When hearing aids no longer provide you or a loved one with speech clarity, a cochlear implant may be the solution to improving hearing and quality of life.
Cochlear Implants
What is a Cochlear Implant?
A cochlear implant system is an electronic medical device designed to restore the ability to hear and understand speech by individuals who get insufficient benefit from properly fitted hearing aids. Adults who are not sufficiently helped with an optimally fitted hearing aid, may benefit from a cochlear implant.
Unlike a hearing aid, which delivers amplified sound acoustically, a cochlear implant directly stimulates the auditory nerve cells with an electrical current, bypassing the damaged hair cells in the cochlea.
In Australia, there are four manufacturers of cochlear implant systems that are registered for use with the Australian Register of Therapeutic Goods:
How does a cochlear implant work?
A cochlear implant system is divided into two parts – an external sound processor and an internal implant:
The external sound processor
The external sound processor detects sounds in the environment via microphones. These sounds are then analysed by a tiny computer and then transformed into digital signals. These digital signals are then transmitted to the internal component.
The internal implant
The internal implant is a prosthetic implant which is surgically placed into the cochlea by a specialised Ear, Nose, and Throat surgeon. The implant has a receiver stimulator package that converts the digital signal from the external sound processor into an electrical signal and this electrical signal is then sent down the electrode array directly stimulating the auditory nerve providing a signal the brain then learns to understand.
How do I know if I am a candidate?
Contrary to popular belief, cochlear implants aren’t only for people who are “stone deaf” and even those who get partial benefit from hearing aids may receive significant improvements with a cochlear implant.
Criteria for cochlear implantation is regularly changing due to significant advancements in technology and most adults who are candidates for a cochlear implant do not know that they are. Your GP or usual hearing health professional may not be aware of the benefits of a cochlear implant.
Common signs that you or someone close to you might be a cochlear implant candidate include:
- Limited benefit with appropriately fitted hearing aids
- Difficulty on the telephone
- Reliance on visual cues for successful communication
- Family and friends report that you experience communication difficulties even with the use of appropriately fitted hearing aids
- You need someone else to make appointments for you
- Reports that noise significantly impacts speech perception
How do I get a cochlear implant?
Cochlear implants involve a team of professionals with a range of skills working together to achieve a holistic outcome. Typically this team also involves your close family, your general practitioner, your usual audiometrist or audiologist, a specialist Ear, Nose, and Throat Surgeon (ENT) and can occasionally include a speech language pathologists, and psychologists or social workers.
At a minimum, to determine if someone is a candidate they require an assessment with an audiologist with specialist training in cochlear implants as well as an ENT surgeon who performs the operation.
Cochlear Implant Pathway
While not everybody's cochlear implant journey is the same, there is a typical pathway that an adult follows to getting a cochlear implant.
01
Candidacy Assessment
The first step is referral for a candidacy assessment. Often your usual audiologist will refer you for an assessment or they may have training in cochlear implants. A candidacy assessment typically includes:
- Comprehensive case history and diagnostic testing
- Functional and Quality of Life assessment
- Assessment of aided speech perception with optimally programmed hearing aids
- Counselling regarding outcomes and expectations
- Discussion of funding pathways
- Referral to ENT specialist for one or both ears
If you are determined to be a candidate, you will then be referred for a review with a specialist ENT.
02
Pre-Op Medical assessment
The second step is a specialist evaluation with an ENT specialist that performs cochlear implantation. This typically includes:
- Medical and hearing case history
- Physical ENT examination
- Radiological investigations (e.g. MRI & CT scans)
- Counselling about expectations and outcomes
- Counselling about CI surgery and related costs
03
Surgery
If you are an audiological and medical candidate, then the next step is surgery. Typically, during surgery:
- The implant is inserted into the cochlea
- The implant is tested to ensure functionality
- Post operative recovery
04
Post-Op Appointments
Following successfully surgery:
- Post op review with ENT Specialist
- Implant activation and counselling with audiologist
- Ongoing device management and appointments
- Auditory rehabilitation program and training
- Annual follow-up appointments after first year to include mapping, device evaluation, and speech perception testing
05
Ongoing management and Care
Holistic patient care will be ongoing:
- New technology and review of external speech processors including non-implanted ear
- Replacement of batteries
- Additional listening devices and equipment
- Quality of Life and functional outcome reviews
- Holistic patient review with primary communication partners
Ongoing Care & Maintenance
Cochlear implant sound processors will require ongoing maintenance and repairs. External speech processors are generally covered by a standard manufacturer warranty; however, it is recommended that the sound processor is insured against loss through your home and contents insurance.
As technology improves and new innovations become available the external sound processor will be able to be upgraded without any additional surgery.
There are several potential funding pathways for this which may include:
- Private health insurance
- DVA
- Self funding
- National Disability Insurance Scheme (NDIS)
N.B. The NDIS does not cover the costs of a cochlear implant system or surgery. However, funding may be allocated for ongoing auditory rehabilitation, assistive listening devices or for upgrades of speech processors. For more specific advice please talk to your hearing health provider.
We know that clear and open communication is essential
Whether you’re a patient, healthcare professional, or GP seeking more information or support, our team is ready to assist you.
Reach out to us for a prioritised referral, inquiries about implantable hearing technology, or to learn more about our services. Let us connect you with the care and expertise you need.
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