Hundreds more children and adults eligible for cochlear implants on the NHS

NICE| January 2019 | Hundreds more children and adults eligible for cochlear implants on the NHS

Following a review of the definition of severe to profound deafness which is used to identify if a cochlear implant might be appropriate, NICE have updated their eligibility criteria for cochlear implants. 

Meindert Boysen, director of the Centre for Technology Evaluation, said: “The appraisal committee listened to stakeholder concerns regarding the eligibility criteria for cochlear implants being out of date. Upon review it was concluded this needed to be updated.



“The new eligibility criteria for cochlear implants will ensure that they continue to be available on the NHS to those individuals who will benefit from them the most.”

Severe to profound deafness is now recognised as only hearing sounds louder than 80dB HL at 2 or more frequencies without hearing aids, a lowering of the previous threshold (Source: NICE).

NICE [press release]

Cochlear implants for children and adults with severe to profound deafness (part review of TA166)

See also:

Nursing Times  Hundreds more patients to be eligible for cochlear implants

The Independent NHS to offer hundreds more deaf people life-changing  cochlear implant 


New technique developed to synchronise cochlear implant signals

Science Daily | May 2018 | Synchronizing cochlear signals stimulates brain to ‘hear’ in stereo

American researchers have developed an innovative technique to synchronise the cochlear signals that stimulate the brain in a way that is similar to people who can hear.  The ability to use both ears to hear enables the recognition of speech and improves sound localisation (via Science Daily).


At a forthcoming event, the 175th Meeting of the Acoustical Society of America, being held May 7-11, 2018, the researchers will present data that demonstrates how this technique synchronises the cochlear signals that stimulate the brain in a similar way to people who can hear without a cochlear implant.  It will enable people with an implant to have a more realistic hearing experience.

Although the technique has yet to be tested outside of a laboratory setting, it is hoped that the research team can work with cochlear implant manufacturers to enable people with cochlear implants to benefit from this synchronous hearing.

Full news item at Science Daily

Children with cochlear implant learn words faster than hearing children

Researchers have found that deaf children with a cochlear implant learn words even faster than those with normal hearing | Scientific Reports | via ScienceDaily


A current study at the Max Planck Institute for Human Cognitive and Brain Sciences has revealed that when deaf children get their cochlear implants, they learn words faster than those with normal hearing. Consequently, they build up certain word pools faster.

The reason for this finding could be that children with cochlear implants are older when they are first exposed to spoken language. Those with normal hearing learn aspects of language, such as the rhythm and melody of their mother tongue, from birth and even in the womb. In deaf children, this only starts at the time of their cochlear replacement, at the age of around one to four years. By this time certain brain structures necessary for language acquisition are already well developed.

Full story at ScienceDaily

Full reference: Vavatzanidis, N. K. et al. | Establishing a mental lexicon with cochlear implants: an ERP study with young children |Scientific Reports, 2018; 8 (1)

Change in loneliness after intervention with cochlear implants or hearing aids

The aim of the study was to investigate the impact of hearing aid (HA) and cochlear implant (CI) use on loneliness in adults| The Laryngoscope

Image source: Joonas Tikkanen – Flickr // CC BY-ND 2.0

One hundred and thirteen adults, aged ≥ 50 years, with postlingual hearing loss and receiving routine clinical care at a tertiary academic medical center, were evaluated with the University of California at Los Angeles Loneliness Scale before and 6 and 12 months after intervention with HAs or CIs. Change in score was assessed using linear mixed effect models adjusted for age; gender; education; and history of hypertension, diabetes, and smoking.

Treatment of hearing loss with CIs results in a significant reduction in loneliness symptoms. This improvement was not observed with HAs. We observed differential effects of treatment depending on the baseline loneliness score, with the greatest improvements observed in individuals with the most loneliness symptoms at baseline.

Full reference: Contrera, K.J. et al. (2017) Change in loneliness after intervention with cochlear implants or hearing aids. The Laryngoscope. Vol. 127 (Issue 8) pp. 1885–1889

Interaction of tinnitus suppression and hearing ability after cochlear implantation

To study the postoperative impact of cochlear implants (CIs) on tinnitus, as well as the impact of tinnitus on speech recognition with CI switched on | Acta Oto-Laryngologica 

Methods: Fifty-two postlingual deafened CI recipients (21 males and 31 females) were assessed using an established Tinnitus Characteristics Questionnaire and Tinnitus Handicap Inventory (THI) before and after cochlear implantation. The tinnitus loudness was investigated when CI was switched on and off in CI recipients with persistent tinnitus. The relation between tinnitus loudness and recipients’ satisfaction of cochlear implantation was analyzed by the visual analogue scale (VAS) score.

Results: With CI ‘OFF’, 42 CI recipients experienced tinnitus postimplant ipsilaterally and 44 contralaterally. Tinnitus was totally suppressed ipsilateral to the CI with CI ‘ON’ in 42.9%, partially suppressed in 42.9%, unchanged in 11.9% and aggravated in 2.4%. Tinnitus was totally suppressed contralaterally with CI ‘ON’ in 31.8% of CI recipients, partially suppressed in 47.7%, unchanged in 20.5%. Pearson correlation analysis showed that tinnitus loudness and the results of cochlear implant patients satisfaction was negatively correlated (r = .674, p < .001).

Conclusion: The study suggests six-month CI activation can be effective for suppressing tinnitus. The tinnitus loudness may affect patients’ satisfaction with the use of CI.

Full reference: Wang, Q. Interaction of tinnitus suppression and hearing ability after cochlear implantation. Acta Oto-Laryngologica Vol. 137 (Issue 10) pp. 1077-1082

Cochlear implantation – which child when?

In the last 30 years, the field of cochlear implantation has rapidly evolved | Paediatrics and Child Health


Technological advances in hardware and corresponding developments in surgical techniques, along with new sound processing strategies and innovative rehabilitation, have combined to maximise functional outcomes. Informed by the evidence base of such outcomes, the inclusion criteria for children who might benefit from a cochlear implant (CI) has been refined and expanded. CIs are now the standard of care for children with severe to profound hearing loss where the desired outcome is spoken language. There are several emerging trends within the field of paediatric CIs that have already translated into clinical practice in some countries, but have not yet been universally adopted.

These include, but are not limited to, the expansion of audiometric CI candidacy criteria for cohorts with:

  • (1) more residual hearing;
  • (2) partial hearing which may benefit from electric-acoustic stimulation (EAS)
  • (3) asymmetric hearing levels. This review will describe the historical context and provide an overview of the candidacy trends as they relate to children.

Full reference: Maggs, J. et al. (2017) Cochlear implantation – which child when? Paediatrics and Child Health. Published online: July 12, 2017

Outcomes of cochlear implantation for the patients with specific genetic etiologies

Cochlear implantation (CI) is the most important and effective treatment for patients with profound sensorineural hearing loss. However, the outcomes of CI vary among patients | Acta Oto-Laryngologica 

One of the reasons of this heterogeneous outcome for cochlear implantation is thought to be the heterogeneous nature of hearing loss. Indeed, genetic factors, the most common etiology in severe-to-profound hearing loss, might be one of the key determinants of outcomes for CI and electric acoustic stimulation (EAS). Patients with genetic causes involving an ‘intra-cochlear’ etiology show good CI/EAS outcomes.

This review article aimed to summarize the reports on CI/EAS outcomes in patients with special genetic causes as well as to assist in future clinical decision-making. Most of the cases were suspected of an intra-cochlear etiology, such as those with GJB2SLC26A4, and OTOF mutations, which showed relatively good CI outcomes. However, there have only been a limited number of reports on patients with other gene mutations.

Most of the cases with gene mutations of intra-cochlear etiology showed relatively good CI outcomes. To progress toward more solid evidence-based CI intervention, a greater number of reports including CI outcomes for specific gene mutations are desired.

Full reference: Nishio, S-Y. & Usami, S-I. (2017)Outcomes of cochlear implantation for the patients with specific genetic etiologies: a systematic literature review. Acta Oto-Laryngologica. Vol. 137 (no. 7) pp. 730-742