What are cochlear implants?
Cochlear implants are prosthetic devices that uses electrical stimulation to provide sound.
There are two parts to a cochlear implant:
- An external part
- An internal part
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 part is surgically implanted on the mastoid bone behind the ear. It is made up of the ‘receiver package and the electrode array (pictured).
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 my child 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 child’s hearing and hearing aids and discuss with you whether a cochlear implant assessment is the right thing for your child.
What happens once my child has been referred to the North East regional cochlear implant programme?
Once your child has been referred to the North East regional cochlear implant programme, they will need to undergo a range of assessments in order to determine if cochlear implants would be a suitable option for them.
When we receive a referral at the cochlear implant team, we allocate a keyworker. They will be either a qualified teacher of deaf children and young people (Q/ToD) or a specialist speech and language therapist (SLT). They will also contact the local Q/ToD who already visits you.
The keyworker will contact you to arrange the first appointment and will give you the options of having a blended model of care which means the parents can choose between the virtual and face to face appointments for all future rehabilitation appointments.
You will also receive a number of appointments by post. The appointments will be at The James Cook University Hospital in Middlesbrough or at other venues in the North East region.
Your child will be seen by a consultant Ear, nose and throat surgeon, an audiologist and an implant keyworker who are specialised in working with cochlear implants. Some appointments will be at the hospital or audiology clinic and some will be virtual. This is by parents’ or carers’ choice.
Your child will need an MRI or CT scan as well.
Your child will already have hearing aids before they are referred to the cochlear implant team. They need to be wearing their hearing aids all the time for at least three months before the audiologist can decide whether or not hearing aids or cochlear implants will help your child to hear enough to hopefully learn to speak.
If your child is not wearing their hearing aids very much it will hold up the assessment process. We need to be sure if your child had cochlear implants they would keep them on their ears and that you would try hard to help them do that as well.
What do we want to find out during the assessment process?
The audiologist on the cochlear implant team wants to find out what your child can hear in each ear without their hearing aids. Some of the tests they do will have been done by the audiologist in your local hospital but it is important that the cochlear implant audiologist repeats these tests because they have to make the decision about whether a cochlear implant will benefit your child.
The surgeon wants to check your child is medically suitable for the operation and that includes checking that the cochlear and auditory nerve are suitable, which is why your child has to have scans.
The team also want to be sure that families have realistic expectations about what is going to happen when their child has cochlear implants and that they are keen to help them make the best progress.
Assessment complete – what next?
Once we have gathered all the information and test results, we will discuss them at our monthly team meeting.
A decision will be made as to whether your child would benefit from cochlear implants, and you will then be informed.
If your child would benefit, you will be sent a date for the operation with an appointment for a pre-anaesthetic assessment; this appointment is where the nurse will check if your child is healthy and fit for surgery.
During this appointment you will be given instructions about preparing your child for their hospital stay.
You will also receive an appointment to see the surgeon to discuss the operation and sign a consent form. You will have an appointment to discuss the processors and accessories and to make a colour preference.
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 happens when my baby is referred for a cochlear implant?
If your audiologist refers your baby to the North East cochlear implant programme it enables both the local team and the cochlear implant team to work together closely with you to assess your baby’s hearing and offer the best way forward. Your local audiologist will continue to see your baby with their hearing aids.
When we receive a referral at the cochlear implant team, we allocate a keyworker. They will be either a qualified teacher of deaf children and young people (Q/ToD) or a specialist speech and language therapist (SLT). They will also contact the local Q/ToD who already visits you.
The keyworker will contact you to arrange the first appointment and will give you the options of having a blended model for future rehabilitation appointments.
The first keyworker appointment is to discuss your questions and concerns.
During the appointment the keyworker will explain to you what will happen in the cochlear implant assessment. They will tell you about the different people you will meet and the timescales for the appointments. The local QToD will be informed.
We will also send you a letter to tell you we have accepted the referral, a consent form to choose between the face to face or virtual appointments or combined approach for all future rehabilitation appointments and provide some information about cochlear implants.
During the assessment process you will still visit your local audiology department for your baby’s hearing aid care.
What about my views?
We carry out a cochlear implant assessment so that we can decide whether or not cochlear implants are likely to help your baby hear more than they can with hearing aids, and therefore give a better opportunity for them to learn to hear and speak. However, the decision whether to go ahead once that advice has been given is only with parents/carer’s agreement. There will be many people who parents and carers can talk to during the assessment, including other families who have a child with a cochlear implant. We hope this will help you to make your decision when the time comes.
What devices do we offer?
We currently offer two different processors; the Advanced Bionics Marvel Sky CI M90 and the Cochlear Nucleus 8. If your child is 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 their 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.