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Cochlear implant history

How We Got to the TICI: A History of the Cochlear Implant

Living with a cochlear implant7 min read· Reviewed

TICI, the totally implantable cochlear implant, went on sale for the first time on September 29, 2026, when MED-EL launched TICI UNICO in Europe. Nothing about it is worn on the outside. It sits at the end of a line that started in a Paris operating room in 1957. This page walks that line one step at a time, with a date and a source for each step. It names the people the sources name, in every country where the work happened.

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For cochlear implant users

Who invented the cochlear implant?

No single person invented the cochlear implant. It was built in steps over about twenty years. Teams in several countries each added a piece.

In Paris in 1957, André Djourno and Charles Eyriès placed a wire on the hearing nerve of a deaf person during surgery. When they sent a current through it, the person heard sound. In Los Angeles in 1961, William House gave two people a cochlear implant with a single electrode. It helped them notice sounds and lip-read, but speech stayed unclear.

The cochlear implant most people use today has many channels, so different parts of the inner ear get different pitches. Two teams built one at the same time. Ingeborg and Erwin Hochmair's design was implanted in Vienna on December 16, 1977. Graeme Clark's team implanted theirs in Melbourne on August 1, 1978.

Others made it work for speech. Michael Merzenich at the University of California, San Francisco, helped work out how a cochlear implant should connect to the brain. In 1991, Blake Wilson in North Carolina described a way of processing sound that let most users understand speech without lip-reading. More than one million people now use a cochlear implant, according to the Broad Institute.

The big prizes name these people together.

  1. The Lasker Award goes to Graeme Clark, Ingeborg Hochmair and Blake Wilson. The award names them "for the development of the modern cochlear implant."

    Lasker Foundation

  2. Clark, Erwin and Ingeborg Hochmair, and Wilson are named among the laureates of the Queen Elizabeth Prize for Engineering, which honors pioneers of neural interfaces.

    Engineering Council

  3. The Merkin Prize in Biomedical Technology goes to Clark, both Hochmairs, Merzenich and Wilson as pioneers of the modern cochlear implant.

    Broad Institute

  4. The Honda Prize goes to Graeme Clark and Ingeborg Hochmair.

    Honda Foundation, via Kyodo News PR Wire

Single-channel beginnings, 1957 to 1984

The first cochlear implants had one electrode, or a few wired as one. They told people when a sound happened and roughly how loud it was. That helped with lip-reading. Speech on its own stayed hard to follow.

  1. In Paris, André Djourno and Charles Eyriès stimulate a deaf person's hearing nerve during surgery, and the person hears sound.

    ENT Today, History of the Cochlear Implant

  2. In Los Angeles, William House gives two people a single-electrode cochlear implant.

    Lasker Foundation

  3. At Stanford, Blair Simmons places a six-electrode system, connected through a plug in the skin.

    ENT Today, History of the Cochlear Implant

  4. At UC San Francisco, Robin Michelson's team places a two-electrode system in three people.

    ENT Today, History of the Cochlear Implant

  5. In Paris, Claude-Henri Chouard's team works on a twelve-electrode array.

    ENT Today, History of the Cochlear Implant

  6. The US Food and Drug Administration (FDA) approves the House/3M single-channel cochlear implant for adults.

    ENT Today, History of the Cochlear Implant

No single person invented the cochlear implant. The pioneers the sources name worked in France, the United States, Austria and Australia.

Many channels, 1977 to 1991

A multichannel cochlear implant sends different pitches to different places along the inner ear. That is closer to how a healthy ear works. It is what let many people follow speech without watching lips.

  1. In Vienna, surgeon Kurt Burian places the multichannel cochlear implant designed by Ingeborg and Erwin Hochmair.

    MED-EL company history

  2. In Melbourne, Graeme Clark and surgeon Brian Pyman place the multichannel cochlear implant built by Clark's team. The first person to receive it is Rod Saunders.

    Medical Journal of Australia, 2018

  3. The FDA approves a multichannel cochlear implant for adults for the first time.

    Lasker Foundation

  4. FDA approval is extended to children aged 2 and older. The age drops to 18 months in 1998 and to 12 months in 2000.

    ENT Today, History of the Cochlear Implant

  5. Blake Wilson reports continuous interleaved sampling, a way of processing sound that helps most users understand speech without seeing the speaker's face.

    Lasker Foundation

From a box on the belt to behind the ear

Early sound processors were boxes worn on the body, with a wire up to a piece on the head. Over the next fifteen years they shrank until they fit behind the ear like a hearing aid.

Two companies each describe a different "first" here. Both are listed below, in the companies' own words.

  1. Cochlear releases its first sound processor: a box worn with a shoulder strap, with a wire up to the ear.

    Cochlear, Nucleus system evolution

  2. MED-EL says it launches the world's first behind-the-ear speech processor.

    MED-EL company history

  3. Cochlear says it releases the first behind-the-ear sound processor.

    Cochlear, Nucleus system evolution

Off the ear, 2013 to 2017

Next, the processor moved off the ear. An off-the-ear processor sits on the head over the cochlear implant, held in place by a magnet. Nothing hooks behind the ear. It is smaller, but it is still something you put on in the morning and take off at night.

  1. MED-EL's RONDO, a single-unit processor with no ear hook and no cable, launches in the US.

    Hearing Review

  2. Cochlear launches Kanso, its first off-the-ear processor.

    Cochlear, Nucleus system evolution

  3. MED-EL releases RONDO 2, which it calls the first cochlear implant processor that charges wirelessly.

    MED-EL company history

A side road: fully implantable middle-ear hearing devices

These are not cochlear implants. They are part of this story because people searching for "invisible" hearing often find them first.

A fully implantable middle-ear hearing device sits under the skin and moves the small bones of the middle ear. It is meant for moderate to severe hearing loss. A cochlear implant is for deeper hearing loss, and it sends signals straight to the hearing nerve.

  1. MIT Technology Review reports that the Carina, a fully implantable middle-ear hearing device from Otologics, is in trials.

    MIT Technology Review

  2. The FDA approves Envoy Medical's Esteem, a fully implantable middle-ear hearing device, after an advisory panel voted 15 to 0 in its favor.

    MedCity News

  3. Cochlear sponsors a study of the Carina.

    ClinicalTrials.gov, NCT02309541

  4. A London hospital reports fitting a Carina in a 15-year-old, and its news story calls the result invisible.

    Guy's and St Thomas'

The first research on a totally implantable cochlear implant

A TICI puts every part under the skin: the microphone, the processor and a rechargeable battery. Nothing is worn on the head in everyday use.

The hard part was the microphone. Under the skin, it also picks up body sounds, like chewing and your own voice. Much of the early research was about that problem.

  1. Cochlear and the HEARing CRC research centre in Melbourne begin the first research in people on a totally implantable cochlear implant, later called TIKI.

    Cochlear media release, 2018

  2. Researchers report on the first three adults to use TIKI. The microphone under the skin and body noise limited how much they used it fully implanted.

    Briggs et al., Otology & Neurotology, 2008

  3. Cochlear says it acquires implantable microphone technology.

    Cochlear media release, 2018

  4. Cochlear's second research system goes into 10 adults in Melbourne. Word scores in fully implanted mode were lower than with an outside processor. Two of the ten stopped working. Both were replaced with conventional cochlear implants.

    Briggs et al., Ear and Hearing, 2025

  5. The first MED-EL totally implantable cochlear implant goes into a study volunteer in Liège, Belgium. Six adults in Belgium and Germany take part.

    ClinicalTrials.gov, NCT04571333

A different design from Envoy Medical

Envoy Medical's Acclaim has no microphone at all. A small sensor rests on one of the middle-ear bones and picks up how it moves. The battery sits in the chest, wired to the part on the head. It needs a healthy middle ear to work.

  1. The FDA gives Acclaim a breakthrough designation, according to Envoy Medical.

    Envoy Medical press release

  2. Envoy Medical announces that the first person has received an Acclaim, at Mayo Clinic.

    Hearing Health Matters

  3. Envoy Medical's main US trial starts. It enrolls 56 adults at seven sites.

    ClinicalTrials.gov, NCT06699797

  4. The last of the 56 people in that trial receives an Acclaim, according to Envoy Medical.

    Envoy Medical release, via Barchart

The trials and the launch, 2024 to 2026

Three companies now have a totally implantable cochlear implant in people. One is on sale in Europe. The other two are in their final trials. None is approved in the United States.

  1. MED-EL's main trial starts, with 30 adults at centres in Austria, Belgium, Germany and Poland. It finishes on September 24, 2025.

    ClinicalTrials.gov, NCT06459765

  2. Results for MED-EL's first six users are published. Their speech scores in quiet and in noise were close to their scores with an outside processor.

    Lefebvre et al., Communications Medicine, 2025

  3. Cochlear's ENTERPRISE trial starts in Australia and France. It enrolls 36 adults.

    ClinicalTrials.gov, NCT07139327

  4. Cochlear's main US trial starts at 11 sites. It enrolls 56 adults.

    ClinicalTrials.gov, NCT07287124

  5. MED-EL's TICI UNICO gets its CE mark, the approval it needs to be sold in Europe.

    British Cochlear Implant Group

  6. Cochlear announces that enrollment for both of its main trials is complete.

    Cochlear media release

  7. MED-EL launches TICI UNICO in Europe, the first TICI on sale anywhere. About 40 people had one by launch day.

    MED-EL press release

  8. The British Cochlear Implant Group says TICI UNICO is not routinely available in the UK, including on the NHS, and is not approved for children.

    British Cochlear Implant Group

  9. Envoy Medical announced that it expects an FDA decision on Acclaim by the end of 2027 or early 2028. That is the company's own forecast.

    Envoy Medical press release

Which "first"?

"First" means different things depending on the question. Each company on this page is first at something, so it helps to say which one.

First multichannel microelectronic cochlear implant: Vienna, December 16, 1977, by Ingeborg and Erwin Hochmair, who went on to found MED-EL.

First multichannel cochlear implant in Australia, and the start of Cochlear's products: Melbourne, August 1, 1978, by Graeme Clark's team.

First research in people on a fully internal design: Cochlear, from 2005.

First fully implantable middle-ear hearing device the FDA approved: Esteem, 2010.

First totally implantable cochlear implant on sale: MED-EL's TICI UNICO, in Europe, September 29, 2026.

The part that has not changed in fifty years

Every step on this page changed where the parts sit. None of them changed what the brain has to do. A cochlear implant turns sound into electrical signals on the hearing nerve, and the brain has to learn what those new signals mean.

The US National Institute on Deafness and Other Communication Disorders says this process "takes time and practice." That was true for the first users in Vienna and Melbourne. It is just as true for someone switched on this year, whether the processor sits behind the ear or nothing shows at all. MED-EL's own steps after a TICI UNICO is switched on include listening exercises at home.

Practice is how that learning happens. Short sessions with real words and sentences work well, with a clear answer each time so you know what you caught. People reliably get better at the listening tasks they practice. How far that carries is still being studied.

FAQ

Who invented the cochlear implant?

No single person invented the cochlear implant. André Djourno and Charles Eyriès first made a deaf person hear sound by stimulating the hearing nerve, in Paris in 1957. William House gave two people single-electrode cochlear implants in Los Angeles in 1961. The multichannel cochlear implant used today was developed at the same time by two teams. Ingeborg and Erwin Hochmair's was first implanted in Vienna on December 16, 1977, and Graeme Clark's in Melbourne on August 1, 1978. Michael Merzenich and Blake Wilson in the United States also shaped it, and all five shared the 2026 Merkin Prize.

When was the first cochlear implant?

It depends on what you count. Electrical stimulation of the hearing nerve first let a deaf person hear sound in Paris in 1957. The first cochlear implants people lived with had a single electrode and went to two people in Los Angeles in 1961. The first multichannel cochlear implant, the kind used today, was implanted in Vienna on December 16, 1977.

When did the FDA approve the cochlear implant?

The FDA approved its first cochlear implant, the House/3M single-channel model for adults, in 1984. It approved the first multichannel cochlear implant for adults in 1985. Approval was extended to children aged 2 and older in 1990.

What is a TICI cochlear implant?

TICI, the totally implantable cochlear implant, has every part under the skin, including the microphone and a rechargeable battery. Nothing is worn on the head in everyday use. The first one on sale is MED-EL's TICI UNICO, launched in Europe on September 29, 2026. It is not FDA-approved, and it is for adults who already qualify for a cochlear implant.

Is a TICI cochlear implant the same as the Carina or the Esteem?

No. The Carina and Envoy Medical's Esteem are fully implantable middle-ear hearing devices. They move the small bones of the middle ear and are meant for moderate to severe hearing loss. A totally implantable cochlear implant sends signals to the hearing nerve. It is for adults with severe to profound hearing loss who qualify for a cochlear implant.

Who else is making a totally implantable cochlear implant?

Cochlear and Envoy Medical both have one in trials. Cochlear announced on September 28, 2026, that its two main trials had finished enrolling: 56 adults in the US, and 36 in Australia and France. Envoy Medical announced on October 20, 2026, that it expects an FDA decision on its Acclaim by the end of 2027 or early 2028. That is the company's own forecast.

How many people have a cochlear implant?

More than one million people use a cochlear implant, according to the Broad Institute. It gave that figure when it announced the 2026 Merkin Prize for the modern cochlear implant on June 15, 2026.

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