Bimodal Hearing: Using a Cochlear Implant and Hearing Aid Together

A common assumption about cochlear implants is that once you have one, hearing aids are no longer part of the picture. For many recipients, that’s not the case.

If you have usable hearing in the ear that hasn’t been implanted, combining a cochlear implant with a hearing aid in the opposite ear (known as bimodal hearing) can significantly improve your outcomes in ways that a cochlear implant alone can’t achieve.

What Is Bimodal Hearing?

Bimodal hearing means using two different types of devices simultaneously: a cochlear implant in one ear and a hearing aid in the other.

The cochlear implant provides electrical stimulation directly to the auditory nerve in the implanted ear. The hearing aid in the opposite ear amplifies sound acoustically. Together, they give the brain two streams of auditory information, one from each ear. This combination is called bimodal because it uses two modes of hearing: electric hearing (cochlear implant) and acoustic hearing (hearing aid).

Why Does Bimodal Hearing Help?

The benefits of hearing with two ears rather than one are well established. The same principles apply to cochlear implant recipients with usable hearing in the opposite ear.

Better sound localisation

When sound arrives at two ears at slightly different times and intensities, the brain uses those differences to calculate where sound is coming from. A cochlear implant in one ear alone can’t do this. Adding a hearing aid in the opposite ear restores some of this spatial processing ability.

Improved hearing in noise

Understanding speech in noisy environments is one of the hardest tasks for cochlear implant recipients. Bimodal hearing typically improves performance in noise compared to a cochlear implant alone, because input from both ears gives the brain more information to work with.

Richer sound quality

The cochlear implant provides electric hearing with excellent clarity for speech and high-frequency sounds. The hearing aid in the opposite ear provides acoustic hearing, preserving the natural qualities of sound the way you’ve always heard them.

These two different modes of hearing complement each other. The electric signal from the cochlear implant excels at delivering crisp speech detail, while the acoustic signal from the hearing aid contributes the natural sound characteristics many recipients find familiar and comfortable. Together, they create a fuller auditory experience than either device alone.

Some recipients also find that having acoustic hearing preserved in one ear makes music more enjoyable and environmental sounds more natural, while the cochlear implant handles the speech clarity they need for communication.

What Does Bimodal Programming Involve?

Programming a bimodal fitting is more complex than programming either device in isolation. The cochlear implant and the hearing aid need to be calibrated to work together, not just independently.

At Precision Hearing, we manage both devices as a team. The goal is to ensure the loudness balance between the two ears is appropriate, that both devices can stream from the same sources (phones, TVs, and other connected devices), and that the combined signal gives you the best possible speech understanding.

Bimodal streaming

Modern cochlear implant manufacturers have established partnerships with specific hearing aid brands to enable seamless bilateral streaming, where both your cochlear implant and hearing aid receive audio simultaneously from phones, TVs, and accessories.

We fit hearing aids from all major brands and program cochlear implants from all manufacturers, so regardless of which cochlear implant system you have, we can recommend the hearing aid brand that provides the best bimodal integration for your specific processor.

Costs

• Cochlear implant programming (including bimodal coordination and streaming setup) is bulk billed as part of your ongoing cochlear implant care.
• The hearing aid itself is priced separately according to the technology level and brand you choose (standard hearing aid pricing applies).
• Hearing aid adjustments and programming are included for the first 12 months after your initial hearing aid fitting. After 12 months, hearing aid follow-up appointments are charged at our standard rates, separate from your bulk-billed cochlear implant care.

We’ll provide clear pricing for the hearing aid component during your bimodal consultation.

Remote Programming

Programming appointments don’t always have to happen in person. For cochlear implant adjustments between scheduled visits, we offer remote programming via secure telehealth technology.

Your audiologist can adjust device settings, troubleshoot issues, and fine-tune programming from wherever you are. This is particularly useful if you live regionally, have mobility challenges, or need a quick adjustment without making the trip to the clinic.

Remote programming doesn’t replace in-person care entirely. Certain assessments require you to be present. But it adds flexibility and means you’re never stuck with suboptimal settings between appointments.

Remote Monitoring: Cochlear’s Remote Check

For recipients using Cochlear processors, Remote Check takes remote care a step further. Your processor automatically sends diagnostic data to your clinical team between appointments, without you needing to do anything.

This means your audiologist can monitor your device performance proactively: identifying potential issues like reduced battery performance, connectivity problems, or usage patterns that might benefit from a programming adjustment, before they become frustrating.

Think of it as your cochlear implant checking in with your audiologist on your behalf. If something needs attention, we’ll contact you. You don’t have to wait until your next scheduled appointment.

Availability of remote monitoring varies by manufacturer and processor model. We’ll discuss which remote care options work with your specific system at your appointments.

One Clinic, Both Ears

Managing two devices, often from different manufacturers, across two ears is genuinely complex clinical work. The advantage of having one team manage both is that there’s no gap in communication between your cochlear implant and hearing aid care.

At Precision Hearing, we program cochlear implants from all three major manufacturers and fit hearing aids across all major brands. Regardless of which cochlear implant system you have or which hearing aid is most appropriate for your non-implanted ear, we manage both.

Learn about cochlear implant care at Precision Hearing