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What to expect - adults

Referral

WEHIP receives referrals from GPs, ENT Consultants, Audiologists, Hearing Therapists and other healthcare professionals.

The majority of patients referred to the Adult Programme present with progressive hearing loss and no longer receive adequate benefit from conventional hearing aids.

We also assess patients with congenital hearing loss and sudden losses due to trauma or as a result of meningitis. In cases of meningitis, which can cause bony growth in the cochlea, we would aim to implant as soon as possible.

Adult cochlear implant patient pathway

Initial assessment and information session at St Michael's Hospital

This is a chance for you to learn about cochlear implants and for the team to learn about you. We want to know about your medical history and your hearing loss and whether you have tried good hearing aids. We do hearing and speech tests to assess whether a hearing aid or cochlear implant will help you most. 

At this stage, you may embark on a hearing aid trial, or go on for a full cochlear implant assessment. We will give you lots of information and a chance to meet a cochlear implant user, so that you understand properly what it is all about.

Full assessment

The full assessment includes:

  • Speech and language assessments, to determine both how well you can understand speech through your hearing aids and your own speech and spoken language skills
  • CT/MRI scan of your inner ear and cochlea, to show whether the operation is surgically possible - it usually is!
  • Balance and hearing tests
  • Medical assessments
  • Psychological assessments - answering questions about your motivation, expectations and understanding of the cochlear implant
  • Promontory stimulation test, to assess whether the hearing nerve still works (some patients don't need this test)

The decision

If the team think you will benefit, they will offer you a cochlear implant and you will decide whether you want to go ahead. If you accept the offer, you will go on the waiting list for surgery.

The operation

Cochlear implant surgery is now a routine procedure which takes about 2 hours. The operation is carried out, under a general anaesthetic, at the Bristol Royal Infirmary by one of our experienced surgeons. Complications are rare and will be discussed with you at the pre-operative clinic.

Depending upon where you live, it may be possible to come into hospital early on the day of surgery and go home later the same day. Sometimes it is necessary to stay in overnight.

For patients living further afield, it may be necessary to come into hospital the night before surgery.

Adults usually receive only one cochlear implant.

General advice is to take 2 weeks off work post operatively. You will not be able to hear anything from the implanted ear until the speech processor is activated 3-4 weeks later.

Fitting the speech processor - the 'switch-on'

You will return to the hospital for 'switch-on' about four weeks after your operation.  The audiologist will link your speech processor to a computer and play a series of bleeps to measure each electrode.  This process takes about an hour.  The audiologist uses these measurements to create 'programmes' or 'maps' which are stored in your processor.  The processor is then switched on and you will be aware of sound around you.  It may sound strange at first, but you will get used to it and learn to interpret the sounds over the next few weeks and months.

Testing and rehabilitation

In the first few months after switch on, you will return to the hospital several times for further programming and training. Audiologists, speech and language therapists and hearing therapists work closely together to create an intensive training programme to ensure you get the best you can from your implant.  The more you wear your speech processor, and the more you practice, the better it will sound.

Some people adjust to the new sensation of sound quite quickly and need fewer appointments. Other people need more help to adjust and may require more appointments. You will be encouraged to practice some exercises at home with partners, friends or local therapists, which will help you to get used to the sound.

Follow up appointments

We will see you regularly to monitor your progress and ensure that you are getting the maximum benefit from your implant. Sometimes we work with you on your speech as well as your listening. We carry out a formal evaluation of your progress at one month, six months and twelve months after switch on. After that you will continue to be seen annually, either at St Michael's Hospital, Bristol or at one of our outreach clinics in Newton Abbot, Barnstaple or Truro. Ongoing maintenance and support of your cochlear implant will be available for life.

Download  Safety Considerations for Cochlear Implant Users.