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Pre-operative Visits

At all levels of the candidacy process, we aim to involve the patient in the decision-making process. For younger adolescents, this may involve meeting with cochlear implant users or other candidates and giving them age-appropriate information about the process of receiving a cochlear implant. Older adolescents, they are involved in making the final decision about receiving an implant. We try to involve the entire family as well as any other professionals involved in the adolescent's care.

Deciding if a cochlear implant is right for a patient involves testing in many different areas. The main areas of concern are:

Medical candidacy

This includes an MRI or CT scan. The person also needs to be fit and well for surgery.

Audiological candidacy

We need to know about the persons history of hearing, their current hearing levels and how hearing aids help. Hearing tests are performed on all patients to determine the type and severity of hearing loss.  Testing with words and sentences helps us gain information on the amount of speech that a patient is able to understand when using their hearing aids.

Speech and language development

Speech and language ability will also be tested for most candidates. This assessment includes measures of how well a patient's own speech can be understood as well as tests of how well they are able to understand and use language.

Expectations

It is important that the young person and their family have a clear understanding of the assessment process and what to expect after they have a cochlear implant. Appropriate expectations predict better success with a cochlear implant and it is important that the patient understands what appointments they will be asked to attend, what listening with an implant may sound like and what can help the process of getting used to their new way of hearing.

Assessment process

Several appointments pre- implant will be needed to help decide  if a cochlear implant is the right choice. These are some of the appointments the person will be asked to attend. Each patient is different and visits are likely to take place in a different order for everyone.

Initial meeting

Once a referral has been received by the centre, the family will be scheduled for an initial meeting. The purpose of this visit is to: obtain a full history; describe the pre-operative process to the family; discuss the cochlear implant and some of the risks and benefits; and, complete some hearing testing. Patients and their families will be given the opportunity to ask questions at this visit and they will be given an idea of what to expect for the rest of the process.

Further audiology

Depending on the patient's history and outcome of the initial visit, the patient may be scheduled for more tests of their hearing or ability to understand speech. A full battery of tests may be completed including pure tone air and bone conduction audiometrytympanometry, hearing aid assessment, speech perception measures and any other tests felt to be necessary or relevant.

Speech and language assessment

In order to determine if a cochlear implant is a good option for a patient, their current level of speech and language development may be tested using formal tests.

Scan

Patients will be listed for a scan relatively early on in the pre-operative process as the wait lists for scans can sometimes be quite long. A scan is required before the consultant can determine if a patient is suitable for a cochlear implant. Generally, an MRI scan is recommended with a CT scan in addition if necessary.

Meeting with a consultant

All patients referred to the programme will be offered a meeting with the ENT consultant even if they are not going to get a cochlear implant. If they are going to get an implant, they will be listed for surgery at this visit. The consultant will also discuss the medical risks of surgery and discuss the surgical process.

Other assessments

Other tests may include vision testing, psychological testing, developmental assessment, or other specialist referrals as necessary. Vaccination records will also be checked and any further vaccinations that may be required will be requested from the patient's own GP