Referral pathway

If your baby is diagnosed with hearing loss through the Newborn Hearing Screening Programme, they will automatically be referred to an ear, nose and throat (ENT) doctor who will explain the options. Tests will determine whether or not your child will benefit from a hearing implant of any kind. See Tests for hearing loss in babies and children

Family Doctor

However, if your child develops hearing loss, you experience a sudden hearing loss or you think your hearing is getting worse, your GP should be your first port of call. They should give you or your child an ear examination to rule out temporary blockages, signs of infection or other abnormalities.

Audiologist/ENT consultant

If there’s no sign of a temporary, treatable problem that could be causing your hearing loss and you are over 60, your GP should refer you straight away for tests with an audiologist at a local hospital or clinic. Read more about the tests you might undergo here .

Children, teens and adults under 60 should be referred by a GP to an ENT consultant for an ear examination in addition to having audiology tests. To find out more about the tests, click here.

Initially, a hearing aid may be prescribed while suitability for an implant is assessed. Persevere with hearing aids even if the sound isn’t clear because it’s important to keep the auditory part of the brain stimulated. Research indicates that the nerve pathways from the ear to the brain begin to weaken if there’s a lack of sound stimulation for any length of time.

Referral to an implant centre

If test results suggest a hearing implant may be suitable for you or your child, ask your ENT consultant to write a letter of recommendation for an assessment at a UK implant centre of your choice.

Choosing the implant centre

You can, of course, ask your ENT consultant’s advice on hearing implant centres but it’s also a good idea to do your own research, both on the internet and by contacting the centres. Here are some key points to consider:

  • How much choice of brand do you get at each clinic? (You may want to research the different brands before choosing a clinic.)
  • How experienced are the surgeons at each clinic – for instance, how many implantations are they doing per year?
  •  How long has the implant programme been running in this clinic?
  • How much focus does the clinic put on rehabilitation?
  • What impression do you have about the level of service and support at the clinic?

A HearPeers mentor can tell you what to look out for when choosing an implant centre.

Find a Clinic

Click here to find a hearing implant centre near you.

At the implant centre

You or your child will be given comprehensive tests by a medical team to assess suitability for an implant. This will involve a series of appointments. Besides hearing tests, these will include fitness for surgery, internal ear structure, the presence of a functioning auditory nerve, and how likely you or your child are to benefit from the implant. Both children and adults will usually need a trial period of three months with hearing aids, too.

Questions to ask the audiology team

Here are a few basic questions but you probably have many more of your own to add:
  • What is the cause of my/my child’s deafness?
  • What is the degree of my/my child’s deafness?
  • What are the alternatives to implants?
  • Will my child develop good spoken language without implants?
  • How likely is it that my child will be able to attend mainstream school without having implants?
  • What benefits should I/my child gain from the implant
  • What does surgery involve?
  • How many hearing implant surgeries has the surgeon performed?
  • What is the surgeon’s success rate and how does this compare to the success rate of other surgeons?
  • What are the risks of the surgery and how do they relate to me/my child?
  • What will happen after surgery?
  • What will the rehabilitation or auditory training process involve?
  • What are the main differences between the implant brands available?
  • How does the reliability data between the brands compare?

A HearPeers mentor can tell you more about the assessment process for hearing implants.

  • Medication examination – This will involve an overall fitness assessment for surgery and examination of your ears. You’ll probably need either a CT (computerised tomography) or MRI (magnetic resonance imaging) scan to examine the internal ear structure.
  • Hearing tests – Read more about the hearing tests you may undergo here. In word recognition tests, it’s important not to guess the answers, else you may be denied an implant that could help you, because you might score too high. It may be tempting for you to do this if you’re used to guessing words in everyday life. If you are denied an implant, you have the opportunity to be re-tested. 

What does a hearing implant assessment for adults involve?

  • Auditory brainstem response test – Electrodes are attached to your head and pick up your auditory nerve’s responses to sound. It’s useful for assessing people with profound hearing loss and is totally painless.
  • An assessment of your hearing aids if you wear them and a hearing aid trial if you don’t.
  • Lip reading assessment to see how much you currently rely on lip reading.
  • Full explanation of what’s involved, and counselling to make sure that your expectations are realistic.

What does a hearing implant assessment for children involve?

Children are assessed according to whether their speech, language and listening skills are appropriate for their age, developmental stage and cognitive skills. This is very detailed and may take some time. It will involve:
  • A detailed hearing assessment. Read about hearing tests your child may be given here
  • A hearing aid assessment and trial.
  • The cochlear implant team will visit your child at home and school. There will be assessments of language, communication, education and expectations by the advisory teachers, speech and language therapists and psychologists.
  • Auditory brainstem response test – Electrodes are attached to your child’s head to measure their auditory nerve’s responses to sound. It’s totally painless.
  • A CT (computerised tomography) scan and possibly an MRI (magnetic resonance imaging) scan will be carried out to examine the internal structures of the ear.

Application for NHS funding

There are very clear NICE guidelines for cochlear implants.  If you or your child fit the criteria, a funding application will be made. The surgical procedures will be explained and you’ll be shown options for your implant devices.

There are no NICE guidelines for middle ear implants or active bone conduction implants. However, they are provided on the NHS in certain circumstances.

Connect with a HearPeers mentor

and exchange experiences about the hearing journey.