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Using a Cochlear Implant and Hearing Aid Together

Today, bilateral cochlear implantation is a common practice; however, it is not always an option due to insurance restrictions, personal preference or significant residual hearing in the non-implanted ear.

A successful treatment option for these patients is to combine electric hearing from a cochlear implant in one ear with amplification from a traditional hearing aid in the other ear.

Why pair cochlear implants and hearing aids?

Amplification with a hearing aid has shown to be beneficial, even when the ear that is amplified with a hearing aid has little to no open-set speech understanding by itself. Combining the electric and acoustic signal may provide the highest level of speech understanding and sound quality.

Some of the benefits experienced when pairing cochlear implants with hearing aids are:

  • Improved speech comprehension
  • Single-word recognition improvement up to 20%
  • Sentence recognition in background noise improvement up to 30%
  • Improved speech understanding in non-implanted ears in the severe hearing loss (profound) range

How does pairing devices improve locating sounds?

In addition to improving speech understanding, the use of a hearing aid and cochlear implant together (rather than using one alone) can help an individual feel “balanced" between the two ears. When two ears are working together (a phenomenon called binaural hearing), they are better able to determine the location of sound by comparing the arrival time of sound at the two ears.

Enhanced sound quality with cochlear implants and hearing aids

While a cochlear implant is successful at conveying speech, it is not especially efficient at portraying fine-grained spectral and pitch information. In other words, a cochlear implant user may report that the sound quality of speech or music does not sound “natural." Therefore, sound quality can often be enhanced with the addition of a hearing aid to the non-implanted ear.

Patients using a hearing aid and a cochlear implant often report that speech sounds “more natural," “richer" or “fuller." Likewise, in a music appreciation study by Kong et al. (2005), melody recognition was enhanced by using a hearing aid in the ear opposite to a cochlear implant.

If you have any questions regarding your hearing or amplification devices, please contact a Boys Town Audiologist by calling (531) 355-6520 or visit Boys Town Hearing and Balance Center to learn more.​


  1. Ching, T.Y.C., van Wanrooy, E., Dillon, H. (2007). Binaural-bimodal fitting or bilateral implantation for managing severe to profound deafness: A review. Trends in Amplification, 11, 161-192.
  2. Dorman, M.F., Gifford, R.H., Spahr, A.J., McKarns, S.A. (2008). The benefits of combining acoustic and electric stimulation for the recognition of speech, voice and melodies. Audiology & Neurotology, 13, 105-112.
  3. Dunn, C.C., Tyler, R.S., Witt, S.A. (2005). Benefit of wearing a hearing aid on the unimplanted ear in adult users of a cochlear implant. Journal of Speech, Language, and Hearing Research, 48(3), 668-680.
  4. Gifford, R.H., Dorman, M.F., McKarns, S.A., Spahr, A.J. (2007). Combining electric and contralateral acoustic hearing: Word and sentence recognition with bimodal hearing. Journal of Speech, Language, and Hearing Research, 50, 835-843.
  5. Kong, YY, Carlyon, R.P. (2007). Improved speech recognition in noise in simulated binaurally combined acoustic and electric stimulation. Journal of the Acoustical Society of America, 121(6), 3717-3727.
  6. ​Zhang, T., Spahr, A.J., Dorman, M.F., Saoji, A. (2012). Relationship between auditory function of nonimplanted ears and bimodal benefit. Ear & Hearing, published ahead of print, doi: 10.1097/AUD.0b013e31826709af.
Cochlear Implants;Hearing Aids Hearing and Balance