difficult to overstate.

Disadvantages of hearing aids
Hearing aids that deliver a truly customizable, quality experience are expensive. A common problem with hearing aids is unwanted feedback, either from the wind or from other noises, though experts are working hard on technologies that reduce this feedback, and many hearing aids today have features that do reduce feedback. Another disadvantage of hearing aids is that they need to be refitted from time to time because of changes in the user's body. Some hearing aids, depending on the model, also need to be cleaned frequently.

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Bottom line: Cochlear implant or hearing aid?

Cochlear implants are best for those with severe to profound hearing loss. Cochlear implants are very expensive, but they provide the possibility of experiencing sound when before it was impossible. This can completely change a loved one's life.

Hearing aids are best for those who have mild to moderate hearing loss. If you think that your life could be improved by being better able to hear the sounds around you, consider purchasing a hearing aid. Once you have chosen a hearing aid, an experienced audiologist will help you fit it.

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Profile picture of Tom Rains
by Tom Rains ConsumerAffairs Research Team

Tom Rains graduated from the University of Oklahoma in 2014 with a master’s degree in Professional Writing. Tom’s passion for delivering quality content fuels him to provide consumers with accurate, well-researched information on major life purchases.