Hybrid Cochlear Implants

Helping Millions of People with High-Frequency Hearing Loss

Closeup of a hybrid cochlear implant

Cochlear implant candidacy guidelines have been expanded over the years to include adults and children with severe to profound hearing loss bilaterally who do not benefit from the use of hearing aid amplification.

Millions of children and adults across the world have taken advantage of cochlear implant technology and have been successfully implanted to improve their hearing and communication.

But, what about the millions more who have severe high frequency hearing loss who are not cochlear implant candidates but are still struggling to hear conversations, particularly in noisy environments? Because their low frequency hearing is “too good” to qualify them as a candidate for a traditional cochlear implant, they are stuck in the middle between hearing aids and cochlear implants.

Traditional hearing aids are not enough for a lot of people with severe high frequency hearing loss because they can not sufficiently amplify high frequency information for it to be discernible, especially in background noise.

These individuals have been left frustrated.

A solution has now emerged. It is called a hybrid cochlear implant. It is for those who do not benefit from a hearing aid, but are not quite a candidate for a traditional cochlear implant.

A recent NYU-led multi-center study implanted 50 adults with severe high frequency hearing loss with a hybrid cochlear implant. Their speech recognition scores were tested one-year post implantation, with 45 participants showing a significant improvement in hearing and speech recognition. None of the participants hearing or speech recognition was worse following implantation.

What is a Hybrid Cochlear Implant?



It combines two proven technologies, a hearing aid and a cochlear implant, into one device. It uses the acoustic amplification of the hearing aid to improve low frequency hearing, while using electrical stimulation of the cochlear implant to improve high frequency hearing.

Clinics have been creating their own form of a hybrid implant for years by using a cochlear implant with a shorter, partially inserted electrode array, and wearing an in-the-ear hearing aid at the same time. Now, companies have combined the two devices into one system and, as of 2014, it is approved by the FDA for use in adults.

How does a Hybrid Cochlear Implant Work?


The external processor of the hybrid cochlear implant picks up incoming sounds and transmits the low frequency information to a hearing aid, which amplifies the sound based on the wearer's low frequency hearing loss. The high frequency sound information is transmitted to the cochlear implant component of the device, which is then converted into electrical impulses stimulating the high frequency regions of the hearing nerve.

How is a Hybrid Cochlear Implant Different from a Cochlear Implant?

A hybrid cochlear implant differs from a traditional cochlear implant in that it's electrode array is much shorter (less than 2 cm). With the electrode array being shorter, it does not go as far into the cochlea of the inner ear, only providing electrical stimulation to the high frequency sounds, leaving the low frequency hearing region undisturbed to preserve low frequency residual hearing.

A traditional acoustic hearing aid is then coupled with the processor of the implant to provide amplification to low frequency sounds as needed.

Who is a Hybrid Implant for?

A hybrid cochlear implant is for those with a severe to profound high frequency hearing loss with intact or moderately impaired low frequency hearing. Age-related hearing loss (presbycusis) and noise-induced hearing loss are the most common causes of sensorineural hearing loss, and almost always result in a high frequency hearing loss.

The hearing loss is caused by damage to the inner hair cells in the cochlea. The high frequency inner hair cells are more susceptible to aging and noise effects, resulting in that common high frequency hearing loss configuration. This has often been referred to as “nerve damage”, although that term is very misleading, as the hearing nerve remains intact.

The loss of high frequency hearing causes difficulty with speech recognition, especially in background noise. It can severely affect an individual's social and work environments and can lead to isolation and depression. The high frequency sounds create clarity of speech. When you are unable to hearing those high frequency consonant sounds, words can be difficult to distinguish and sound muffled.

Stuck in the Middle No More

There are currently two cochlear implant manufacturers that are now offering a hybrid implant system, Cochlear and MedEl.

Those with high frequency hearing loss who do not benefit from traditional hearing aids now have options. A hybrid cochlear implant uses “hybrid hearing” from both acoustic and electric stimulation to help these people hear and communicate easier.

For more information check out the video below to see one woman's experience with a hybrid cochlear implant:

Leave a reply

Clear Living values your comments but kindly requests all posts are on topic, constructive and respectful. Please review our commenting policy.

  • Ray Glover
    Just thought I would add my experience of using a hybrid cochlear implant. I was an early recipient in 2004 and I expect the protocols for preserving residual hearing have improved since then. I lost the residual hearing suddenly after 7 years of use. I can say the hybrid performed excellently until then, the most important part being I retained directional hearing until the loss. Once this occurred I found it much harder to hear in noise. I found that overlapping the frequency bands of electric and natural hearing degraded understanding and made listening to music unpleasant. It took some experimentation to get the centre frequency of the apical electrode filter just right but I found this to be a very sensitive parameter to being able to recognize tunes and pitch.
  • William C Pinson
    How invasive is the implant surgery? Also, what's the typical cost of the surgery, roughly (order of magnitude)?
  • Mary Cunningham
    Hi I live in Ireland and I was wandering if hybrid cochlear implants available here? I was born with not hearing high frequencies. I have worn hearing aids on and off but really didn do what i need ed them to do like making conversation clear - hearing a phone in the next room - being able to distinguish sounds. the hearing aids just increased the noise level.
  • Rebecca S. Conners
    I am an identical twin that was born premature. I have struggled my whole life with my hearing loss; cochlear damage. My left ear is moderate to profound, my right ear moderate to severe. I have suffered so much in school, work and social life. I can't tell you, when I just read about the Hybrid, I wanted to cry! How expensive are they, and could I qualify for one of the Hybrids?.
    • Lindsey Banks, Au.D.
      Hi Rebecca Candidacy for a hybrid implant will depend on your hearing loss, as well as how well you do with traditional hearing aids. From what you described, you may be a candidate. Do you currently wear hearing aids? I would recommend that you speak to your Audiologist about the hybrid implant and see if you can be evaluated for candidacy. Not all Audiologists work with implants so it may be necessary to find someone in your area that does for an evaluation. Also, depending on your insurance, they may be covered. Hope that helps!