Like most hearing people, I did not know the differences between hearing aids and cochlear implants until I started taking ASL and was learning about the resources available for Deaf people. At first glance, hearing aids and cochlear implants both look like same devices that help Deaf people hear and communicate better. This is true to some extent. While the ultimate goal for both devices is the same, both cochlear implants and hearing aids function differently and are better suited to a distinct type of population based on the type and extent of deafness. Consumer Affairs estimates that in 2021, around 12 million people use hearing aids in the US while only 50,000 people have cochlear implants. This makes sense because hearing aids were first invented in 1898 whereas cochlear implants were invented in 1961. So, hearing aids have been around for much longer than cochlear implants.
A hearing aid has three parts: a microphone, an amplifier, and a speaker. The microphone collects the sound waves from the surroundings, converts them to electrical signals, and sends it to be amplified in the amplifier. The amplifier then passes that magnified electrical signal to the ear through a speaker. Such amplified sounds follow the normal auditory system pathway after that i.e. they pass through the ear canal, eardrum, middle ear bones, cochlea, and auditory nerve. On the other hand, cochlear implants have an external sound receiver and an internal magnetic transmitter that is surgically placed inside the skin of a deaf person. The external receiver picks sound from the surroundings, sends it to the internal transmitter, which then converts the sounds to electrical impulses and sends it to the auditory nerve directly, via an electrode array. Hence, sound does not follow the general auditory system pathway in the case of cochlear implants, like it does in the case of hearing aids. This means, any damaged portion of the auditory system pathway can be bypassed by the cochlear implant system. This is not possible in the case of hearing implants, which functions more like a speaker and requires all parts of the auditory system to be functional.
In addition, hearing aids are completely removable on a regular basis. Deaf people, with hearing aids, are often known to remove hearing aids while going to sleep or when they feel like blocking all external sounds. Cochlear implants, on the other hand, are surgically placed and are not easily removable. Moreover, hearing aids cost $3000- $6000 per pair whereas cochlear implants and the accompanying surgery costs around $100,000. Fortunately, most costs associated with hearing aids and cochlear implants are covered by insurance. Looking at these differences, hearing aids definitely seem like a more flexible and lower risk option to mitigate hearing loss. However, given the way hearing aids function, they are not suitable for everyone. This is where cochlear implants come in. As hearing aids function like speakers, they are more suited to people with mild to moderate hearing loss, whose hearing loss lies in the outer or middle ear. For people with more severe hearing loss in the inner ear, cochlear implants are a better option because they bypass the entire auditory system pathway and feed electrical signals directly to the auditory nerve.
It is important to note that while hearing aids and cochlear implants facilitate sound reception, they do not completely restore someone’s natural hearing. Having them is not the same as being transformed into a hearing person. Unlike online videos where they show kids smiling as soon as they get these devices for the first time, adjustment to these devices takes months as the brain needs to rewire. It is known to be uncomfortable, frustrating, and is accompanied by months of speech therapy. Hence, we should learn to not only appreciate the science behind invention of such important devices, but also understand the emotional, financial, and physical costs associated with them. There is no one-size-fits-all solution to deafness and over-glamorization of hearing devices can result in a lot of disappointment for deaf people looking to supplement their hearing.
Resources consulted for this post:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913847/
https://www.consumeraffairs.com/health/cochlear-implants-vs-hearing-aids.html
https://www.nidcd.nih.gov/health/hearing-aids
Comments
Susmita, I am glad you wrote about the hearing aids vs cochlear implants controversy. We covered this topic in our final cultural presentation but because it is so relevant, I am glad to see you have expanded on it further. Whenever I think about cochlear implants, I think back to Ms. Kaye's story about the one kid in her class whose parents have forced him to get cochlear implants and just how painful and difficult that experience was for him. As technology evolves, I hope we can find a better middle ground for those people who exclusively want to be part of the hearing world.