Pathways

Any person interested in having a Cochlear implant must seek professional medical advice.

This section is written in the context of the health provision services in the UK.

With the onset of deafness or any problem concerning your hearing, your first point of reference is your General Practitioner (GP). If you are over 60 years of age your GP will or should refer you directly for audiological testing at a local hospital. If this does not occur then press for this as until you know what your audiogram readings are neither you nor any professional can begin to consider your situation. For children, adolescents and adults under the age of 60, your GP will or should refer you to an ENT consultant at a regional hospital where you will be examined in addition to having an audiogram test performed. Again press for these steps to be undertaken if there is any delay or deferment.

New born babies are now screened for hearing problems soon after birth and those failing the simple test based on otoacoustic emissions (OTEs) are referred to a specialist team for further clinical evaluation including tests of the auditory brainstem response (ABRs). Some rare causes of deafness such as auditory neuropathy are not discovered by the otoacoustic emission test so you should seek help from your GP should you suspect that your baby is not hearing properly.

If this is the first time you have been through this procedure you may well be prescribed a Hearing Aid (HA) in order to assist your hearing. Even if your status is that of being severely deaf, this first level of support will be required in order to help you whilst the pathway towards a potential cochlear implant is considered. It is important to persevere with hearing aids even if the sound is not intelligible because research indicates the neural pathways from the ear to the brain begin to degrade in ears that have been without sound for any length of time.

The Criteria section will form the basis of whether this is likely to happen. If you feel that you are a suitable and willing candidate then press the ENT consultant and your GP for you to be considered for referral. It is recommended that you get your GP to write a letter of support to the ENT consultant who can forward it with his/her own recommendation to the CI centre of your choice.  Assessments take place at one of the 17 specialised cochlear implant (CI) centres across the UK (see Implant Centres). (Also see the BCIG listing for fuller details).

Your audiological status will be measured by an audiogram and a word recognition hearing test (BKB) together with a clinical examination together with a hearing nerve test by the resident Otolaryngologist who is an implant surgeon. If, having satisfied the NICE criteria, they consider you to be a suitable candidate then the formal process of applying for funding begins though this is often automatic.

You will have the surgical procedures explained (see Treatment) and will be shown options for your choice of the implant equipment (see Implant Choice).