Cochlear Implant Surgery by ENT Specialist Dr Lau Chee Chong
What is a Cochlear Implant?
Hearing connects us to the world around us — to conversations, laughter, and familiar sounds that shape daily life. When hearing loss becomes too severe for hearing aids to help, many people begin to feel disconnected from those moments. In such cases, a cochlear implant can offer renewed access to sound and speech. This electronic hearing device helps individuals whose inner ear can no longer transmit sound effectively, allowing them to recognise voices and environmental sounds again. In Singapore, cochlear implant surgery is performed by Ear, Nose, and Throat (ENT) specialists who are trained in diagnosing and treating complex hearing conditions in children (paediatrics) and adults.
To understand how a cochlear implant makes this possible, it helps to first know how the ear works. The ear consists of three main parts: the outer ear, middle ear, and inner ear, which together convert sound waves into signals the brain can recognise. The outer ear collects sound and channels it toward the eardrum. The middle ear, made up of three small bones called the malleus (hammer), incus (anvil), and stapes (stirrup), amplifies these vibrations and sends them into the inner ear. The cochlea, a spiral-shaped organ lined with fine hair cells, then converts these vibrations into electrical impulses that pass through the auditory nerve to the brain. This natural chain of events allows us to hear and interpret the sounds around us.
When these hair cells are damaged, sound signals cannot reach the brain clearly, no matter how powerful a hearing aid may be. This type of hearing loss, known as sensorineural hearing loss, makes it difficult to understand speech or recognise sounds in daily life. A cochlear implant addresses this problem by bypassing the damaged parts of the ear and sending sound information directly to the auditory nerve through carefully controlled electrical signals. By re-establishing this pathway, it allows the brain to perceive sound once again. In the next section, we will explore how a cochlear implant works and the technology that makes this possible.
How Does a Cochlear Implant Work?
Hearing through a cochlear implant begins with the simple act of detecting sound, but what happens next is a remarkable blend of engineering and biology. The device recreates the ear’s natural hearing process by translating sound waves into finely tuned electrical signals that the brain can recognise as meaningful sound. This is achieved through a seamless interaction between the cochlear implant’s external and internal parts, which communicate constantly to restore the connection between the ear and the brain.
External Components
The hearing process starts outside the body. A small microphone, typically worn behind the ear, captures sounds from the environment and sends them to a sound processor. Inside the processor, these sounds are analysed, refined, and converted into digital signals. The signals are then transmitted across the skin by a transmitter coil, which uses radio frequency to relay the information to the internal receiver implanted beneath the skin.
Internal Components
Once the sound information reaches the internal system, it is converted into electrical impulses that the brain can interpret. The receiver and stimulator, located under the skin behind the ear, collect the transmitted signals and generate precise patterns of electrical energy. These impulses are carried through a thin array of 24 electrodes, which has been surgically inserted into the cochlea. Each electrode activates specific nerve fibres corresponding to different sound frequencies and pitches, replicating the natural process of hearing.
Through this coordinated system, a cochlear implant re-establishes the pathway between sound and the brain. It allows people with severe hearing loss to perceive voices, music, and environmental sounds with clarity that hearing aids alone cannot provide.
Rehabilitation and Activation of the Cochlear Implant
Several weeks after the cochlear implant surgery procedure, when healing is complete, the external components of the implant are fixed on and activated. This marks the beginning of the “switch-on” phase, when sound is first delivered to the brain through the implant. After activation, patients attend a series of follow-up sessions for device tuning and auditory training. These sessions help the brain adapt to the new way of hearing and refine the clarity of sound over time. With consistent rehabilitation and support, most individuals experience steady improvement in speech understanding and overall communication.
While most patients recover well and enjoy significant hearing improvement, it is natural to have questions about safety. The next section outlines the possible risks of a cochlear implant surgery and how they are carefully minimised by your ENT specialist.
What Are the Risks Involved for a Cochlear Implant Surgery?
A cochlear implant surgery is a safe and well-established procedure when performed by an experienced ENT specialist. Although every surgery carries some degree of risk, complications from this procedure are rare. Most side effects are mild and temporary, such as short-term dizziness, slight balance changes, or minor swelling near the implant site as the body heals. Occasionally, patients may develop a small infection at the incision area or brief irritation of the facial nerve, but these typically resolve with proper medical care. More uncommon issues, such as loss of any remaining natural hearing or minor technical faults with the implant’s internal components, are further minimised through precise planning, careful monitoring, and attentive post-operative management.
Who Can Benefit from a Cochlear Implant?
Hearing loss affects more than just sound; it can make conversations difficult, distance people from loved ones, and gradually reduce confidence. When hearing aids are no longer effective in providing clarity, a cochlear implant offers a way to restore access to sound and communication. By directly stimulating the auditory nerve, the cochlear implant helps individuals hear more distinctly and re-engage with the world around them.
For many adults, this renewed clarity transforms daily life. Those who depend on communication for work, family, or social activities often find it easier to follow conversations and connect more naturally. The improvement is equally meaningful for older adults, who might experience reduced isolation, better cognitive engagement, and greater independence through improved hearing. With structured rehabilitation and regular follow-up care, a cochlear implant supports lasting confidence and connection at every stage of adulthood.
Children benefit in a similar way, though early intervention makes an even greater difference. During the first few years of life, the brain is especially receptive to sound and language, making timely implantation crucial for speech and listening development. Some children might also be suitable for bilateral implantation, where cochlear implants are placed in both ears during the same operation to provide balanced hearing and clearer sound awareness.
Start Your Hearing Journey with ENT Specialist Dr CC Lau
At the Ear Nose & Throat Centre CCLau, every consultation begins with understanding your hearing needs, concerns, and goals. Led by Dr Lau Chee Chong, an experienced ENT specialist and cochlear implant surgeon in Singapore, the centre provides evidence-based compassionate care for adults and children with hearing loss and related ear conditions.
With more than three decades of medical experience, Dr Lau has performed numerous cochlear implant surgeries and is highly regarded for his work in treating complex hearing and balance conditions. His approach combines precise surgical skill with a strong emphasis on long-term hearing support, working closely with audiologists and therapists to help patients adapt, recover, and reconnect with sound. Contact us today to schedule a consultation and find out how we can help you hear better, live fuller, and stay connected to the world around you.
Our Singapore ENT clinic specialises in the end-to-end management of all ear, nose, and throat conditions while keeping the best ENT practices in mind.
Frequently Asked Questions About Cochlear Implants
What is a cochlear implant?
Think of a cochlear implant as an electronic hearing system for people with severe hearing loss. Instead of boosting volume like a hearing aid, it routes sound information to the hearing nerve so the brain can interpret it. The system includes an internal receiver-stimulator under the skin and an external sound processor worn behind the ear.
How does a cochlear implant work?
Sound is picked up by the external processor’s microphone and converted into digital information. That information is sent through the skin to the implanted receiver, which delivers tiny electrical impulses along an electrode array inside the cochlea, stimulating the auditory nerve so the brain perceives sound.
What are the benefits of having a cochlear implant?
For many who gain little from hearing aids, cochlear implants can improve speech understanding and everyday communication. Children who receive cochlear implants early tend to develop speech and language more effectively, and adults often report greater confidence and participation in conversations and social life.
How should someone prepare for a cochlear implant surgery?
Preparation involves a full assessment with an ENT specialist and audiology, including hearing tests and imaging, discussion of risks and expectations, and planning for post-operative rehabilitation and follow-up cochlear implant programming sessions. Family support helps with the adjustment.
What happens during a cochlear implant surgery?
A cochlear implant surgery is performed using general anaesthesia. The surgeon makes a small incision behind the ear, places the internal receiver, and gently inserts the electrode array into the cochlea before closing the incision. Surgery time varies by patient and centre, commonly around two to four hours. Most adults go home the same day or after an overnight stay, and the device is typically activated two to four weeks later.
3 Mount Elizabeth, Suite 14-11 (14th Floor)
Mount Elizabeth Medical Centre
Singapore 228510
