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. Any on-going care
and maintenance is subject to your entitlement to receive NHS
Hospital services in line with the provision of the NHS Overseas
Visitors NHS Hospital Charging Regulations.
Download
Safety Considerations for Cochlear Implant Users.
