As a natural extension of the paediatric programme, the Adolescent programme also offers regular one-to-one intervention and school support while supporting the adolescent’s individual needs. The clinical setting is more appropriate for adolescents and the specialised service allows the team to focus on the needs of this unique group.
In addition to those patients referred directly to the adolescent programme, all children who received a cochlear implant on the paediatric cochlear implant programme will transition to the adolescent programme during the summer holidays prior to the start of secondary school. By 18 years of age most of our young people will transition to the Adult programme.
In order to help prepare young people for the move to the Adult Service patients over 16 are offered the opportunity to be seen on their own for appointments, without the presence of their parent or carer. Adolescents can also choose to attend with the support of a family member, friend or partner.
- Mr Simon Freeman, Consultant Otolaryngologist and Skull Base Surgeon
- Prof Simon Lloyd, Consultant Otolaryngologist and Skull Base Surgeon
- Prof Iain Bruce, Consultant Otolaryngologist
- Emma Stapleton, Consultant Otolaryngologist and Skull Base Surgeon
- Morag Lockley, Clinical Scientist in Audiology
- Craig Went, Audiologist
- Angela Brown, Assistant Technical Officer
- Andy Cooper, Assistant Technical Officer
- Deniece Walker, Outpatient Coordinator
- Anne Stockbridge, Secretary of Cochlear Implant Programme
Additional appointments can be requested at any point post operatively (whether the habilitation package is ongoing or complete), should patients require further support. The patient’s aims and requirements will be discussed and further input may be offered as necessary. More specific support can be provided in the areas of: transition, hearing therapy, tinnitus counselling, telephone training and advice re: assistive listening devices.
The Assessment Process
The main goal of the pre-operative assessment process is to determine if a cochlear implant is the best option for an individual. In general, if it is felt that a cochlear implant could provide more benefit to a patient than their current hearing aid (s) or residual hearing for learning language and communication then they will be considered for an implant. Another goal of the assessment process is to provide the young person and family with realistic expectations about what an implant will do for them. This will allow them to make an informed decision about whether to proceed with an implant. Finally, the pre-operative process will determine a patient’s medical suitability for implant surgery and provide the patient with any relevant surgical information.
At the first appointment a full history will be taken, hearing aids will be checked and several different types of hearing tests will be performed depending on the age, hearing and ability. Tests will include pure tone hearing tests, an evaluation of hearing aid function, and tests of response to speech or speech understanding where appropriate. It may take more than one appointment to complete the audiological assessment depending age, ability and needs.
After the first visit, more testing may be required. Other tests that may be performed include objective tests of the auditory system (ie, auditory brainstem responses (ABR), otoacoustic emissions (OAE), acoustic reflexes, etc.
This is usually offered on a 1:1 basis to allow us to tailor the discussion around the young person’s individual needs. There are plenty of opportunities to ask questions and to understand what a cochlear implant is and why it can offer more than hearing aids for some people. We talk about how the cochlear implant works; what to expect to hear with an implant; the surgery and risks and give the opportunity to look at the internal device and speech processor.
In order to help us decide if a cochlear implant is a good option for someone, their current level of speech and language development may be assessed using formal tests. If a young person is not making expected progress with their hearing aids, they may be offered extra appointments to look at how they learn through listening and to find out if there are issues which may make it harder for them to benefit from a cochlear implant.
The young person’s readiness and acceptance of the process of cochlear implantation is essential. During every step of the assessment process, they will be fully involved in the decision-making process. Every effort will be made to ensure that the pre-operative process engages them and that they understand the assessment results and the next step in the process.
A key part of the assessment are the scans of the structures of the inner ear. Different types of scans may be recommended eg Magnetic Resonance Imaging (MRI) or Computer Tomography (CT) scans. The scans may be completed in Manchester or at a local hospital. If you have already had a scan carried out we will request access to that information and it may not be necessary to do further scans as part of the assessment.
Multidisciplinary Team (MDT) Meeting
Everyone who is referred for a cochlear implant and has an assessment is discussed at a multi-disciplinary team meeting. The MDT consists of surgeons, audiologists and therapists with information from other healthcare professionals including radiologists and others. The team will discuss the results of the assessment and then decide whether or not to recommend implantation.
After the assessment is complete and the case has been talked about at the MDT meeting, patients meet one of the ENT consultants. At this visit, the scan results will be discussed and a final decision about implantation will be made. We also talk about the surgery and risks associated with the operation.
This is an appointment at the hospital for a medical health check to be sure the person is well and safe to have a general anaesthetic and the operation.
The operation typically lasts about 2 hours. Patients are usually admitted to hospital in the morning, have their operation and go home in the evening. Some people may need to stay in hospital a bit longer depending on their own health needs and how far away they live from the hospital.
Initial programming (switch on)
This visit will take place 3-4 weeks after surgery. At this visit, the external speech processor is fitted and switched on for the first time.
Habilitation appointments and Mapping appointments
We offer a series of mapping and habilitation appointments. The goal is to fine tune the settings of the device and make sure the person is hearing at the best level with their cochlear implant. Advice is also given on activities and strategies to support getting used to the cochlear implant and how to get the most out of the new equipment.