The Cochlear Implant Journey: From Evaluation to Activation

Cochlear Implants

The Cochlear Implant Journey_ From Evaluation to Activation

The journey to receiving a cochlear implant involves several crucial steps, each designed to ensure the best possible outcome for the individual with the cochlear implant. Here’s an in-depth guide detailing the process from initial evaluation through to device activation and follow-up care:

Step 1: Initial Evaluations and Candidacy Assessment

1. Referral and Initial Consultation:

  • The process typically begins with a referral from an audiologist or an ENT specialist to a Victorian Cochlear Implant Program clinic which includes Victorian Hearing.
  • Initial consultation includes a discussion about the individual’s medical history, hearing loss progression, and communication challenges.

2. Audiological Evaluation:

  • Comprehensive hearing tests are conducted to assess the type, degree, and configuration of hearing loss.
  • Detailed speech perception tests are performed to determine the individual’s ability to understand speech with and without hearing aids.

3. Medical Evaluation:

  • An ENT (Ear, Nose, Throat) surgeon evaluates the health of the middle ear, inner ear (cochlea), and auditory nerve.
  • Imaging tests such as CT scans or MRIs may be done to assess the anatomy of the cochlea and auditory pathways.
  • There may also be a need for further Balance assessments for some individuals.

4. Candidacy Determination:

  • A team of specialists, including audiologists, ENT surgeons, and sometimes psychologists or social workers, review the evaluations. This is carried out every Monday across all Cochlear Implant clinics with the Royal Victorian Eye and Ear Hospital.
  • Factors considered include the severity of hearing loss, speech understanding ability, auditory nerve function, and overall health.
  • Candidates typically have little to no benefit from hearing aids.

Step 2: Pre-Implantation Counselling and Decision-Making

1. Counselling:

  • Detailed discussions with the cochlear implant team about the benefits, risks, and expectations of cochlear implantation.
  • Psychological evaluation may be conducted to assess readiness and understanding of the implantation process.

2. Decision-Making:

  • The individual decides whether to proceed with cochlear implantation based on the information provided and personal considerations.
  • Consent forms and paperwork are completed for the surgery and implantation process.

Step 3: Surgical Procedure

1. Implantation Surgery:

  • The surgery is typically performed under general anaesthesia and is conducted by an experienced ENT surgeon specialising in cochlear implants.
  • Steps involve making a small incision behind the ear, placing the internal receiver-stimulator device beneath the skin, and inserting the electrode array into the cochlea.
  • Surgery duration is generally 2-3 hours, and most patients stay overnight for observation.

2. Post-Surgical Recovery:

  • Mild discomfort, swelling, and temporary restrictions on physical activities are common.
  • The surgical site is monitored for healing, and any concerns are addressed during follow-up appointments.

Step 4: Activation and Initial Programming

1. Activation:

  • Several weeks after surgery, the external components of the cochlear implant (speech processor) are fitted and activated.
  • An audiologist performs the initial activation, which involves testing and adjusting the settings to determine the levels of electrical stimulation for each electrode.

2. Mapping and Programming:

  • Electrodes are activated sequentially to assess the individual’s perception of sound.
  • Programming adjustments are made to optimise speech understanding and comfort levels.
  • Guidance is provided on using the speech processor, battery management, and troubleshooting.

Step 5: Rehabilitation and Follow-Up Care

1. Auditory Rehabilitation:

  • Targeted speech rehabilitation activities will be discussed and provided for home based auditory training.
  • Activities focus on auditory training, speech perception, and improving communication skills.

2. Follow-Up Appointments:

  • Regular visits are scheduled with the audiologist and ENT surgeon to monitor progress and make programming adjustments.
  • Speech perception tests and evaluations of device function are conducted to track improvement over time.

3. Support Services:

  • Access to support groups, educational resources, and workshops to assist with adjusting to life with a cochlear implant.
  • Continued updates on technological advancements and maintenance of the device.

The Cochlear Implant Journey with Victorian Hearing

The cochlear implant journey is a comprehensive multidisciplinary process involving thorough evaluation, surgical intervention, activation, and ongoing rehabilitation and support. Each step is crucial in ensuring the implant’s effectiveness and the individual’s successful adaptation to hearing with the device. With advancements in technology and specialised care, cochlear implants continue to provide life-changing benefits, enabling individuals with profound hearing loss to communicate more effectively and engage fully in their daily lives.

Victorian Hearing is here to support your Cochlear Implant journey. To find out more, attend one of our regular implant information sessions with your significant other or book a complimentary personalized implant discussion appointment please contact us today. With ten clinics across Melbourne, you are sure to find a friendly smile and support from the Victorian Hearing team. Call (03) 9558 8842 or book online.