Cochlear implant

A cochlear implant is a small electronic hearing device for adults or children. We put (implant) this device in your or your child’s ear through surgery.

A cochlear implant may be an option if you or your child have severe to profound sensorineural hearing loss in both ears. This is a permanent type of hearing loss caused by damage to the cochlea (the hearing organ in the inner ear).

How a cochlear implant can help

The tiny hair cells in the cochlea usually pick up sound vibrations. They send these vibrations through the hearing nerve to the brain. If the hair cells are damaged or missing, sound cannot reach the hearing nerve properly.

A cochlear implant may be suitable if:

  • hearing aids do not help you or your child much or at all
  • you or your child cannot hear or understand the full range of speech sounds

Instead of making sound louder like a hearing aid, a cochlear implant turns sound into electrical signals. It does the job of the damaged or missing hair cells and sends these electrical signals directly to the hearing nerve. They then travel to the brain, which recognises them as sound.

A cochlear implant does not restore normal hearing and the results can be different for each person. However, most adults notice an improvement in their ability to hear or understand speech and everyday sounds. If children have a cochlear implant, this can help them listen and learn to speak.

Videos on getting a cochlear implant

Before getting a cochlear implant, you or your child need an assessment with our team of specialists at St Thomas' hearing implant centre. We check if a cochlear implant is likely to help you or your child. The implant is only suitable if the hearing nerve that carries sound to the brain works properly.

We have made some videos about the assessment process for a cochlear implant at St Thomas’ hearing implant centre. This series of videos also explains the possible outcomes of having a cochlear implant.

The videos are intended for patients, family members, friends and support staff.

The team at St Thomas' hearing implant centre

This video introduces the different professionals that patients meet and explains what their roles are during an assessment for cochlear implants. 

Hi, my name is Jeanette, and I'm a teacher of the deaf at St Thomas' Hearing Implant Centre. I'm going to talk to you about who we are and what we at the Hearing Implant Centre.

During your or your child's assessment you will meet a lot of different clinicians. These are: surgeons, who will take a full medical history and sign consent for any operations. Audiologists, who will check the ears, carry out different types of hearing tests, and check hearing aids. Speech therapists, who for children will assess communication and listening skills. For adult patients they will carry out questionnaires and counsel around expectations of cochlear implants.

For paediatric patients, there are also teachers of the deaf who visit homes and schools, support children's listening in the classroom, and support local professionals and help with access to radio aid systems. Assistant technical officers, who will look after broken or lost equipment such as hearing aids, and our admin team who will help was appointments.

We also work closely with other local professionals and can refer to other local services such as clinical psychologists and neurologists if needed. We work together as a team to assess whether you or your child are suitable for a cochlear implant.

Cochlear implant assessment process

This video outlines all of the appointments that patients will attend during their assessment for cochlear implants.

My name's Caroline and I'm a speech and language therapist at St Thomas' Hearing Implant Centre and I'll be talking about all of the appointments that you'll attend if you undergo assessment for a cochlear implant.

There will be lots of different appointments, including an information day where patients and their families can find out more about cochlear implantation, and for adult patients there will be a palentypist to help them follow what has been said.

At the initial screening appointment you'll meet a member of the team who will take a full case history and answer any questions you or your child may have.

At the medical assessment, you'll meet an ENT surgeon who will take a medical history, check the ears and talk you through the MRI scan that's needed to take a picture of your or your child's ears and auditory nerves. They'll feed back about the MRI scan towards the end of the assessment.

There will be a number of audiology appointments but they'll carry out different hearing tests and check the hearing aids.

There will be an appointment with a speech and language therapist, and for children, they'll assess their communication skills, and for adults they'll talk about the impact of your hearing loss and what to expect from a cochlear implant.

At the end of the assessment you'll have an appointment with an ENT surgeon and they'll discuss the results of the cochlear implant assessment and, if you're suitable and wish to, you can sign consent for cochlear implant surgery. If you or your child wish to go ahead for cochlear implants then there'll be a pre-admissions check where they ensure that patients are medically fit for surgery.

There are lots of appointments in the assessment process for cochlear implants in order to offer the best intervention for you or your child.

Who is suitable for a cochlear implant

This video explains the main factors taken into consideration when assessing who is suitable for a cochlear implant.

My name's Caroline and I'm a speech and language therapist at St Thomas' Hearing Implant Centre, and I'll be talking about who's suitable for a cochlear implant.

There are lots of individual factors that affect a patient's suitability for cochlear implants, but typically we find that patients have a bilateral severe to profound sensorineural hearing loss. This means that there's a hearing loss in both ears, it's at a significant level, and it's caused by the cochlear.

Patients that are suitable also get little benefit from their hearing aids. This means that even when they're wearing their hearing aids, they find it hard to follow and listen to what is being said and patients also need to be medically fit for surgery.

It should also be taken into consideration if the patients and their families are committed to the post-operative rehab and have realistic expectations from a cochlear implant.

It's important to remember if you or your child are suitable for a cochlear implant, it's you and your family that make the final decision.

Choosing a cochlear implant device

This video explains how we decide which brand of cochlear implant is best suited to each person.

Hello, I'm Josh, and I'm part of the repairs team and speech and language team here at St Thomas' Hearing Implant Centre. Today, I'm going to talk about your choice of cochlear implant device.

Here at St Thomas' Hearing Implant Centre, we offer a number of different cochlear implant brands. The implant team will look at which device suits you or your child best based on a number of different reasons.

One of the main reasons is the results of your MRI scan. This may show that one device brand is best suited for the structure of the ear. There are also audiological reasons – this is to preserve any natural hearing you may have. This is particularly important in devices that combine both cochlear implants and hearing aids.

There are other reasons to consider, including how to keep the processor on and your choice of assisted listening device. Where possible the team will try to give you your choice of cochlear implant device.

Possible outcomes of having a cochlear implant

These videos give more information about the possible outcomes and factors that can influence these, for adults and children who have cochlear implants.

For adults

Hi, I'm Tash and I'm a speech and language therapist at the Hearing Implant Centre at St Thomas'. In this video I'm going to be talking about the outcomes of cochlear implants for adults.

If you are recommended a cochlear implant, this means the team believes it will provide you a better opportunity to hear a range of sounds compared to your hearing aids. It is important to remember that a cochlear implant does not restore normal hearing, but does provide access to sound and improve quality of life. At first listening with a cochlear implant can be strange and confusing. Adult patients report that it can sometimes sound electronic or robotic. After some time with the cochlear implant, sound will begin to sound more natural. You will be able to recognise sounds around you and follow speech. This may take a matter of weeks, and sometimes months. Everybody's progress with a cochlear implant is individual.

Following surgery, it is important to attend all appointments at the Hearing Implant Centre to ensure the best outcomes. These benefits include being able to hear sounds in the environment, being able to follow conversations face-to-face, and finding listening less effortful and less tiring. Some adults even report they are able to follow conversations without lip reading and sometimes are able to manage conversations in noisy environments.

There are some listening situations that adults with cochlear implants still find challenging. These are listening on the telephone, listening in noisy environments such as cafes and restaurants, and following the television without subtitles.

Factors that affect outcomes with a cochlear implant include duration of profound deafness. The longer somebody has had a profound deafness, the longer it takes for them to get used to the cochlear implant. Also, if there are any abnormalities of the inner ear, these are often identified on the MRI scan and are discussed with you in your appointments.

Finally, if you have any additional diagnoses or medical conditions, these can sometimes affect outcomes as well. Factors that specifically affect you will be discussed in your individual appointments at the Hearing Implant Centre.

For children

Hi, my name's Alice. I'm a speech and language therapist and certified auditory verbal therapist at St Thomas' Hearing Implant Centre in London. In this video I'm going to talk about the potential factors that can influence outcomes for children with cochlear implants.

Cochlear implants have the potential to give access to a wide range of environmental sounds and the full spectrum of speech sounds. It's important to remember that they do not restore normal hearing but have the potential to provide access to spoken language and improve quality of life. Typically children don't respond to sound straightaway. It takes time for them to get used to wearing cochlear implants, and learning to listen with cochlear implants. Gradually, over time, parents and sometimes their children themselves start to report the benefits of cochlear implants, such as hearing different environmental sounds, responding to music, and even turning to their name. Each child is different and the outcomes for each child will depend on several factors, such as your child's age.

Children's brains are most adaptable in the preschool years and very young children can learn to listen with cochlear implants very quickly. Research and experience tell us that children who receive cochlear implants around the time of their first birthday have the greater potential to develop age-appropriate speech and spoken language skills. Older children can still make good use of cochlear implants but some may continue to use sign language to support their communication. It's important to remember that if your child's hearing has changed over time, age may not be such a crucial factor.

Another factor is hearing aid use. It's absolutely essential that your child wear their hearing aids consistently. This will help them access any environmental sounds and will also help keep the auditory nerve firing. It's very useful for the team to see how your child gets on with their hearing aids.

Speech, language and communication skills. It's very important that the team know if your child has speech, language and communication difficulties in addition to their deafness. This won't prevent your child from having cochlear implants but it will help the team to talk to you about their potential outcomes and also if it will affect their rate of progress in learning to listen with cochlear implants.

In addition to speech, language and communication skills, it's also very important for the team to know if your child has any additional difficulties. Your child must be healthy enough to undergo an anaesthetic and the team will also take the additional difficulties into account when considering their potential outcomes and rate of progress in learning to listen with cochlear implants.

Another factor is family structure and support. Parents and carers are responsible for making an informed decision about their child going ahead with cochlear implant surgery. If they decide to go ahead they must be responsible for attending an intensive rehabilitation program with many visits to the hospital. They must also be responsible for maintaining the equipment and encouraging their child to wear them all waking hours. Finally, they must be responsible for supporting their child's language and listening development because many young children receive cochlear implants young.

Additional difficulties, both cognitive and developmental, may arise for your child in the future. It's very important to remember that each child is an individual and their outcomes will vary. They may also change over time and the team will spend a lot of time with you throughout the assessment discussing the potential outcomes for your child.

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

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