An adult considering a cochlear implant will first be referred to the Cochlear Implant Surgeon by either their General Practitioner or as a subsequent referral by their local ENT Consultant.

There are certain factors which must be considered before a adult is referred to us as a suitable candidate for a cochlear implant. The following conditions will normally need to be met.

• Adults should have a severe/profound bilateral sensori-neural hearing loss.
• Average aided responses should be greater than 55 dB across the frequency range from 2kHz up to and including 4 kHz.
• There has only been minimal benefit from appropriately fitted, high powered hearing aids.
• Consistent hearing aid use is being actively sought locally.

Other issues to consider are:

1 Patients whose severe or profound hearing loss is a consequence of meningitis should be 'fast tracked' regardless of hearing aid use. This is to reduce the risk of cochlea ossification. These patients will be prioritised throughout their assessment process.

2 Where auditory brainstem response testing is used as the basis for referral or to provide additional information, this should be performed in line with national recommended procedures.

3 Each adult should be medically fit for surgery.