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Welcome to SCIP

What is a Cochlear Implant : Who is a Candidate?

Graphical representation of audiometric thresholds - Unaided ResultsBilateral Severe-to-Profound Sensorineural Hearing Loss

Individuals with audiometric thresholds within the blue region of the audiogram are considered for assessment.

 

 

 

 

 

 

Graphical representation of audiometric thresholds - Hearing Aid ResultsAided thresholds

The basis for determining cochlear implant candidature is whether a patient will benefit more from a cochlear implant than acoustic hearing aids.

A useful indication of benefit from hearing aids is given by the aided sound field thresholds.

Individuals who cannot access the speech spectrum (blue region) with optimally fitted hearing aids are considered for cochlear implant.

 

Speech Perception

Candidature cannot be determined on the basis of an audiogram alone. Functional benefit from hearing-aids is evaluated from speech perception tests, anecdotal evidence and questionnaires. Patients must demonstrate that they have used hearing aids for an adequate period of time (for children this must be in an appropriate rehabilitation setting).

For adult patients, sentence tests are used to measure their ability to perceive speech. Sentences are presented at 70dB and the accuracy of which the respondent reports the content words is measured. Individuals who score between 0% and 30% on BKB Sentences are considered for implant. Results from other speech perception tests are also taken into consideration (e.g. VCVs, AB words, CUNY, CID & IHR sentences).


Spoken Language

Children with little or no spoken language should be <5 years old at time of implant surgery. There should be evidence of pre-verbal communication skills.

Older congenitally deaf children (5 years+) will be considered for cochlear implant if they have developed good spoken language skills through consistent use of acoustic hearing aids.

Congenitally deafened adults are considered for cochlear implant if they have developed good functional spoken language.


Speech Intelligibility

For adults and older children (5 years+) speech should be intelligible to listeners with experience of deaf speech.


Age at time of surgery

No upper age limit per se, so long as the individual is medically fit for surgery and general anaesthesia.

Lower age limit of 12 months (unless exceptional circumstances).


Otology

Tympanic membrane intact. No active middle ear disease.


Satisfactory Imaging

Patent cochlea and satisfactory imaging of the inner ear.


Integrity of Auditory System

No central or retro-cochlear problems.


Support

Appropriate support from family, local professionals and friends. A strong oral / aural emphasis is essential.


Long-term Commitment

Commitment to long-term follow-up: looking after/wearing equipment, keeping appointments and active parental involvement in encouraging the development of spoken language skills.


Expectations

Realistic expectations and a good understanding of the cochlear implant process.


No contraindications

No other contraindications that would prevent the patient from using the device or developing spoken language.