Are Hearing Aids Best for Severe Hearing Loss?

Written by
Dr. Chad Ruffin

Dr. Chad Ruffin

ENT Doc and CI Surgeon

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DECEMBER 19, 2021

Are Hearing Aids Best for Severe Hearing Loss?

Challenges of severe hearing loss

Hearing loss can be a challenging condition to deal with–I can personally attest to this as I was born with severe hearing loss. There are many different types of hearing aids on the market–for specific hearing aid recommendations, see this article that I helped write. Individuals with severe hearing loss may find that hearing aids are not enough to address their needs. In these cases, cochlear implants may be the best option. For many years, I relied on hearing aids to help me hear, but as my hearing loss worsened, I realized they were no longer enough. I was very reluctant to get cochlear implants–I waited for 11 years after being told I was a candidate. Despite my reluctance to undergo surgery, I eventually decided to get cochlear implants. It was one of the best decisions I ever made. This was 25 years ago–cochlear implants have become a very safe procedure and patients rarely lose their residual hearing in the short term.

Two photos. Left is a male caucasian child standing left of an older Asian male physician in a white coat. Right panel shows a caucasian man in black fleece and scrubs with a pager.
Dr. Ruffin as a child receiving treatment for severe hearing loss and in 2016 training as a cochlear implant surgeon. Image description: Left panel shows a Caucasian child and an an Asian physician. Right panel shows a young man in scrubs with a pager and a black fleece.

Signs of have severe hearing loss

Cochlear implant candidates have severe hearing loss but don't know it. Few hearing healthcare professionals know when it's time to refer a patient for cochlear implants. The Here are some signs you are a cochlear implant candidate:

  • You struggle on the phone even with well professionally fit hearing aids. To cope, you can only hear if you stream the phone to both ears. Unfamiliar people may be very difficult or impossible to hear. You can only talk to close friends and family.
  • It's difficult to hear with masks or without lipreading.
  • You may hear fine in very quite environments, but background noise is terrible.
  • You no longer go out to restaurants or social events.
  • Talking to people in group situations is very difficult.

It's important to realize when you have severe hearing loss. The earlier someone receives a cochlear implant, the better the hearing outcome will be.

What are cochlear implants?

Cochlear implants are devices that are surgically implanted into the inner ear to help individuals with severe hearing loss regain their hearing. Unlike traditional hearing aids, which amplify sound, cochlear implants work by directly stimulating the auditory nerve. This allows individuals with severe hearing loss to hear more clearly and with greater detail.

One of the primary benefits of cochlear implants is that they can be highly effective for people with severe hearing loss. While traditional hearing aids may be able to help individuals with mild to moderate hearing loss, they may not be enough for those with more significant hearing impairment. Cochlear implants can provide a much more robust and comprehensive solution for individuals who struggle to hear.

Cochlear implants also offer other benefits that traditional hearing aids cannot provide. For example, they can help individuals better distinguish speech in noisy environments, which is often a significant challenge for those with severe hearing loss. Additionally, cochlear implants can provide better sound quality and more natural hearing compared to traditional hearing aids.

While some people may be hesitant to consider cochlear implants due to the surgical procedure involved, it's worth noting that the procedure is generally safe and straightforward. Additionally, the benefits of cochlear implants can be life-changing, allowing individuals with severe hearing loss to communicate more effectively and participate more fully in the world around them.

My journey with cochlear implants

At first, I was nervous about the idea of undergoing surgery, and I had concerns about potential complications. But as I researched the benefits of cochlear implants and spoke to others who had undergone the procedure, I began to realize just how life-changing it could be. I decided to take the leap and go for it.

The procedure itself was much easier than I anticipated, and I was surprised at how quickly I recovered. The implant itself felt a bit strange at first, but as my brain adjusted to the new signals, I began to notice a significant improvement in my hearing. I was finally able to hear sounds I had been missing for years, and I was able to communicate more effectively with others.

One of the biggest benefits of cochlear implants for me was being able to hear in noisy environments. Before, I had struggled to understand conversations in crowded places or with background noise. But with my cochlear implants, I could finally distinguish speech more clearly, even in challenging situations. Additionally, the sound quality was much more natural and nuanced than what I experienced with hearing aids.

Looking back, I am so grateful that I decided to get cochlear implants. Indeed, I ended up "going bilateral" or getting the other ear implanted. While I understand the hesitation that some people may feel about the procedure, I can confidently say that the benefits far outweigh the risks. It was a life-changing decision that has allowed me to connect more fully with the world around me, and I would recommend it to anyone struggling with severe hearing loss.


While hearing aids can be useful for many people with hearing loss, they may not be enough for those with severe hearing impairment. Cochlear implants offer a more comprehensive solution that can provide significant benefits, including improved hearing in noisy environments, better sound quality, and more natural hearing. If you or someone you know is struggling with severe hearing loss, it's worth considering cochlear implants as a viable treatment option.

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Audiology doctoral student Sarah Sparks (Twitter: @saralovesears) is in training at Gallaudet University. Ms. Sparks was born typically hearing and initially resisted cochlear implants. This blog post by Med El describes her journey with hearing loss and the reason for her initial skepticism.

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Most people with severe and profound sensorineural hearing loss don’t realize what they’re missing. The average hearing aid user waits for a decade before biting the bullet and getting hearing amplification. A cochlear implant candidate takes even longer—a dozen years before receiving an implant. Learn more about cochlear implants.

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