Cochlear Implant

A cochlear implant is an electronic device that is partially implanted surgically into the cochlea, the hearing organ of the inner ear. It uses electrical current to bypass damaged or missing portions of the inner ear and stimulates remaining hearing nerve fibers. A microphone, processor, and transmitter are worn externally.

If you (or your child) has a severe to profound sensorineural hearing loss in both ears and don’t get much benefit from hearing aids, you might be a candidate for a cochlear implant. This means a hearing loss in both ears of greater than 70 dB and poor speech discrimination (less than 50% correct on a sentence recognition test) in the better-hearing ear. To determine whether you are a candidate, you’ll have to have a complete evaluation, including hearing tests and a CT or MRI scan of the ear.

Children as young as 12 months of age can receive a cochlear implant, usually after a 3- to 6-month trial with hearing aids in both ears and intensive auditory training. It’s important to ensure that hearing aids can’t provide the child the same amount of benefit as an implant.

At My Speech & Hearing  Clinic, we routinely perform cochlear implant Assessment and Management. Implant surgery is done using general anesthesia, but can be performed as an outpatient procedure or may require a night in the hospital. If you are a candidate for bilateral cochlear implants (implants on both sides), the implantation surgery may be performed for both ears at the same time. Some people get a cochlear implant in one ear and then later choose to have the other side implanted as well.

What is a cochlear implant?

A cochlear implant is an electronic device used to replace the damaged hair cells in the inner ear. A cochlear implant does not restore normal hearing. Once you receive a cochlear implant, you should be able to hear sounds that you were not able to hear with your hearing aids. Although you will be able to hear more sounds, you will need to be trained to use and understand these sounds. Receiving a cochlear implant is simply the first step in a very long process.

Before your appointments

Please bring with you any hearing aids you or your child wears and a list of the healthcare professionals involved in your/their care.

The assessment process

The assessment process may differ depending on your/your child's needs, and takes place over a number of appointments.

The expected length of assessment, from referral to operation, is usually around 18 weeks, but may be quicker, or take longer, depending on your needs and situation.

Initial screening assessment (two hours)

Initial meeting with an Audiologist and possibly a member of the rehabilitation team who will:

Explain the assessment process

Take a full case history

Discuss issues surrounding cochlear implantation

Carry out some Audiological assessment, for example a hearing test.

Medical assessment (30 minutes)

Initial meeting with an ear, nose and throat (ENT) surgeon will involve discussion of:

Your/your child's medical case history

Decisions made regarding further assessments required

Magnetic resonance imaging (MRI) and computer tomography (CT) may be discussed.

If appropriate a full assessment will then consist of:

Audiology assessments (two hours per appointment)

Further clinic appointments will be needed to assess your/your child's hearing, amplification needs and functional aided hearing abilities.

The number of appointments required will vary but will typically include the following:

Hearing aid fitting

Auditory brainstem hearing test (non invasive)

Speech perception testing.

Speech and language assessments (up to two hours)

An evaluation of your/your child's communication skills and the impact hearing loss has had will be carried out. Issues surrounding implantation, expectations and outcomes will also be discussed.

Magnetic resonance imaging (MRI) and computerized tomography (CT) scans

MRI and CT scan (if appropriate) will be carried out to check the integrity of the cochleae and hearing nerves.

You will receive feedback from the scan when you meet with the surgeon at the end of the assessment or at your/your child's next appointment with the team.

Information day (three hours)

You will be invited to attend an information day, which is open to extended family, to find out more about cochlear implantation. This will help you to be better informed for the decision making process. A palantypist (speech to text) will be available for those who find lip reading problematic.

Final ENT (30 minutes)

A final appointment with the surgeon will involve discussion of:

Medical issues surrounding cochlear implant surgery

Surgical consent.

Once consent is signed you/your child will be offered the next available surgery slot by the ENT admissions team. They will endeavor to give you as much notice as possible. If you are unable to accept the date they offer, then you will be offered an alternative date.

After surgery

In the months following your/your child's surgery we will continue to see you regularly for clinic sessions and rehabilitation. We will then continue to see annually as required.

You can contact the department at any stage should you have any questions or concerns in between these follow-up appointments.