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Hearing aids and cochlear implants can amplify sounds and make them easier for people to hear. Hearing aids do not need surgery, but cochlear implants do.

This article explores the difference between cochlear implants and hearing aids, what to consider before buying these devices, several products a person might want to consider, and why hearing tests are important.

Hearing aids are small, battery-operated devices that a person can wear in or behind the ear. They help people with mild-to-profound hearing loss hear better by amplifying sounds.

Hearing aids comprise three parts:

  • a microphone, which receives and converts sound waves into electrical signals
  • an amplifier, which magnifies the sound
  • a speaker, which sends the amplified sound into the person’s ear

Most hearing aids feature different sound profiles suitable for multiple sound environments, such as a quiet room and a busy stadium.

There are multiple styles of hearing aids, including behind-the-ear (BTE), completely-in-canal, and receiver-in-ear. Some of these styles may be more suitable for different degrees of hearing loss.

Learn more about hearing aids here.

Cochlear implants are small devices that sit behind the ear, with one part surgically inserted underneath the skin with strings or electrode arrays placed in the ear’s cochlea. Surgeons fit this by drilling the skull to anchor the implant.

These devices bypass the inner ear to stimulate the auditory nerve directly, giving a sensation of sound for those with profound hearing loss.

However, cochlear implants are only suitable for those with sensorineural hearing loss. This form of hearing loss results from damage to the hair cells in the inner ear, the brain’s central processing centers, or the vestibulocochlear nerve. Some common causes of sensorineural hearing loss include head injuries, diabetes, and noise-induced hearing loss.

Some cochlear implants, such as hybrid models, are suitable for people with residual hearing. These hybrid devices can help preserve hearing for these individuals, with research showing they can aid speech recognition in noisier environments.

Cochlear implants feature four main parts: a microphone that picks up sound and sends it to a speech processor, which a transmitter and receiver pick up and convert into electric impulses. An electrode array then collects this information and sends them to the auditory nerve.

One of the largest differences between hearing aids and cochlear implants is that individuals can easily take off their hearing aids, whereas cochlear implants are permanently attached. Most individuals will undergo outpatient surgery to have a cochlear implant. However, children and those with underlying health conditions need inpatient surgery.

Hearing aids are more suitable for those with mild-to-severe hearing loss, whereas cochlear implants are more suited for those with profound hearing loss. While hearing aids amplify sounds, cochlear implants provide a sense of sound. An audiologist can recommend which device is more suitable depending on an individual’s type of hearing loss.

Cochlear implants directly stimulate the auditory nerve, which the brain interprets as sound. They have different frequencies, and users can hear strange sounds due to magnetic fields, while other sounds can have an artificial quality.

Additionally, the National Institute of Deafness and Other Communication Disorders states that infants under 18 months old with profound hearing loss may benefit more from cochlear implants. A 2019 review found that implantations on infants early in life resulted in better outcomes, allowing them to learn language and understand speech.

Individuals will need extra support after having a cochlear implant. Speech-language pathologists and audiologists can help people interpret the signals that cochlear implants send.

The Food and Drug Administration (FDA) regulates both hearing aids and cochlear implants as medical devices. The organization also states that public health insurance providers — such as Medicare, Medicaid, and the Veterans Association — and over 90% of commercial health insurance companies cover cochlear implants.

However, not all health insurance plans cover the costs of hearing aids. Medicaid covers hearing aids for children and young adults under 21 years of age. However, adults over 21 years should check with their insurance provider before purchasing.

Cochlear implants are not available to purchase online. Individuals can make an appointment with an audiologist or otolaryngologist to determine whether they are eligible for these devices.

Hearing aids and cochlear implants are medical devices — a doctor or audiologist can suggest which product is more suitable for an individual’s requirements.

Once an audiologist has made their recommendation, there are several factors to consider when choosing a hearing aid or cochlear implant.

People purchasing a hearing aid may wish to consider whether the device has:

  • different sound profiles and programs
  • Bluetooth or wireless compatibility
  • rechargeable or nonrechargeable batteries
  • compatible hearing aid apps
  • warranties, refunds, and guarantees
  • a suitable hearing aid style
  • digital noise reduction and feedback suppression
  • synchronization features if an individual has two hearing aids
  • directional microphone systems

If an audiologist recommends a cochlear implant, individuals may wish to consider whether the cochlear implant has:

  • upgradable, programmable, and future-proof technology
  • water-resistance or waterproof capabilities
  • rechargeable or nonrechargeable batteries
  • a long expected life span
  • warranties and guarantees
  • features that are compatible with their lifestyle requirements, such as suitability during sports
  • easily available replacement parts
  • pre- and post-implantation support

Additionally, cochlear implant users may wish to consider the availability of rehabilitation or support groups and online communities that can advise newer users on how to adapt to the device.

Several brands manufacture hearing aids and cochlear implants. Some hearing aids are available to buy online, and others are only available through an audiologist. Individuals cannot purchase cochlear implants online.

Below is a list of hearing aids suitable for varying levels of hearing loss. It also includes a selection of cochlear implants that an audiologist can recommend to those who need them.

Please note that the writer of this article has not tried these products. All information presented is purely research-based.

Lively

These BTE hearing aids come in pairs and are suitable for those with mild-to-moderate hearing loss. A person can also customize the devices through the Lively app and use it to contact a Lively audiologist.

Additionally, these aids feature:

  • availability in rechargeable and nonrechargeable battery variants
  • Bluetooth connectivity, allowing people to answer calls and stream music with them
  • a 100-day money-back guarantee
  • a 3-year repair warranty and 3-year coverage for loss and damage

Learn more about Lively hearing aids here.

MDHearingAid Volt

These BTE hearing aids are rechargeable, water-resistant, and suitable for those with mild-to-moderately severe hearing loss.

The company states that hearing aid users who wear glasses will not need to buy any accessories with the Volt, as this device is thin enough for eyeglasses to sit on the ear comfortably. People can also buy a single hearing aid or a pair and apply for a 12-month payment plan.

The MDHearingAid Volt also features:

  • bi-directional microphones
  • four program settings
  • noise and feedback cancellation
  • free shipping
  • a 45-day risk-free guarantee

Learn more about MDHearingAid here.

Oticon Opn S miniRITE T

This BTE device is suitable for those with mild-to-severe hearing loss. Additionally, people can purchase other accessories compatible with their hearing aids, such as phone and TV adapters and remote controls. It is only available through an audiologist.

The Opn S miniRITE T features:

  • a sleek and almost invisible design
  • a telecoil function, which offers a better sound experience in public places with looping systems
  • push button volume control

Learn more about Oticon here.

Cochlear Nucleus 7 processor

With the Nucleus 7 processor cochlear implant, individuals can choose from several additional features, including different wireless hearing capabilities, a mini microphone, a phone clip, and TV streamer. It comes with a disposable battery, two rechargeable batteries, a charger, and other accessories such as a carrying case.

The Nucleus 7 also features:

  • a highly customizable design
  • water resistance
  • a choice of power options, such as rechargeable batteries and USB or Y charger
  • a 5-year warranty

Advanced Bionics Naida CI Marvel

This device automatically senses and adapts to every situation using wireless connectivity. Individuals can stream TV audio and phone calls directly into the ears.

Additionally, the Naida CI Marvel features:

  • water resistance
  • background noise reduction for hearing clarity
  • availability in a range of colors

Advanced Bionics offers an online rehabilitation portal to offer extra support for cochlear implant users. There is also an online program where people can practice listening to different sounds from home. The 10-year warranty that the company offers may vary depending on regional regulations.

Hearing exams are an important part of protecting hearing health, and individuals should have regular hearing checkups. The Centers for Disease Control and Prevention (CDC) states a doctor can check for a person’s hearing during a routine checkup and may refer them to a hearing specialist if:

  • family and friends say that the person has difficulty hearing
  • a person has past exposure to a loud noise
  • a person is experiencing changes with their hearing

Loud noises can cause hearing loss. The following signs and symptoms may indicate hearing loss from noise exposure:

  • tinnitus, a ringing in the ears
  • muffled speech and other sounds
  • difficulty understanding conversations over the phone or in noisy places
  • asking people to repeat, speak louder, or speak in a slow, clear manner
  • sensitivity to sound

The United Kingdom National Health Service (NHS) recommends that people follow these measures to protect their hearing:

  • wearing hearing protection if they are around loud noises
  • reducing the volume while wearing earphones and headphones
  • staying away from loud noises when possible

Both hearing aids and cochlear implants are helpful for people with hearing loss. While hearing aids may be more suitable for those with mild-to-moderate hearing loss, cochlear implants are appropriate for those with profound hearing loss or who are severely hard of hearing.

People should consider their level of hearing loss and lifestyle requirements when purchasing a hearing device. Some hearing aids are available to buy online, and others are only available through an audiologist. Individuals cannot purchase cochlear implants online and need an appointment with an audiologist or otolaryngologist to determine if these devices are suitable for them.