Making the most of my residual hearing

One of the things we make sure our patients understand is that after you have a cochlear implant, you cannot go back to just wearing a hearing aid on the implanted ear.

For most people who have a hearing loss at the level where a cochlear implant will help, there is very little useful hearing left (although if it’s the only hearing you have, we don’t underestimate how useful and important it feels to you).

Having a cochlear implant for most people with only a small amount of useful hearing left is a trade off – it is likely that you won’t retain that small bit of hearing after the surgery, but what you stand to gain is very much more hearing than you had. If we honestly thought we wouldn’t be able to give you better hearing with a cochlear implant than with a hearing aid, we would tell you not to risk it.  We absolutely do not want anyone to end up in a worse position with their hearing than before.

For adults, who can only access one cochlear implant through NHS funding (children up to the age of 18 are funded for two implants), we usually recommend carrying on with your hearing aid in your better hearing ear, and having a cochlear implant in your worse ear, unless there are clinical reasons why this wouldn’t be an option for you.

For children, the research is absolutely unequivocal – two implants at the same time, ideally while you are young, gives the best possible outcomes.

There are a small number of people who come for cochlear implant surgery who have lost their high frequency hearing (which is the hearing at 1500 Hz, 2KHz, 4KHz and higher), but still have good low frequency hearing with their hearing aid.  For these people, sometimes an Electric Acoustic Stimulation (EAS) device is an option.  This is a hybrid speech processor which has a hearing aid component for low frequency hearing which the surgeon will try to preserve during your implant surgery.  Hopefully, we can then use this to top up the sound you get from your cochlear implant but we are not able to guarantee that the low frequencies will be preserved during the operation.


There are just a few people who this kind of device will work for.  Most people who have a cochlear implant do not have enough useful residual low frequency hearing left for this to give them a good result.

If we think you could be a candidate, we will tell you after your Initial Audiology appointment.  As a guideline, here are the candidacy guidelines for an EAS (pictured right).  If your unaided hearing test results are all within the purple box, you might be a suitable EAS candidate. There are other factors which would mean this kind of device isn’t an option for you – for example, if you have a progressive hearing loss or if you would prefer to use a speech processor that does not sit behind your ear, this will not work for you.

Speak to your Audiologist about what options may be available for you.