What is a cochlear implant?
A cochlear implant is a prosthetic device that uses electrical stimulation to provide sound.
There are two parts to a cochlear implant:
The external part
This is the part that looks like a hearing aid.
It is made up of two main parts:
- The sound processor
- The headpiece
The internal part
The internal bit is surgically implanted on the mastoid bone behind the ear. It is made up of the ‘receiver package and the electrode array.
The receiver package receives signals from the speech processor through the headpiece (which is held in place with a magnet) and converts them into electrical pulses.
The electrode array sends these impulses to different parts of the hearing nerve and they are interpreted as sounds
Who is suitable for a cochlear implant?
Adults or children with severe to profound hearing loss who gain little or no benefit from conventional hearing aids.
I think I might be suitable for a cochlear implant, what do I do now?
Speak to your local audiology service so that they can arrange an appointment to check your hearing and hearing aids and discuss with you whether a cochlear implant assessment is the right thing for you.
Frequently asked referral questions
Everyone referred for a cochlear implant assessment has many questions. Most people have very little knowledge about cochlear implants before they come for an assessment.
Here are some of the most common questions. You will be able to ask as many questions as you like during your assessment.
If I come for an assessment am I committed to having a cochlear implant?
No. You can withdraw from the process at any time, including after the team have met to discuss your case.
Can I bring someone with me to my assessment appointments?
Yes of course. It is very useful to bring a family member or close friend with you to your appointments. This means you have someone to talk things over with as it is a big decision.
Is there an age limit for cochlear implants?
No. We will consider individuals of any age for a cochlear implant.
What would I hear with a cochlear implant?
A cochlear implant does not give you back normal hearing.
Everyone is different and some people get more benefit from their cochlear implant than others. What you are likely to hear depends on your hearing history and will be discussed in detail with you during the assessment.
When an implant is first switched on it sounds very strange. Some people just hear beeping noises and some people say that all speech sounds like a robot or a cartoon character. The sound improves with time and it takes time and effort from the individual to get the best from their implant.
If I got a cochlear implant and didn’t like it could I go back to my hearing aids?
No, a cochlear implant replaces your hearing so you would not be able to go back to hearing aids. This is why we are so careful that the people we implant are suitable candidates.
Adults are only fitted with one cochlear implant so if you wear two hearing aids you would keep the hearing aid in the other ear.
Will a cochlear implant help me hear in background noise?
A cochlear implant may help you to hear better in background noise compared to your hearing aids. However, the majority of cochlear implant users still struggle to hear in background noise to some degree.
Would I be able to use the phone with a cochlear implant?
Some people with a cochlear implant are able to use the phone, but many cannot. It is by no means guaranteed.
Are there different models of cochlear implant available and do I get a choice?
Yes, there are different models available and you would get to express your preference as to which you prefer. The final decision regarding which model you will receive will be made by the implant team
Does the cochlear implant last forever?
No. An implant is like any electrical device, at some point it will need to be replaced. The companies expect the internal part of the implant to last at least 10 years but some people need their implant replacing before then and some people’s last longer than this.
If the internal part of the implant needed to be replaced there would be a further operation involved to replace it.
Does it run on batteries?
Yes. The sound processor needs batteries to work. These are usually rechargeable.
Can I use a loop system with a cochlear implant?
A cochlear implant can be used with existing loop systems or with bluetooth devices.
What happens once I am referred to the NERCIP?
Once you are referred to the Cochlear Implant Programme, you will need to have a range of assessments to see if you would benefit from a cochlear implant. The appointments will be at The James Cook University Hospital, Middlesbrough, or at other venues in the north east region.
You will be seen by a range of professionals which may include one of our consultant ENT surgeons, a senior audiologist and an adult hearing rehabilitationist who specialises in working with cochlear implants.
These appointments will not be in any particular order because our aim is to complete the process as quickly as possible. Each professional will be assessing different aspects to see whether you would be suitable for a cochlear implant.
After we have received your referral, you will be invited to attend your first appointment within six weeks. As patients are all individuals with different requirements, the timescale of the assessment process may vary. The cochlear implant assessment process requires commitment as you have to attend several appointments possibly at different locations within the north east region.
An audiologist on our team will need to assess your hearing loss and the benefit you are getting from your hearing aids. It may be completed in one appointment or may take several appointments. It is expected that you wear your hearing aids consistently before and during the assessment process.
It may be necessary to return to your local audiology department to have your hearing aids adjusted during the assessment and the cochlear implant audiologist will advise you about this. The audiologist will decide during this appointment whether the assessment for a cochlear implant will continue.
If the assessment for a cochlear implant is to continue then you will be given some questionnaires to fill in and bring to the keyworker appointment.
Your keyworker will be an adult hearing rehabilitationist. They will talk to you about the assessment process, explain how a cochlear implant works and talk about expectations and limitations of a cochlear implant. They will also assess your lip-reading skills and general communication tactics.
ENT consultant clinic appointments
If the initial assessment suggests you may benefit from a cochlear implant you will meet one of the consultant surgeons on our team. This is to check general fitness for surgery, take a medical history, and to refer you for a CT scan. This is to obtain information which will help to decide whether an implant might be possible and successful.
During the consultation you will be able to ask your own questions about the implant and the operation.
Some patients may be referred to other professionals outside the implant team for additional assessments such as psychology or cardiology. This is because these may be needed as part of the implant assessment. You will be advised if this is necessary.
According to National Institute for Clinical Excellence (NICE) guidelines, if an implant is offered, adults will be offered one implant only unless a patient also has visual difficulties when implants for both ears will be considered.
Assessment complete – what next?
Once these assessments are completed the whole team meet together to discuss them and to decide whether or not you would benefit from a cochlear implant. If the decision is to offer an implant, you will be listed for surgery and you will be sent a date for surgery through the post and an appointment to see the surgeon to sign the consent form.
Prior to the surgery you will have a pre-anaesthetic assessment appointment where the nurse will check if you are healthy and fit for surgery. During this appointment you will be given instructions about preparing for your hospital stay.
You will also receive an appointment to see the audiologist before the surgery date. At this appointment you will be advised if there are any options you need to decide about such as the colour of the processor and any additional accessories.
We can also arrange for you to meet a cochlear implant user if you think that would be helpful. As with all of the appointments, you will be able to ask any questions about the implant and the operation.
You are advised that the venues for appointments pre and post cochlear implant may change and we do use venues throughout the north east region.
What devices do we offer?
We currently offer two different processors; the Advanced Bionics Marvel Naida CI M90 and the Cochlear Nucleus 8.
If you are found to be suitable for a cochlear implant you will receive an appointment to discuss the features of each of these processors and express your preference for which you feel best meets your needs.
Please bear in mind we offer a device preference not a choice. We will try and give you the device you prefer but the final decision is the surgeon’s.