Assessment (adults)

The Yorkshire Auditory Implant Service thoroughly assesses each adult referred to determine whether they would be a suitable candidate for a cochlear implant. The length of the assessment varies depending on each individual. During the course of the assessment adults meet the ENT Consultant, Speech and Language Therapist, Audiologist and Head of Service. This section describes each stage of the assessment procedure shown in the diagram to the left.

Adult Assessment

Initial Audiology Assessment: At the initial audiology appointment a full case history of the adult’s hearing loss is taken. Hearing tests are completed if the adult is using optimally fitted hearing aids. It may be necessary to trial new hearing aids before completing the hearing tests.  This will involve additional appointments.

Initial Speech and Language Assessment:  An informal communication assessment is completed by the speech and language therapist and information about equipment and services for deaf people is provided.  A quality of life questionnaire may be completed at this stage.

Clinic: During the initial clinic a medical consultation is completed by the Consultant ENT Surgeon.

Adult assessment

Decision to Continue: An initial decision is made by the team about whether a cochlear implant will be of benefit to the adult.  If a cochlear implant is not the right way to proceed for the adult then the reasons are given and are discussed fully with them at a clinic appointment with the Consultant ENT Surgeon. The referrer is informed of the outcome of the assessment.   If a decision is made to continue with assessment the adult will need to attend further appointments as outlined below:

Scan: A scan is carried out in Bradford which is used to show the structure of the inner ear.

Information Session: Adults will attend a session to provide information about how the cochlear implant works, the benefits and limitations and what they can do to achieve best outcomes.  We strongly recommend that adults attend this session with relatives or friends who will be able to support them after they have had their implant.

Meeting Established Cochlear Implant Users: Adults have an opportunity to meet or contact an established cochlear implant user to discuss their experience of getting used to and using a cochlear implant.   Regular Cochlear Implant User Groups meet in Bradford, Barnsley and Hull and people under assessment are welcome to attend these.

Decision and Offer: A final decision is made by the team and, if appropriate, the adult is offered an implant which they can either accept or decline. If it is decided the a cochlear implant is not suitable then the reasons are explained and discussed.

Pre-operative assessment and cochlear implant operation consent: These are arranged on the same day if possible but as a number of departments within the hospital are involved this is not always the case.

During the consent clinic the risks of surgery are discussed and the consent form is signed if the adult is happy to go ahead.

Baseline Assessment: Assessments are completed to establish listening, lipreading and communication skills before having a cochlear implant. The same assessments are carried out at intervals after the operation to assess progress.

Device Preference: There are three major cochlear implant manufacturers.  Most adults are given a choice of implant.  If this is the case they will be given information about each implant available to enable them to make their choice.

Operation The hospital stay is normally one to two nights.  The operation lasts 1.5 to 2  hours and is usually under general anaesthetic. It is advised that the adult has two weeks off work following the surgery.