While hearing aids can be helpful for most people with hearing loss, there are some for whom hearing aids either do not help or help insufficiently. In such cases, cochlear implants can be helpful and are being used by more people with severe and profound hearing loss who no longer benefit from hearing aids. A cochlear implant consists of an internal and external component. The internal component is surgically inserted under the skin behind the ear, and a narrow wire is threaded into the inner ear. The external component, which looks somewhat like a behind-the-ear hearing aid, is connected to the internal one through the skin via an external magnetic disk.
Incoming sounds are converted to electrical currents and directed to a number of contact points on the internal wire. This operation creates an electrical field which directly stimulates the auditory nerve, thus bypassing the defective inner ear. Unlike hearing aids, cochlear implants convert sound waves to electrical impulses and transmit them to the inner ear, providing people with the ability to hear sounds and potentially better understand speech without reading lips.
The cochlear implant has become widely recognized as an established treatment for profound hearing loss.
According to Steven Marcrum, Otolaryngology, Pediatrics, Speech and Language Pathology University Hospital Regensburg It is very tempting and common for parents of young, hard of hearing children to want to wait for the next big break-through in gene therapy, cochlear implant technology, etc. The fact remains, however, that for children with thresholds beyond around 70 dBHL (perhaps even slightly less), results with cochlear implants are generally superior to results with hearing aids. Structurally, the internal components of cochlear implants should last a lifetime. However, with a future of implantable microphones, capabilities for maybe hundreds of electrodes using nano-technology, and a myriad of other advances, it is questionable whether someone implanted today might not consider re-implantation with a more modern device 40 years down the road.
However, we also know that time is of the essence, with results decreasing significantly beyond around the 4 year of life. Therefore, given the outstanding results obtained with modern CIs, it is advisable to implant now to allow for brain development and to consider advances as they arrive. If you miss the critical period, I do not think it will really matter what technologies are available. The brain simply will not catch up. The external components can, of course, be swapped out as newer technologies develop.
While the future will eventually bring new treatments (and hopefully a cure) for deafness, cochlear implants are the best, long term solution for those who are beyond the reach of hearing aids. I certainly do not see anything coming in the next 20 years that would give me pause in implanting a patient today.