What is a Cochlear Implant?

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A cochlear implant is a device which restores some hearing to individuals who have a severe to profound hearing loss. A cochlear implant consists of internal and external components. The internal component, also known as the receiver/stimulator, is inserted during an operation which lasts approximately 2 hours. The external component, known as the speech processor, allows the internal component to receive sound and is generally fit 3-4 weeks after surgery.

Click here for a demonstration of how a cochlear implant changes sound into electrical stimulation and allows the deaf to hear sound.

Candidacy Process

People are usually referred for a cochlear implant assessment by their GP, ENT consultant, or other healthcare professional. First visits will consist of hearing testing and information gathering. The team will be able to give the patient an indication about whether a cochlear implant is the right option for them or their child.

In general, cochlear implants are considered for those patients who have a significant  sensorineural hearing loss (ie, nerve deafness) for whom  hearing aids are not beneficial. Candidacy for each person will be decided on an individual basis and each patient will be counselled about cochlear implants and their limitations and potential benefits. There will be plenty of opportunities for patients to ask questions and become familiar with the procedure before surgery takes place.

For more specific information about candidacy for an implant, please click on the appropriate link: Adults, Adolescents, Paediatrics (link to pre-operative visits section for each)

Surgery

Surgery for an implant is considered routine and the side effects are limited. Patients and parents will be fully advised of the risks of surgery prior to giving consent and every opportunity will be given for patients and their families to ask questions.

In general, implant surgery lasts about two hours. Most patients are admitted as day cases but some patients may be kept in the hospital overnight for observation and usually go home the next day. Patients are advised to stay out of work or school for approximately two weeks after surgery. The risks of surgery are similar to any type of ear surgery and will be discussed fully with the patient/parents before the surgery takes place.

After surgery

The external parts of the cochlear implant will not be fitted for about 3-4 weeks after surgery to allow time for the scar to heal. Patients will be able to hear sound through the implant when the external components are fitted, but their ability to understand what is heard will be limited at first. This will change considerably over the first weeks, months and even years of use. Patients will require frequent programming changes and therapy during the first months of use. The post-operative follow-up is very different for adults and children. Please click on the links for information about follow-up for adults, adolescents and adults.(link to each section on follow-up care)

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Is this a new or experimental technology?
The field of cochlear implants is very exciting and new technologies are constantly being introduced and researched. The first experimental cochlear implants were performed in the late 1970’s in the United States. In 1984, the first multi-channel cochlear implants were developed in Australia and marketed throughout the world. Although technology has progressed a great deal since that time, the basic structure and function of cochlear implants has been well-established for over twenty years. Currently, nearly 9,000 people in the UK use cochlear implants (source: BCIG survey 2011) and there are over 75,000 cochlear implant users worldwide (source: Cochlear Corporation, Advanced Bionics Corporation and MedEl Corporation).
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What does a cochlear implant sound like?
A cochlear implant allows users to hear and understand speech and allows some users to appreciate music. Most users report that the sound is slightly “mechanical” at first and the first sounds heard through an implant may range in quality from just “beeps and buzzes” to being able to understand voices without lipreading.
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Who may receive a cochlear implant?
Cochlear implants are designed to restore some level of hearing when traditional hearing aids do not provide enough benefit. Candidacy for a cochlear implant is carefully determined for each patient on an individual basis. Generally, adults who are severe to profoundly hearing impaired and who lost their hearing and who use spoken language are considered to be candidates if they perform poorly on tests of speech recognition. Children who are severe to profoundly hearing impaired and are unable to make progress on spoken language with hearing aids are also considered for candidacy. It is important to remember that the process of determining candidacy will be different for each person. The goals of the procedure and the possibility of reaching those goals will be discussed at length with each candidate before a decision is made. Click here for further referral guidelines (link to adult, adolescent and paediatric referral guidelines).
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Are there different types of cochlear implants?
There are three main cochlear implant manufacturers in the UK and throughout the world. These are

Each of the manufacturers has its own design of internal  receiver/stimulator and  speak processor. There are many different types of speech processors that have been available throughout the years for cochlear implants; many of the differences are related to changes in technology. Currently, ear level processors are available for all three manufacturers. Although there is no conclusive evidence that patients perform better with one manufacturer over another, there are differences in the way the speech processors look, how they function and the options that are provided. The clinicians will advise patients which is the most appropriate device in their case.

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How can I find out if a cochlear implant is right for me?
Potential candidates are referred to the cochlear implant programme by their GP, local audiology or  ENT services. Discuss with your doctor or  audiologist if a referral is appropriate.