If you have just learned that you are suffering from hearing loss, a host of questions is undoubtedly running through your mind. Will you still be able to enjoy music, talk on the phone, or simply hear the voices of your loved ones? These are all questions that may be preoccupying you.
Depending on the degree of your hearing loss, your hearing care professional may recommend a hearing aid or even a cochlear implant. A cochlear implant is a medical device implanted in the inner ear.
It bypasses the usual structures of the ear to allow for hearing. Since cochlear implants short-circuit the normal functioning of the ear, they are often nicknamed "bionic ears."
Here is an overview of the sound produced by different hearing assistance devices, what they offer, and which one will suit you best.
Hearing aids
The most widely used hearing assistance device is the hearing aid. These are devices placed in the ear canal that amplify the volume of sounds reaching your ear. Hearing aids come in many styles and types: prescription, over-the-counter, in-the-ear, or behind-the-ear.
Here is how hearing aids work, how they change the sounds you perceive, and what distinguishes the different types of devices.
How do hearing aids work?
The way hearing aids work is quite simple. Regardless of the type of device, four main components make them function: a microphone, a processor, a battery, and a speaker.
The microphone picks up noise from the immediate environment and converts it into a digital signal. This signal is then transmitted to the processor, where the intensity of the sounds is increased. Once the signal is amplified, it is sent to the speaker, which reproduces the same sound, but louder.
The different styles of hearing aids
Hearing aids come in many formats and styles: invisible-in-canal, in-the-canal, in-the-ear, and behind-the-ear.
Many people prefer compact hearing aids because they are easy to hide and less noticeable than larger models like traditional behind-the-ear aids. As a rule, the smaller a hearing aid is, the more expensive it is.
At CLARIA, we offer very compact hearing aids at a fraction of the price charged by other brands. Not only are they small, but they are also high-performing and packed with features that far exceed their price range. Take the CLARIA Atom: its Atom™ sound technology and patented Comfort+ design are the best illustration of this.
What does a hearing aid sound like?
Unlike cochlear implants, hearing aids maintain the use of the normal anatomy of the ear. Sound waves still reach the eardrum and are conducted like any other noise. The speaker located at the entrance of the ear canal actually reproduces all the sounds that would naturally reach your ear, simply at a higher volume.
In terms of sound quality, hearing aids offer a much more natural sound than a cochlear implant. The ear is comparable to a finely tuned acoustic instrument: it is capable of differentiating noises and capturing the subtleties of sounds.
Cochlear implants, on the other hand, have the delicate task of transforming sound into a stimulation signal, which results in sound that is less natural and less true to reality.
Cochlear implants
Cochlear implants are hearing devices that many people are unfamiliar with. These are hearing aids implanted in the inner ear. They are intended for people with severe hearing loss or total deafness.
Unlike other devices such as hearing aids, which rely on the acoustics of the ear, cochlear implants are completely autonomous: the device itself performs most of the conversion of sound into nerve impulses.
Here is a more detailed look at cochlear implants, how they work, and what they sound like.
How does a cochlear implant work?
Cochlear implants may seem complicated, but their operation is actually quite simple. A cochlear implant consists of two main parts: the internal part and the external part.
The internal part is the one that is implanted; it contains an electrode and a receiver. The whole thing is placed under the skin. The receiver is housed between the skull and the scalp to facilitate communication with the external part.
The external part includes microphones, a processor, a battery, and a transmitter. This is the brain of the device: it is what converts sound into an electrical signal, which is then transmitted to the implant.
The two components work together to make sound perception possible. When a sound is captured by the external part, it is converted into a digital audio signal sent to the processor. The latter translates it into a format transmitted to the implant in order to coordinate the electrical stimulation of the inner ear.
What does a cochlear implant sound like?
Although cochlear implants are hearing aids, it should be noted that the sound perceived with an implant is very different from that of natural hearing. Several factors determine exactly what a cochlear implant sounds like.
The first factor is the time in your life when you receive the implant. Some people have worn a cochlear implant since childhood. For them, the implant is the only way of hearing they have ever known. They will most likely tell you that the sound seems normal to them.
Conversely, people who have lived most of their lives with natural hearing before switching to an implant will likely tell you that the difference is considerable. This significant gap can make comprehension a bit difficult, but over time, implant wearers adapt and generally end up getting used to this new sound. Right after implantation, sounds are often described as robotic, metallic, or echoing.
Another factor that influences the output is the implant itself. There are many different designs of cochlear implants, and these differences change the perceived sound.
One element that weighs heavily on sound quality is the implanted electrode. The implant electrodes have multiple outputs, called channels. Early cochlear implants had only one, while current models can have up to 22.
The final factor that can change the output of a cochlear implant is the external part. Most of the time, cochlear implant manufacturers use different equipment from one another, which influences the sound perceived by the user. Differences in microphone quality or processing power can make the sound more natural or more metallic.
Cochlear implants or hearing aids: which to choose?
Now that you know what a cochlear implant and a hearing aid sound like, you may be wondering which solution is best for your situation. Generally speaking, a cochlear implant is reserved as a last resort to help you hear.
If you suffer from mild to severe hearing loss, a hearing aid is most likely the best option. With these forms of hearing loss, your ears remain capable of interpreting sounds. Hearing aids help bring softer sounds above your hearing threshold so that you hear better.
For people with profound or near-total deafness, hearing aids will not be very useful because the hearing range is almost non-existent and you can only increase the volume of sounds to a certain limit. This is typically the scenario where a cochlear implant is recommended, as it allows for the restoration of a certain level of hearing where the person would otherwise be deaf.
Cochlear implants are reserved for severe hearing impairments because the anesthesia required for implantation carries risks and residual hearing may be reduced. If your hearing loss is mild, it is simply not worth the effort. A simple and practical hearing aid may be more than enough.
In conclusion
A cochlear implant is a hearing device that allows people with profound deafness to perceive sounds in their environment. While this technology restores access to hearing, it is not yet capable of exactly reproducing the sound of natural hearing.
Some describe it as slightly robotic, metallic, or echoing. As technology progresses, the day may come when cochlear implants perfectly reproduce everyday sounds.
Sources
The cochlear implant: Historical aspects and future prospects | NCBI.
Types of Hearing Aids | FDA
The Bionic Ear | Stanford Health Care
Hearing Aids — Styles/Types & How They Work | NIDCD
