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Welcome to our Health Professionals section, offering comprehensive information and resources for medical practitioners dedicated to advancing cochlear implant care and improving patient outcomes.
The below outlines the general process of referring patients.
Patient struggling to hear with their hearing aids on.
Refer the patient to an audiologist so they can conduct a full diagnostic audiogram.
Audiologist to conduct a full diagnostic audiogram, including:
-Air and Bone Conduction
-Speech Testing & Immittance
-Optimise hearing aid performance
If the audiogram shows severe hearing loss and ≤ 60% in the better hearing ear for monosyllabic words,
refer them to a local Cochlear implant clinic (the Hearing House for the north of Taupo or the Southern Cochlear Implant Programme for the south).
Note: A referral does not guarantee a publicly funded cochlear implant.
The referral is evaluated by the clinic's lead audiologist.
If any issues arise during the assessment, the case goes to the Adult Review Meeting for further recommendations.
The patient and the assessing professionals decide whether to proceed with the cochlear implant.
Patient struggling to hear with their hearing aids on.
Audiologist to conduct a full diagnostic audiogram, including:
-Air and Bone Conduction
-Speech Testing & Immittance
-Optimise hearing aid performance
If the audiogram shows severe hearing loss and ≤ 60% in the better hearing ear for monosyllabic words, refer them to a local cochlear implant clinic (the Hearing House for the north of Taupo or the Southern Cochlear Implant Programme for the south).
The referral is evaluated by the clinic's lead audiologist.
If any issues arise during the assessment, the case goes to the Adult Review Meeting for further recommendations.
The patient and the assessing professionals decide whether to proceed with the cochlear implant.
The below outlines the assessment process mentioned earlier.
(1-2 hours) to test hearing with and without aids, verify the extent of hearing loss, and check middle ear function.
(1-2 hours) for speech perception tests.
(if needed, 1-2 hours) to discuss your needs and expectations.
To ensure the cochlea can accommodate an implant.
A 45-minute meeting to discuss the implantation process.
The typical schedule post-surgery.
(usually 1 hour) Device Programming & Rehabilitation Auditory Perception Assessment
Device Mapping (1hr) Rehabilitation (1hr)
ORL review: Device Mapping (1hr) & Rehabilitation (1 hour)
(usually 1 hour) Device Mapping and Rehabilitation
Cochlear implant surgery is performed under a general anaesthetic and takes approximately 1 to 3 hours, with an overnight stay in the hospital. The procedure is considered a routine surgery with low risk.
An ENT surgeon, specialising in cochlear implants, 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 taken to your room for recovery and an overnight stay.
What are the risks of surgery?
An ENT surgeon, specialising in cochlear implants, 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 taken to your room for recovery and an overnight stay.
Cochlear implant surgery is performed under a general anaesthetic and takes approximately 1 to 3 hours, with an overnight stay in the hospital. The procedure is considered a routine surgery with low risk.
What does a cochlear implant sound like?
This varies from person to person. At switch on, the most commonly reported sounds are described as “mechanical,” "robotic," and "cartoonish,” with some people sounding as if they are “talking with marbles in their mouth.” Some clients will only “feel” the stimulation of the implant when it is first turned on. It is very important to recognise that this is a process. Over time, recognise that the sound quality will change as the brain re-learns the stimulation patterns provided by the cochlear implant. For the majority of clients, the sound quality will continually improve over the next twelve months.
Is cochlear implant surgery painful?
Cochlear implant surgery is performed under a general anaesthetic and takes approximately 1 to 3 hours, with an overnight stay in the hospital. The procedure is considered a routine surgery with low risk.
Do I need to avoid magnetic toys and underlays?
You can safely use these items as they have low magnetic strength.
Are MRI scans safe with the implant?
The magnetic field in MRI scanners exerts force on any magnetic materials in the vicinity. This can be an issue for people with some cochlear implants, particularly those with a fixed magnet.
Cochlear Nucleus Profile™ Plus, the latest implant offering, provides access to MRI at 1.5 T and 3.0 T with magnet in place. The Profile and CI24RE implants are approved for MRI conditional with magnet surgically removed. MRI access is available for the majority of Nucleus implant recipients, but the specific conditions and access differ based on implant type.
For a comprehensive Cochlear Ltd MRI Guideline, click here.
Footnotes
MRI compatibility varies by country depending on regulatory approvals in each country. Please check the MRI guidance provided in your country by contacting your local cochlear representative or clinic before proceeding with an MRI scan.
Eligibility for the public cochlear implant program in New Zealand requires:
Speech audiometry scores of ≤ 60% in the better hearing ear for monosyllabic words.
Sufficient prior hearing ability (aided or unaided) to have developed spoken language.
New Zealand citizenship or residency, with a minimum of 187 days per year spent living in New Zealand.
The cochlear implant (CI) team has determined that you are in good health for surgery.
Consistent use of hearing aids, unless there is no benefit from their use. In such cases, ear molds may be provided to assess any lip-reading advantages.
Significant hearing loss (>65 dB HL) due to meningitis requires prompt referral to address potential ossification risks, regardless of standard audiometry criteria.
Notes:
Eligibility for private cochlear implant funding requires:
Hearing thresholds within certain limits for one or both ears, taking into account conditions like Ménière's disease hyperacusis and cases of private implantation in only one ear.
Significant hearing impairment, demonstrated by speech audiometry results of <60% (Pimax on CVC or AB words) in either ear.
Completion of a full diagnostic test and optimization of aids/molds before assessment.
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