Differences in Hearing Aids and Cochlear Implants

Hearing Aids vs. Cochlear Implants

Hearing aids and cochlear implants are devices used by individuals who have a hearing loss to help amplify sounds. Hearing aids are made up of a microphone, amplifier (digital processor), a receiver, ear hook, and batteries. Sometimes, depending on the age of the user, they will have ear molds made. Cochlear implants also have a receiver and microphone but, cochlear implants are made up of many more pieces. Other than a receiver and microphone, cochlear implants have a transmitter, external magnet, speech processor, receiving antenna, internal magnet, and an electrode array.

Diagram of a Hearing Aid

Diagram of a Cochlear Implant

Hearing Aids

Hearing aids come in many different designs depending on what a client is looking for. What hearing aid someone prefers depends on how they want it to look, what their degree of hearing loss is, what it will take to repair it, and what tasks they want it to perform. Those who have a hearing loss of 25 dB HL or greater qualify for being fit for a hearing aid. The different styles of hearing aids include:

Behind-the-Ear

Receiver-in-Canal

In-the-Ear

Completely-in-Canal

Behind-the-Ear (BTE)

The Behind-the-Ear hearing aid is the most commonly used hearing aid. The build of this aid allows for the user to use it longer because of its longer battery life. Behind-the-Ear hearing aids also allow for an array of many different special features such as rechargeable batteries, bluetooth, and other options. These hearing aids can also be connected to an ear mold, which sits in the opening of the ear canal to help keep the hearing aid on the ear. This option is often seen with young children who wear hearing aids.[7]

Receiver-in-Canal (RIC)

A Receiver-in-Canal hearing aid is a more discreet and smaller version of the Behind-the-Ear. Like the BTE hearing aid, this aid supports rechargeable batteries. This model allows for a more "open" fit, which allows for more natural sound quality for the wearer. A setback to this hearing aid is that the speaker is more susceptible to earwax and moisture clogging.[8]

In-the-Ear (ITE)

This hearing aid, like it's name, sits within the ear cavity. It is custom fit to the users ear and has a larger, rechargeable battery. There are volume and memory controls that won't be found on the smaller custom hearing aids. The down side to In-the-Ear hearing aids is that they may pick up more wind noise. This hearing aid may be used by someone who prefers a cosmetically pleasing hearing aid or wants to limit how much of the aid they want others to see.[9]

Completely-In-Canal (CIC)

Like the ITE hearing aids, the Completely-in-Canal hearing aid is a custom aid that is fit to the users ear. It is less visible and the second smallest hearing aid that can be used. While these are cosmetically pleasing, individuals with dexterity issues may have difficulties with these hearing aids. The batteries do not last as long and because of it's small size, this hearing aid cannot have manual or memory controls.[10]

Cochlear Implants

Cochlear implants are for individuals who present a severe to profound hearing loss. When an individual is implanted with a cochlear implant, they meet with a variety of individuals to help them adjust to their new world. The multidisciplinary team is limited to but not defined by otolaryngologists, audiologists, speech-language pathologists, psychologists, teachers of the Deaf, social workers, and parents. The candidacy for receiving a cochlear implant is different for adults and children.

The criteria for adults is based on what type of hearing loss they are presenting, to be eligible for a CI, an adult needs to have a moderate to profound SNHL bilaterally, score a 50% or less on Hearing In Noise Test, and 60% or less in the opposite ear. Insurance requires a less than 40% Word Recognition Score.

For children, they need to be 12 months of age or older. The child needs to present a sensorineural profound hearing loss (>90 dB HL) for 12-24 months, a severe to profound sensorineural hearing loss (>70 dB HL) in 24 to 18 year olds with limited benefit from hearing aids.

After implantation, a patient with a CI has to wait up to 4 weeks before the device can be activated. At the appointment when the device is turned on, it is programmed with telemetry, tested for electrical dynamic range, electrically evoked compound action potential, and then it goes live. Follow-ups for the programming falls 2 weeks after, than 4 weeks, 3 months, 6 months, 12 months, 18 months, 2 years, and then annually. During this time the patient will also have speech perception testing, aided cochlear implant testing, auditory training, and speech therapy.

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