Cochlear implants vs hearing aids: Which is right for me?

Mar 02, 2023
All the nitty-gritty details you need to know about hearing aids and cochlear implants. Source: Getty

You may have assumed that cochlear implants and hearing aids are the same things. While both help aid people with hearing loss, these two hearing solutions are quite different and depending on your diagnosis, your hearing specialist may recommend one over the other.

How do hearing aids work?

Hearing aids are a common solution for hearing loss and can improve the quality of life for people with hearing difficulties. They work by amplifying sounds and making them louder, making it easier for people with hearing loss to hear and understand speech and other sounds in their environment.

Hearing aid features

Today’s hearing aids often come with a wide range of advanced features that can enhance the user’s hearing experience. For example, directional microphones can help users to focus on specific sounds or voices while reducing background noise. Selective noise reduction can help to filter out unwanted background noise, making it easier to hear speech and other important sounds.

Bluetooth connectivity is another popular feature in many modern hearing aids, allowing users to stream audio directly from their smartphone, television, or other devices. This can be especially helpful for people who enjoy listening to music or watching movies, as well as for those who use their phones for work or communication.

Other features that may be available in some hearing aids include feedback cancellation, telecoil functionality, and remote control options.

How do cochlear implants work?

Cochlear implants are a type of medical device that can provide hearing to people with severe to profound hearing loss who cannot benefit from traditional hearing aids. Unlike hearing aids, which amplify sound, cochlear implants directly stimulate the auditory nerve using electrical signals, bypassing damaged parts of the inner ear.

Cochlear implants features

Cochlear implants consist of two main parts: an external processor and an internal implant. The external processor is worn behind the ear and contains a microphone, speech processor, and transmitter that sends signals to the internal implant. The internal implant is surgically placed under the skin behind the ear and contains an electrode array that is inserted into the cochlea, the part of the inner ear that converts sound vibrations into neural signals.

Once the cochlear implant is activated, it sends electrical signals directly to the auditory nerve, which the brain interprets as sound. For many people with severe to profound hearing loss, cochlear implants can provide significant improvements in speech understanding and overall communication ability.

The different types of hearing aids for the hearing impaired and the deaf. Source: Getty

The different types of hearing aids

There are many types of hearing aids that cater to different levels of hearing loss. Some hearing aids have benefits such as being positioned within the ear canal so they are cosmetically appealing and not subject to wind noise.

Some other popular styles of hearing aids include:

Invisible In the Canal (IIC)

The IIC is cosmetically appealing as it sits deep in the second bend of the ear canal, hidden from view. It is suitable for most mild to severe hearing loss. It has Bluetooth capability but no directional microphones, or telecoil, and can require good eyesight and dexterity to insert and maintain (clean and change batteries etc.).

Completely In the Canal (CIC)

The CIC is also hidden, positioned in the first bend of the ear canal at the entrance. It is considered more powerful than the IIC and is suitable for mild to profound hearing loss. Again the CIC has Bluetooth functionality, but no directional microphones or telecoil.

In the Canal / In the Ear (ITC/ITE)

Slightly larger than a CIC, the ITC sits in the entrance and external portion of the ear canal. It is suitable for mild to profound losses and can be fitted with a directional microphone which helps facilitate hearing in background noise. The ITC has both telecoil and Bluetooth capability and the larger size makes it easier to insert and manage.

Receiver in the Canal (RIC), Over the Ear (OTE), Behind the Ear (BTE)

This virtually invisible device is suitable for any type of hearing loss. It has an external directional microphone and is fitted with an open dome coupling for those with industrial deafness and early-stage age-related hearing loss. The RIC has telecoil and Bluetooth capability.

When to consider hearing implants

Cochlear implants are often recommended for people with severe to profound sensorineural hearing loss, which is caused by damage to the hair cells or nerves in the inner ear. People with this type of hearing loss may have difficulty understanding speech, even with the use of hearing aids.

The decision to choose between hearing aids and cochlear implants will depend on your individual hearing needs and preferences. Source: Getty

The different types of implantable hearing solutions

Cochlear Implants

A Cochlear Implant is an electronic medical device that replaces the function of the damaged inner ear and can be a long-term solution for those with moderate to profound hearing loss (in one or both ears). Unlike hearing aids, which make sounds louder, Cochlear Implants do the work of damaged parts of the inner ear (cochlea) to provide sound signals to the brain allowing recipients to hear sounds they may not have heard for a long time, such as birdsong, music or conversations in a noisy restaurant.

Cochlear Baha

A Cochlear Baha is a bone conduction implant system. It is best suited to people who have single-sided deafness, conductive hearing loss, and those with mixed hearing loss who cannot otherwise wear “in the ear” or “behind the ear” hearing aids because of ear infections and irritation. The Baha picks up sounds coming from the hearing loss side and transfers them to the good ear, making speech easier to understand, with crisp, clear sound.

Which is right for you?

While your healthcare clinician will provide guidance and advice, it’s important to arm yourself with information. Any hearing advice you receive should be tailored to your:

  • Degree and type of hearing loss
  • Anatomy and physiology of your outer ear and ear canal
  • Your ability to hear speech with suitable amplification
  • The ability for your brain and hearing system to process speech in the presence of competing background noise, vision, dexterity, cognitive capacity (memory and attention)
  • Lifestyle

If you are experiencing hearing loss, it’s important to see an audiologist or other hearing healthcare professional to determine the cause and severity of your hearing loss and to explore your treatment options.

Your hearing healthcare professional can help you to understand the benefits and risks of each option and determine the best course of treatment for your individual needs.


Curious to learn the relationship between hearing health and healthy ageing? Join us on World Hearing Day, Friday, 3 March at 10am AEST, for a FREE online webinar where we chat with hearing experts to learn more about the hidden risks associated with untreated hearing loss. Click here to learn more.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.

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