What is a Cochlear Implant?
Cochlear implants provide useful hearing to adults and children
who get little or no benefit from a hearing aid. They consist of:
- The internal part: the receiver, surgically implanted in the mastoid bone behind the ear, with electrodes inserted into the inner ear, (cochlea).
- The external part: the microphone and speech processor convert sound into an electrical signal which is sent to the electrodes in the inner ear. These then send the signal through the auditory nerve to the brain, where it is perceived as sound
Thinking about an implant?
Don’t delay referral!
If as a parent, adult or professional you think a referral should be made for implantation, what should you do?
If you think that an implant should be considered, then contact your local ENT consultant or audiology service, to obtain a referral. If you are unsure about whether an implant is the right way forward, it is a good idea to ask for a referral to a Cochlear Implant Centre, because the implant process will involve the many tests and assessments which will help to clarify the situation.
Assessments should involve the whole family as well as the child or adult – deafness in the family affects everyone,and cochlear implantation will make a difference to the family as well as to the individual. It is important during the process to meet others with implants and experienced professionals to discuss the options with you.
Before the referral, there must be an audiological evaluation and the best possible hearing aids fitted, with good ear moulds. Any ear problems should be carefully managed. Make sure you ask about the outcomes from the implant centre, about the devices used, about the important issues and what follow-up care will be offered – medical, scientific and rehabilitative. As well as discussing options with experienced professionals, it is important to ask to meet others with implants and parents of children with implants to ask about the services they received as well as individual outcomes. There are also independent groups who advocate for implant users and are happy to share experiences
Cochlear Implant Centres in the UK
The names and contact details of cochlear implant centres in the UK can be found on our website here.
Each centre will have its own specialist team and information about its services.
Cochlear Implant Pathway (click on the image to download)
When hearing aids are not enough?
When hearing aids are not providing enough – there are a number of options, including cochlear implants and electro-acoustic hearing aids.
The starting point is careful and expert audiological testing and it is essential to explore what benefit the child or adult is receiving through their hearing aids. Tests of speech understanding are important to include when assessing older children and adults.
Some children have unusual or complex audiograms and they respond to speech with their aids but nevertheless they should be considered.
This audiogram shows the general trend in audiological terms.
The National Institute for Health and Care Excellence has updated their guidance and announced a change in eligibility which means that hundreds more people will be able to receive a cochlear implant.
The revisions to the guidance are as follows:
For the purposes of this guidance, severe to profound deafness is defined as hearing only sounds that are louder than 80 dB HL (pure-tone audiometric threshold equal to or greater than 80 dB HL) at 2 or more frequencies (500 Hz, 1,000 Hz, 2,000 Hz, 3,000 Hz and 4,000 Hz) bilaterally without acoustic hearing aids. Adequate benefit from acoustic hearing aids is defined for this guidance as:
for adults, a phoneme score of 50% or greater on the Arthur Boothroyd word test presented at 70 dBA
for children, speech, language and listening skills appropriate to age, developmental stage and cognitive ability.
Did you know?
- Approx 11,000 users in the UK alone.
- The majority of profoundly deaf children in the UK have an implant.
- About 350 children per year are born deaf enough to be considered for an implant.
- About 100 more children per year become deaf early in life and may need an implant, giving an annual recurrent demand of 450 per year.
- In addition to those already implanted, about 7,500 adults are audiologically suitable for an implant.
- The annual recurrent demand is conservatively estimated to be 1200, being 450 children and 750 adults.
Please follow these links to the cochlear implant companies' own websites:
- Advanced Bionics - manufacturer of the HiRes Ultra Cochlear Implant
- Cochlear - manufacturer of the Nucleus cochlear implant
- Oticon Medical - CI system is called the Neuro CI system
Please see map of medicine for guidelines about care pathways for cochlear implantation by clicking here