Cochlear Implant: A life-changing device
November 15, 2021

Cochlear Implant: A life-changing device

A man and a woman are standing on a sidewalk holding hands.

On July 4, 2020, one little girl experienced a life-changing evening that some of us might take for granted. Do you ever find yourself ready to fall asleep on Independence Day but have trouble drifting off because the neighbor, two houses down, is still shooting off fireworks at 11:00pm? Most of us have been there, except those who cannot hear the fireworks. But this year was different for Emmalyn.


Emmalyn was born profoundly deaf. But Emmalyn is able to hear with the aid of cochlear implants. What are cochlear implants? Cochlear implants, which were approved by the U.S. Food and Drug Administration (FDA) more than 40 years ago, are surgically implanted devices that provide sound representation to people who cannot benefit from hearing aids. The implants do not cure hearing impairment; rather, the device directly stimulates the auditory pathway. Cochlear implants replace the function of the damaged inner ear to provide sound signals to the brain for processing.


Cochlear implants have come a long way since the first recipient of the earliest version of the technology received an implant in 1977. In the more than 40 years since that revolutionary milestone, the precision of this technology and process has been fine-tuned, and more than 500,000 people with hearing loss have benefited from cochlear implants worldwide. As is often the case when technology advances, the devices are now smaller and smarter. They are comprised of two components, which work like this:


1) Internal electrode array. The internal electrode array is implanted by an ear, nose and throat surgeon, also called an otolaryngologist, into the inner ear.

2) External sound processor. The microphones on the external sound processor detect sounds and transfer those sounds through the skin to the internal electrode array. Two options are available for the external sound processor: a behind-the-ear option that sits atop the ear and looks similar to a traditional behind-the-ear hearing aid and an off-the-ear option. The internal electrode array then stimulates the auditory nerve directly and transmits the sound to the brain for processing.


Emmalyn has benefited from this breakthrough in technology since her first implant surgery just before her 1st birthday. But she has always had to adjust to going through periods of hearing and periods of deafness. This happens every night when she removes her external sound processors to go to sleep. This has created a hesitation in Emmalyn and a fear of loud, unexpected noises—the kind of noises fireworks would produce. But this year was different, and Emmalyn made a choice she has never made.


Emmalyn decided she wanted to hear what fireworks sounded like. This year Emmalyn left her external processors on. The joy on that child’s face when hearing fireworks for the first time and exclaiming, “They aren’t that loud!” and “It’s not that scary!” brought her parents to tears. And the life-changing technology and surgery of cochlear implants has made that possible. Emmalyn’s mother Nancy said, “I’m continually amazed at how this little girl finds so much joy in life and in the things that we often take for granted. She keeps us smiling and so full of joy while we get to share these special moments with her.”


“Since 2017, Johnson Audiology has provided support for cochlear implant patients by way of initial diagnostic evaluation and ongoing follow-up care,” says Megan Johnson, Au.D. and owner of Johnson Audiology. Dr. Johnson has been an audiologist for more than 17 years, and her experience as a cochlear fellow began as soon as she embarked on her career. She and Johnson Audiology’s Madison Sakaan, Au.D. serve cochlear implant patients through initial candidacy testing and through post-surgical ongoing care.


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Last autumn, access to cochlear implantation reached a new milestone in the Chattanooga area when Johnson Audiology teamed up with otolaryngology surgeons Dr. Doug Leining and Dr. Alex Sokohl from Associates in ENT to give Chattanoogans a complete continuum of care for cochlear implantation. With the surgery performed right here at Memorial Hospital in Chattanooga, cochlear implant patients no longer have to travel to Nashville or Atlanta to receive that component of their care. Cochlear implant surgery was an elective that was suspended for a time this spring because of COVID-19; despite that setback, multiple patients have moved forward with implantation.


Dr. Sakaan says, “Our cochlear implant program has really taken off. Patients are overjoyed that cochlear implantation and programming services are now offered locally in Chattanooga. At Johnson Audiology, evaluation for a cochlear implant is extremely comprehensive, as it should be. We perform a typical hearing test and then test the patient’s ability to understand spoken sentences while wearing hearing aids. When programming those hearing aids, we use real-ear measurements (REM), which is considered best practice, to ensure the hearing aids are optimally set. Qualification for a cochlear implant is then determined by the difficulty a patient has in understanding the spoken sentences when wearing hearing aids.”


While cochlear implants can be life-changing, it comes with its own set of challenges. It can take time for the patient to adjust as the brain “re-learns” the stimulation it is receiving from the implants. And the programming is subject to adjustments over the life of the device. Having an audiologist and Ear Nose and Throat (ENT) physician that you trust is key as a lifelong relationship is formed from the first consultation through every mapping, or programming, session after surgery. 

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Madison Sakaan, Au.D. (l) and Megan Johnson, Au.D. (r) work with cochlear implant patients at the Gunbarrel Road location of Johnson Audiology in Chattanooga.

“Helping patients with hearing loss and cochlear implants is my passion,” Dr. Sakaan goes on to say. “Being able to walk with my patients from day one when we evaluate for a cochlear implant, to the day of surgery, to initial activation of the implant, and through the hearing rehabilitation journey is the greatest honor. The team at Johnson Audiology and I are here to help patients during every step of their cochlear implant journey. I believe this is what makes our services here at Johnson Audiology so special. Patients' hearing and quality of life is our top priority, and it shines through in everything we do.”


Cochlear implants are a hearing loss solution for those with moderate to profound sensorineural hearing loss—also referred to as nerve hearing loss—who are receiving limited benefit from hearing aids, such as those who only hear half of what is said in a conversation. Cochlear implantation has become the established treatment for children as young as 12 months who have severe to profound sensorineural hearing loss. Cochlear implants are covered by Medicare, many insurance plans, and typically by Medicaid. However, those interested in cochlear implantation need to be aware that the FDA has set specific guidelines that audiologists and ENT surgeons must follow to determine a person’s candidacy.

 

For more information about cochlear implantation, contact Johnson Audiology’s Gunbarrel Road location in Chattanooga at 423.710.1432 or Associates in ENT at 423.267.6738.


By Jan Hollingsworth June 4, 2025
Like anything new in life, adjusting to hearing aids can take time and perseverance to achieve the best results. Yet many people are too quick to give up, not allowing the brain the chance to relearn how to hear or not giving themselves the opportunity to become accustomed to the use and maintenance of their devices. “We meet so many people who wait—who convince themselves their hearing is not ‘bad enough’ or that they can just get by. But untreated hearing loss quietly steals moments, connection, and joy. At Johnson Audiology, we understand the fear, the frustration, and the doubt. That is why we offer more than hearing aids—we offer compassion, answers, and a partner you can trust. You don’t have to do this alone. Let us help you hear your life again,” says Dr. Megan Johnson, audiologist and owner of Johnson Audiology. “Hearing aids should never be an experience where a person is fit with devices and then they never see their hearing care provider again. To ensure patient success, Johnson Audiology seeks to be a lifelong partner on a person’s journey to healthy hearing, someone who is there at every turn,” says Dr. Megan Johnson, audiologist and owner of Johnson Audiology. What are the most common reasons why people give up on hearing aids and why is it important to stick with it? Reasons why people might give up on hearing aids An adjustment period It is your brain that hears, not your ears. The ears transmit sound to the brain where it is interpreted. Dr. Johnson explains, “When a person’s brain has not been stimulated by sound because of hearing loss and then sound is restored with hearing aids, it can take some getting used to. For some people, it takes more than one appointment to get them up to full sound prescription, stair stepping up gradually to let the brain adjust. The brain’s capacity to do this is called neural plasticity .” Research by the University of Colorado Boulder’s Hearing Epidemiology and Research Diagnostic Laboratory has revealed that what the brain can experience impacts within weeks rather than years when hearing loss reaches a certain level. Dr. Johnson says, “The brain’s temporal lobe is where much of hearing and sound interpretation happens. Electroencephalogram (EEG), which is a medical test that measures the electrical activity of the brain, shows that in the presence of hearing loss, the brain will recruit areas assigned to other tasks—like vision—to compensate. The trouble is that this extra cognitive load can tax those areas. However, after treatment with hearing aids, brain recruitment is shown to reverse, partially or fully.” The adjustment period for hearing aids tends to be more seamless for those who have not been without sound for years and years. Dr. Johnson says, “I always encourage people to get their hearing checked when they first notice they are struggling. Sooner is always better.” An investment in quality of life People often make an investment in their health and well-being—for example, purchasing glasses, getting a knee replacement, straightening their teeth—and yet many relegate hearing to the backburner because of cost. Dr. Johnson says, “I’ve seen many patients struggle with hearing aids after buying inferior products in an attempt to save money. Without the guidance of a hearing care provider, even the best device can quickly become ineffective and frustrating.” Dr. Johnson encourages making hearing a priority and budgeting for your hearing health. Perceived benefits and ease of use Getting in the routine of putting hearing aids in each day and being diligent about regular cleaning and maintenance might be a challenge that some face and which deters them from being successful with their aids. “At Johnson Audiology, we offer a plan for regular in-office cleaning and maintenance, easing the task of upkeep for patients. Plus, our offices have dedicated walk-in hours that do not require an appointment. We are here to answer questions, make hearing aid adjustments, and much more as we seek to help people safeguard their investment in hearing technology and make the process easy and convenient.” Family attitudes and support When it comes to hearing aids, having a support system can be crucial to success. “In my 20 years as an audiologist, I have seen the immense benefits when a person’s family members show patience and support during the adjustment period with new hearing aids,” said Dr. Johnson. What about patients who do not have that familial encouragement? Dr. Johnson says, “We are your support system. That’s where our caring and professional audiologists, audiology assistants, and patient care coordinators can lend a helping hand. Success with hearing aids is our goal for every patient, so we promise to be there every step of the way.” Why is healthy hearing so important Hearing loss is a family affair The positive impact of treating hearing loss is often manifested most significantly through improved relationships with family and friends. Hearing loss leads to miscommunication. It can also cause mounting frustration as family members must constantly repeat every sentence. Dr. Johnson comments, “Living with the TV blaring can put a strain on others living in the same household. Untreated hearing loss can quietly tear at the fabric of your relationships. When words go unheard and conversations fade, love and connection start to suffer, and that pain is felt by all involved.” Healthy hearing can help the brain stay sharp and pliable For many years, researchers at Johns Hopkins University have been studying the relationship between hearing loss and dementia. While there is still much left to discover, increasingly scientists recognize healthy hearing as a key factor in maintaining a healthy brain and potentially decelerating the risk of dementia, like Alzheimer’s disease. Dr. Johnson says, “It seems logical that when certain areas of the brain are not stimulated by sound, they atrophy. In fact, research suggests an actual reduction in the physical size of the brain, especially in areas where sound processing and memory take place.” She goes on to say that “while there are many risk factors that individuals cannot control about the effects of aging on the brain, hearing is definitely one that can and should be addressed.” Healthy hearing keeps a person engaged in life Humans are social beings. Since hearing loss can impair effective communication, it is not difficult to understand how it also could lead to social isolation, which can cause increased anxiety and depression. “Conversely, addressing hearing loss can keep a person engaged in life and connected to family and friends,” Dr. Johnson says. Falls and other health risks The ears have two main functions. Hearing is one that most of us learn as youngsters, but the ears also play a major role in helping a person maintain their balance and knowing where their body is in space. “The fluid, or endolymph, in the ear’s semicircular canals is what helps a person do things like stand up from a seated position without falling, walk a straight line, and not run into a door frame when turning a corner into a room,” says Dr. Johnson. In the presence of hearing loss, the reduction in acoustic signals impairs a person’s ability to process spatial information and can mean a higher risk for falling. In turn, falling can lead to broken bones and other injuries and a cascading effect of hospital stays and loss of independence. If you have been unsuccessful with hearing aids in the past, call Johnson Audiology, a hearing health clinic comprised of caring and professional staff. The team can bring a range of options to the table to help people hear better, including hearing aids from all six of the major manufacturers, custom fit products, cochlear implants, and Lyric, the world’s only extended wear hearing aid. Call your office of choice today or schedule online.
A man is wearing a cochlear implant in his ear.
March 6, 2025
Chipper Gocke, 28, has had many poignant moments in the last six weeks since his cochlear implant surgery. “A workmate commented recently that my speaking voice is the appropriate volume now. Not being able to hear myself, I probably often talked too loud before. It seems like a small thing, but it is a way to be more normalized in my professional and other settings.” His mother, Amy Gocke, also has noticed the changes. “Chipper has never called me on the phone before. With his profound lifelong hearing loss and even using powerful hearing aids, he simply couldn’t communicate by phone. Now I look forward to his calls every day after he gets off work.” These daily experiences that people often take for granted—communicating with a workmate or calling a family member to say hello—are now possible for Chipper because of his cochlear implant. Hearing loss has been a part of Chipper’s life since he was a small child. Chipper’s father, Ted Gocke, relates, “From the time he was 18 months old, Chipper had ear infections that had us in and out of the hospital. That led to tubes in his ears and the diagnosis that he had a significant hearing loss.” As a youngster, Chipper received early intervention services before he even reached school age. He also got established with local audiologist, Darnell Scafe, and they reconnected recently when Chipper sought out Darnell for hearing health care services as an adult. Darnell, who joined the Johnson Audiology team in 2018, says, “I remember Chipper as a sweet little boy who didn’t let his hearing loss slow him down. It’s wonderful to get to know the fine, capable young man he has grown into.” Last year, Darnell encouraged Chipper to consider a cochlear implant, and she referred him to Johnson Audiology’s Cochlear Implant Program Director, Dr. Hannah Dearth. Dr. Dearth then was able to complete cochlear implant candidacy testing. In November of last year, Chipper’s surgery was performed at Murfreesboro Medical Clinic (MMC) in Middle Tennessee by an otolaryngologist (ENT). A native of Chattanooga, Chipper traveled for the initial surgery since there is not currently an ENT in Chattanooga who performs CI surgeries. However, Chipper then had his cochlear implant activated at Johnson Audiology (JA) by Dr. Dearth in early January. Also, there to celebrate activation day was Darnell. “It felt like a full circle moment when Dr. Dearth activated Chipper’s cochlear implant, and he began to have those first sound perceptions.” Dr. Dearth explains, “People often wonder how a hearing aid and a cochlear implant are different. Cochlear implants are designed for patients whose hearing aids are no longer assisting them in understanding in both quiet and noisy environments. A hearing aid is designed to provide amplification for speech sounds that are unintelligible without said amplification. Cochlear implants are a surgical option for those who are no longer able to achieve meaningful understanding with a traditional hearing aid. Hearing aids rely on the ear’s natural pathway for hearing to accomplish this and so may not work well for someone with severe damage to the inner ear. A cochlear implant, on the other hand, bypasses the damaged parts of the ear by stimulating the auditory nerve directly with a mild electrical current that sends the sound signal to the brain.” Chipper is committed to his own success with his cochlear implant and in addition to listening to the speech of those around him, he is also tuning in to podcasts and audiobooks that give him even more speech exposure. Dr. Dearth says that is a huge factor in any patient’s ability to thrive with the device. “The patients who are committed to the aural rehabilitation as prescribed experience faster progress and higher success rates long term.” Chipper will continue regular follow-up appointments for the rest of his life to maintain successful progress with his CI. He gets emotional talking about the social isolation that can be a common side effect of profound hearing loss and, also, mentions the spatial awareness that better hearing offers. “Being able to pinpoint sound and localize stimuli from both sides of the head has positive effects for living a safe life,” Dr. Dearth says. Dr. Megan Johnson, audiologist, founder, and owner of JA, says, “Johnson Audiology has provided support for cochlear implant patients since 2017 with care offered through the practice’s location on Lee Highway in the East Brainerd area. After implantation, every other part of a CI patient’s hearing journey can be accomplished at Johnson Audiology—from initial activation to routine mapping.”  Chipper and his parents encourage people to explore the possibility of cochlear implants since it can make such a difference in a person’s daily life and function. Johnson Audiology is accepting new patients who currently wear hearing aids but would like to pursue cochlear implant candidacy as well as those who already have a cochlear implant. Call Johnson Audiology at 423.556.7185 or visit www.johnsonaudiology.com/schedule for more information or to schedule an appointment.