Cochlear implants can change lives, but many are missing out

International Cochlear Implant Day is celebrated every 25 February, the anniversary of the first procedure that would ultimately lead to ground-breaking cochlear implantation, as performed by French doctors Charles Eyries and André Djourno in 1957. It is estimated that there are now more than one million people around the world who have a cochlear implant (CI)[1], the small but complex electronic device that enables hearing by directly stimulating the auditory nerve. Hearing implants can have a transformative impact on hearing ability as well as overall quality of life, for both children and adults, but unfortunately they remain severely underutilised in those who would most benefit.

In the more than half a century since the first cochlear implantation, cochlear implant technology has evolved significantly – developments such as enhanced sound quality, improved listening in noise, wireless connectivity, and miniaturization of the devices have become a reality. Further enhancements are imminent with the advent of robotics, as well as drug delivery systems/combined devices and totally implantable CI.

Potential of implants stymied by lack of awareness among public and HCPs

Yet data shows that while a significant proportion of those with hearing impairment would benefit from the use of cochlear implants just a tiny fraction who qualify will actually avail of them – globally this is thought to be as low as 5%.

Poor awareness among potential candidates as well as healthcare professionals (HCPs) – including hearing aid dispensers and audiologists – is one of the main reasons for the low access rates to hearing implants. In a US study of over 15,000 people, just one in 10 reported being “very familiar” with cochlear implants, while 31% of those with hearing difficulty reported that they had “never heard” of a cochlear implant. Furthermore, the same study showed that nearly 80% of adults with hearing difficulty said they had never discussed cochlear implants with a medical or hearing care professional.[2]

The EuroTrak 2022 studies found that only 18% of hearing aid owners with severe/profound hearing loss had been informed about cochlear implants by a medical professional.[3] Meanwhile, a European study found that although hearing implants were viewed as being different to hearing aids, there was little understanding that the external sound processor was similar to a hearing aid in its physical characteristics.[4]

Research also shows that implant candidates are being “lost” because they do not glean enough benefit from hearing aids given their severe to profound hearing loss and do not realise there is another, better option. Experts say a better approach to re-engaging with these candidates is crucial. Referral pathways for those with severe to profound hearing loss and the criteria for cochlear implants are not always known or fully understood by healthcare professionals; indeed, referral criteria are ever changing, with significant advances in the types of implantable solutions available for hearing loss, according to the World Report on Hearing, published last year.

More children availing of implants but adults still missing out

Usage has increased among children in recent years, thankfully. One study found that paediatric utilisation ranged from a low of 50% in the United States to a high of 97% in Australia, while adult utilisation is less than 10% everywhere in the world.[5] A Belgian survey for example found that, on average, 78% of deaf children are receiving cochlear implants, but in adults only 6.6% of CI candidates are receiving one.[6]

Cochlear implantation is an effective solution that has low surgical complication rates and generates significant benefit in terms of hearing and quality of life, yet it is misunderstood and underutilised. Education of both the public and healthcare professionals is needed to correct misconceptions and proactively address the lack of uptake.


[1] Fan-Gang Zeng, JASA Express Lett. 2, 077201 (2022)

[2] Marinelli JP, Sydlowski SA, Carlson ML. Cochlear Implant Awareness in the United States: A National Survey of 15,138 Adults. Semin Hear. 2022 Dec 1;43(4):317-323. doi: 10.1055/s-0042-1758376.

[3] EuroTrak surveys 2022.

[4] D’Haese PSC, De Bodt M, Van Rompaey V, Van de Heyning P. Awareness of Hearing Loss in Older Adults: Results of a Survey Conducted in 500 Subjects Across 5 European Countries as a Basis for an Online Awareness Campaign. Inquiry. 2018 Jan-Dec;55:46958018759421.

[5] Sorkin DL, Buchman CA. Cochlear Implant Access in Six Developed Countries. Otol Neurotol. 2016 Feb;37(2):e161-4.

[6] De Raeve L. Cochlear implants in Belgium: Prevalence in paediatric and adult cochlear implantation. Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Jun;133 Suppl 1:S57-60.

Skip to content