Candidacy for cochlear implants is typically determined through a comprehensive evaluation process involving a team of medical professionals. Our role begins, normally, with a referral from a physician, but can also be generated by a patient’s interest, or when one of our providers identifies a patient’s candidacy. Here’s a breakdown of the key factors our team considers:

1. Hearing Loss Severity: Cochlear implants are primarily recommended for individuals with advanced stage (severe to profound) hearing loss in both ears. Audiological tests, such as pure-tone audiometry, tympanometry, and otoacoustic emissions are conducted to assess the severity of hearing loss.
2. Limited Benefit from Hearing Aids: Candidates should receive minimal benefit from hearing aids. However, this must be ruled out as surgical solutions should be recommended only based on medical necessity. This is typically determined through trials with hearing aids to assess speech understanding and communication abilities.
3. Communication Needs: The patient’s communication needs and goals are essential considerations. Candidates may include those who have difficulty understanding speech, even with hearing aids, and who have a strong desire to improve their communication abilities.
4. Health Considerations: Overall health is assessed to ensure that the individual is fit for surgery and can tolerate anesthesia. Medical conditions that may affect surgery or increase the risk of complications are taken into account.
5. Anatomical Considerations: The anatomy of the inner ear and auditory nerve is evaluated through imaging tests such as CT scans and MRI to ensure that the individual’s anatomy is suitable for cochlear implantation.
6. Psychosocial Factors: The candidate’s psychosocial well-being and support system are evaluated to ensure that they have realistic expectations about the procedure and are prepared for the rehabilitation process post-implantation.
7. Age: While there is no strict age limit for cochlear implantation, candidacy criteria may vary depending on age. Children as young as 12 months old may be candidates, while older adults can also benefit from cochlear implants.
8. Linguistic Background: For candidates who use sign language or have a different primary language, considerations are made regarding their linguistic needs and potential benefits from cochlear implantation in terms of language acquisition and communication.

The evaluation process may involve consultations with various hearing and communication professionals, including audiologists, otolaryngologists (ENT specialists), speech-language pathologists, as well as social health professionals such as psychologists and social workers. Eventually a neurologist or other surgeon who specializes in cranial pathologies will be consulted to determine if the individual meets the criteria for cochlear implant candidacy and discuss the potential benefits and risks of the procedure.