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Cochlear Implant Referral and Assessment Protocol
INFORMATION ABOUT COCHLEAR IMPLANTS FOR ADULTS
INFORMATION ABOUT COCHLEAR IMPLANTS FOR ADULTS
What is a cochlear implant?
A cochlear implant is an electronic medical device designed to restore the ability to perceive sounds and understand speech by individuals with severe to profound hearing loss. Adults who are no longer deriving benefit from their hearing aids may benefit from cochlear implants. Unlike a hearing aid, which amplifies sound, a cochlear implant bypasses damaged hair cells in the cochlea and stimulates the auditory nerve via electrical impulses.
How does a cochlear implant work?
A cochlear implant consists of an external processor and internal implant.
The external processor:
- A microphone picks up sounds from the environment;
- The speech processor (a computer) analyzes and digitizes the sound signals and sends them to a transmitter;
- The transmitter worn on the head sends the signal to the surgically implanted internal implant.
The internal implant:
The implant sits just under the skin behind the ear, receives signals from the processor and converts them into electric impulses. The electrode array placed within the cochlea receives the signal from the transmitter and stimulates the auditory nerve, which in turn, sends information to the brain to be interpreted as meaningful information.
To meet the criteria for a publicly-funded cochlear implant you must have a severe to profound hearing loss and derive no benefit from hearing aids. Currently, the Government caps the number of adults eligible for a publicly-funded operation. If you meet the criteria for an implant after the assessment, you are placed on a waiting list. This waiting list is fluid and varies due to the demand for limited publicly funded cochlear implants.
ELIGIBILITY GUIDELINE FOR COCHLEAR IMPLANTS
Who is eligible for a cochlear implant?
In general, if someone is wearing appropriately fitted hearing aids but cannot understand speech without seeing the speaker’s face, they should be referred and assessed for a cochlear implant. There is no age barrier to receiving a cochlear implant, so long as an individual is healthy and well.
As a guide, if an individual answers yes to one or more of the below questions, please get in contact with the cochlear implant programme in your area. Contact details below.
IF YOU ANSWERED 'YES' TO ONE OR MORE OF THE ABOVE QUESTIONS, PLEASE REFER TO THE PUBLIC COCHLEAR IMPLANT PROGRAMS.
FOR THOSE LIVING NORTH OF TAUPO, PLEASE REFER TO THE NORTHERN COCHLEAR IMPLANT PROGRAM, AT THE HEARING HOUSE: WWW.HEARINGHOUSE.CO.NZ
FOR THOSE LIVING SOUTH OF TAUPO, PLEASE REFER TO THE SOUTHERN COCHLEAR IMPLANT PROGRAM: WWW.SCIP.CO.NZ
GUIDE TO THE ASSESSMENT PROTOCOL FOR ADULTS
When someone is referred into the cochlear implant programme, an audiologist and an ENT surgeon specializing in cochlear implant surgery, carry out an assessment to determine if they are eligible for a cochlear implant. The below infographic is a guide to the assessment process.
GUIDE TO POST SURGERY APPOINTMENTS
CLIENT STORIES
BELOW ARE TWO OF OUR INFORMATION BOOKLETS YOU MAY FIND HELPFUL.
Sounds of Life
A year in the Life
COCHLEAR IMPLANT SURGERY
WHAT DOES COCHLEAR SURGERY INVOLVE?
Cochlear implant surgery is performed under a general anesthesia and takes approximately 1 to 3 hours, with an overnight stay in hospital. The procedure is considered a routine surgery with low risk.
Your surgeon makes a 4-6 cm incision behind the ear and then opens the mastoid bone leading to the middle ear. They then make an opening in or near the round window of the cochlea, inserting the implant electrode array into the cochlea. The electronic portion of the device attached to the electrode array is placed under the skin behind the ear. The incision is then closed, a head dressing is applied and you are then taken to your room for recovery and an overnight stay.
Cochlear Implant Surgery
Some people want to know what’s involved in a cochlear implant surgery, warts and all, but it’s not for everyone. In this video, ENT surgeon Bill Baber walks us through CI recipient, Richard Milne’s surgery.
WARNING: GRAPHIC SURGICAL CONTENT
Some additional Q&A about COCHLEAR implant Surgery
WHAT ARE THE RISKS OF SURGERY?
Risks from Cochlear implant surgery are the same or lower than other common ear surgeries. In rare instances the following may occur:
- Bleeding or swelling at the incision site
- Infection in the area of the implant
- Ringing (tinnitus) in the implanted ear
- Dizziness or vertigo (typically resolves a few days after surgery)
- Change in taste/dry mouth (typically resolves within a few weeks or months)
- Numbness around the incision site
- Injury to the facial nerve (extraordinarily rare)
HOW PAINFUL IS COCHLEAR IMPLANT SURGERY?
Everyone’s pain tolerance is different, but generally the pain is mild-to-moderate, lasting a few days and can be controlled with paracetamol.
HOW LONG AFTER SURGERY BEFORE I CAN EXERCISE AND DO SPORT?
It is recommended to wait 1-2 weeks following surgery before starting back to your exercise routine, with a 4-6 week wait before starting back into water-based sports.
ABOUT BILL BABER
Bill is an ear, nose and throat surgeon with a special interest in ear surgery. Along with Ron Goodey, Bill played and integral part in the establishment of New Zealand’s first Cochlear Implant programme. Working with a team of dedicated professionals to restore or develop the sense of hearing has easily made this the highlight of Bill’s career in ENT Surgery.
COCHLEAR IMPLANT WEBINARS
The Pindrop Foundation webinars offer cochlear implant clients, their families and health professionals educational resources on access to and benefits of cochlear implants for adults living with a severe hearing disability. Leaders in cochlear implant technology and services discuss the latest medical information in an easy-to-understand format to empower clients and their families to make informed decisions about their care, in addition to informing health professionals about developments and referral pathways in cochlear implant services. Browse our webinars by topic below, and stay tuned for upcoming webinars.
WEBINARS
UNTREATED SEVERE-TO-PROFOUND HEARING LOSS AND THE COCHLEAR IMPLANT SITUATION: HOW POLICY AND PRACTICE ARE DISABLING NEW ZEALAND SOCIETY
In this webinar, we talk to Cochlear implant user and advocate, Dr Lewis Williams, whose paper 'Untreated severe-to-profound hearing loss and the cochlear implant situation: how policy and practice are disabling New Zealand society' was published last year in the New Zealand Medical Journal.
ADULT COCHLEAR IMPLANTATION: CAN YOUR PATIENT HEAR YOU? WHAT HEALTH PROFESSIONALS NEED TO KNOW ABOUT SEVERE HEARING LOSS
In this webinar, we hear from NZ G.P and Clinical Director for Primary Care Surgical Services at Auckland Hospital, Kathy McDonald, Julie Ligeti, Global Manager Public Advocacy for Cochlear Ltd, cochlear implant recipient and registered nurse, Josie Calcott, as they discuss some of the challenges relating to cochlear implantation for adults and how healthcare professionals can help identify and refer suitable patients.
PUBLIC HEALTH ADVOCACY IN A TIME OF UNCERTAINTY
In this webinar Sue Archbold, Consultant on research, public policy and practice in hearing loss and cochlear implantation, discusses advocacy and empowering community voices- what role can consumers and health professionals play?
THE PATHWAY TO A GLOBAL STANDARD OF CARE FOR ADULTS REQUIRING COCHLEAR IMPLANTS
In this webinar, Associate Professor of Audiology at the University of Auckland, Holly Teagle and Cochlear Implant Surgeon, Michel Neeff discuss the pathway to a global standard of care for adults requiring cochlear implants.
LEARN ABOUT COCHLEAR IMPLANT SURGERY WITH BILL BABER
Some people want to know what’s involved in a cochlear implant surgery, warts and all, but it’s not for everyone. In this video, ENT surgeon Bill Baber walks us through CI recipient, Richard Milne’s surgery.
WATCH THE GLOBAL CI COLLABORATIVE: FUTURES FORUM: WEBINAR SERIES
THE FIRST GLOBAL CONSENSUS ON THE USE OF COCHLEAR IMPLANTS
THE INTERNATIONAL CONSENSUS PAPER
A REPRESENTATIVE PROCESS
TO CHECK OUT MORE WEBINARS FROM THE CI FUTURES FORUM SERIES, PLEASE CLICK THE BUTTON BELOW.
WATCH THE COCHLEAR IMPLANT INTERNATIONAL COMMUNITY OF ACTION (CIICA) WEBINAR SERIES.
COMMUNICATION TIPS
Living with a hearing loss can cause communication challenges, but there are things you can do to help. Remember, even if someone has a cochlear implant or other hearing assisted device these simple tips can help bring clarity when communicating.
- Gain the person’s attention before you speak
- Avoid speaking from another room
- Face the person when talking to them, so they can see your face and lips
- Do not cover your face, touch or put your hands over your mouth when talking (beards and moustaches can make things extra tricky too)!
- Be aware of background noise. It’s very difficult to understand conversations in a noisy room. Some hearing assisted devices amplify the noise rather than giving clarity to speech.
- Keep your face well lit. Do not stand with the light or a window behind you as your face will be in a shadow
- Do not shout! Speak clearly and not too fast or too slow
- Repeat the sentence again (just once) if necessary, then rephrase
- Write down important facts - times, dates, names, places, instructions
- Be calm and patient
- Gestures and facial expressions may help get your message across
AFTER YOU RECEIVE A COCHLEAR IMPLANT, HERE ARE SOME TIPS TO HELP WITH COMMUNICATION.
After you receive your cochlear implant, you need to train your brain on how to listen, hear, understand and communicate with others. To do this, it is important to have conversations with your friends and family. It’s all about communication, communication, communication.
Here are some useful tips to help to keep conversations engaging and mitigate frustrations while you are learning to follow and understand conversations after you have your implant.
You may miss part of a conversation at the start, and instead of saying the word we all tend to use in these situations... “what?” which can be annoying and frustrating to both sides, try these strategies instead to keep the conversation engaging rather than frustrating:
- I think you said ... am I right?
- I think I am following you…just to clarify, we are talking about…
- I heard the last part, but missed the first thing you said, can you repeat it, please?
- I just missed the last thing you said, can you repeat that bit, please?
- I hear you but I am not understanding the words, can you reframe it, please?
- Will you say the same thing again but speak more slowly?
- I’m sorry, I wasn’t ready, will you please repeat that?
Other helpful pointers:
Think about your positioning and lighting when having conversations. For example, try to have chats in quiet, well-lit areas, like a living room as opposed to a noisy kitchen. Position yourself so that your better hearing ear is towards the speaker and one that allows you clear access to the speaker’s face for additional visual cues.
To make your communication experience more enjoyable, educate family and friends on what they can do to be as helpful as possible. Like the above strategies listed at the top of the page.
DOWNLOADABLE POSTERS AND FLYERS
Below are downloadable cochlear implant information posters and flyers you can download and display in your practice.
When funding is available for you to receive your cochlear implant, you will be notified of your surgery date and an appointment will be made for a pre-operative consultation with your ENT surgeon to discuss the surgery and what to expect.
In the Northern Cochlear Implant Programme, the surgery takes place at Gillies Hospital in Epsom, and you are generally admitted on the morning of your surgery and an overnight stay in expected.
Your switch on may occur 1 day after your surgery with scheduled follow-ups throughout the year.
For a comprehensive overview of the process, please visit:
The Northern Cochlear implant Programme here: www.hearinghouse.co.nz
The Southern Cochlear Implant Programme here: www.scip.co.nz
