Cochlear Implant Protocol

Thank you for your interest in the Metropolitan NeuroEar Group and Physicians Audiology Center Cochlear Implant Program. We offer comprehensive medical, audiological and rehabilitative services for those who may benefit from a cochlear implant.

Cochlear implant success begins with an initial medical and audiological evaluation. These evaluations include, but are not limited to a full case history, general health assessment, imaging (i.e. CT, MRI), comprehensive inner and middle ear evaluations and speech testing.

A cochlear implant is a beneficial option for individual who have inner ear hearing loss and limited speech understanding with properly fit hearing aids, those who have post-lingual deafness and for individuals who possess sufficient motivation and/or have a motivated support system to encourage the use and learning process of a cochlear implant.

FDA candidacy for a cochlear implant in adults requires:

  • Age 18 years or older
  • Moderate-to-profound sensorineural hearing loss in both ears
  • Limited benefit from appropriately fit hearing aids, defined as scoring <50% in the ear to be implanted, and <60% in the best aided listening condition on recorded tests of open set sentence recognition
  • No medical conditions that would impede implantation of a cochlear implant
  • A desire to be part of the hearing world

FDA candidacy criteria for a cochlear implant for children 12 months of age or older:

  • Profound bilateral sensorineural deafness
  • Little or no benefit from appropriately fit hearing aids

The following are not contraindications for a cochlear implant:

  • Age, IQ, congenital or pre-linguistic deafness, other disabilities, non-use of hearing aids, previously not an implant candidate

Before undergoing implantation it is necessary to undergo testing with appropriately fit hearing aids. Aided testing can be performed with either the individual's current hearing aids, clinic hearing aids, or the patient may choose to purchase new amplification on a trial basis.

Cochlear implant counseling is imperative. It is encouraged to have a family member or support system present at all appointments. At these appointments, expectations, benefits and information regarding the cochlear implant and processor will be discussed at length.

It is beneficial to contact your insurance company. Once candidacy is determined, we will mail in a pre-determination letter. Insurance companies may review patient medical records prior to making a determination.

Typically within 3-4 weeks following the outpatient cochlear implant surgery, the individual will receive the external processor and the implant will be activated. This is when the processor will be fit and the implant will be "turned on". You will not have heard anything from the implant up until this point. Initial sounds are typically not clear, as your auditory nerve needs to adjust to the new sounds. The adjustment period takes place over several weeks, months and possibly years. Follow-up mapping is critical. Mapping is the processing of fine-tuning the cochlear implant for your hearing needs and abilities. The recipient will be scheduled to come once a week for the first couple of weeks, gradually lengthening the time between appointments as the processor is programmed. Aided speech testing and audio testing is completed throughout this process to ensure and verify benefit.

The need for formal aural rehabilitation varies per individual. There are computer software and videos available to aid in rehabilitation. Appropriate referrals may be made to speech therapists and rehabilitation experts.

Schedule your appointment with us to discuss your candidacy for a cochlear implant. We look forward to working with you!