The Experience of Adult-Onset Hearing Loss and Adaptation to a Cochlear Implant

Background Spoken language and environmental sounds hold rich and nuanced meaning for the listener, but depend on accurate hearing of the soundscape, including the timing, volume, and contrasts of its component pitches. Sensorineural hearing loss with aging degrades these properties, leading to progressive disability. Objectives This case study and review describe my experience and behavioral accommodations to progressive bilateral hearing loss, limited compensation with hearing aids, and the stuttering evolution of gains after a unilateral cochlear implant (CI). Results Despite increasingly powerful hearing aids over 25 years, spoken phonemes and words became increasingly muffled, misheard, and often dissipated into ambient background noise. The cognitive effort to extract meaning and mask my disability grew exhausting. I gradually eliminated many of my usual family, medical career, and social roles. To try to recover some communication-dependent activities, I sought a bionic solution. A right-sided CI initially carried an ambiguous, fizzling code and unrecognizable synthetic voices. With 8 months of auditory rehabilitation, I better deciphered conversational speech and ambient sounds. By audiological testing, I improved from 10% hearing accuracy of single words to 65%, typical of post lingual adult users. Better hearing in ambient noise and for what had been excessively rapid speech evolved out to 18 months, allowing me to re-engage in many of my daily roles. Conclusions Hearing loss beyond the compensation of aids deeply challenges quality of life. Auditory rehabilitation after cochlear implantation engages neuroplasticity to re-establish functional communication.