A Patient's Guide to Cochlear Implants

Cochlear implants are medical devices regulated by the FDA. Each new device must undergo clinical investigation at a limited number of cochlear implant clinics before approved for general use. In general, whether a device is approved or still under investigation makes a difference as to who is a candidate to receive the implant, how frequently return visits to the clinic are required, and how much is known about the safety and benefits of a particular device. Two of the devices we offer currently, the Nucleus 24M and the Clarion CII HF1, have received FDA approval. The third, the Clarion CII HF II, is an investigational device.

Although age at onset of deafness in adults does not affect the outcome, the earlier a person receives an implant following deafness, the greatest the likelihood of benefit.

Criteria for Adults

1. 18 years or older
2. Bilateral severe-to-profound sensorineural hearing loss
3. Minimal benefit from appropriate hearing aids (preop HINT sentence recognition scores of < or = to 50% in the best aided sound-only condition)
4. Postlingual deafness in ear to be implanted
5. English as primary language
6. Ability and willingness to comply with all study requirements as described in the informed consent documents
7. Willingness to participate in future studies conducted by sponsor and investigator and approved by FDA to evaluate these devices.

Criteria for Children

1. 12 months to 17 years old,
2. Profoundly deaf and unable to benefit from appropriate conventional amplification
3. Cooperative enough to undergo the testing required and then willing to wear the external apparatus
4. Educational setting with a strong auditory component.

Parents of children who receive cochlear implants must appreciate the considerable time commitment involved. They must agree to return with the child to the implant center for follow-up testing and monitoring of the cochlear implant. The parents also must be willing to cooperate and work with the child’s educators to provide appropriate habilitation.

The Implant Operation

Cochlear implants are placed under the skin in the temporal area and the electrodes are inserted into the cochlea using a routine surgical procedure. A miniature cord connects the headpiece at the ear with the speech processor, and the speech processor with the transmitting coil. The speech processor is worn by the patients, as they find convenient.

The operation to implant this device takes about 3 hours and is done under general anesthesia. The patient checks in on the day of surgery, stays overnight in the hospital and typically is discharged the next day.

Costs

At this time costs of the implant device and operation, including most follow-up visits for the first three months postoperatively, may total from $40,000 to $50,000, depending on a number of medical and nonmedical factors. These costs are the responsibility of the patient’s family and their health insurance plan or other third party payor. The implant devices are usually warrantied for a period of three years, but thereafter maintenance of the device is the responsibility of the user. Purchase of maintenance contracts from the manufacturer is strongly advised (currently these contracts are priced at around $300-400/year).

Some insurance contracts will cover a majority of the costs of implantation. Medicaid may cover a smaller portion; but in both cases it is necessary to obtain prior approval of benefits. Medicare will cover a portion of the costs and supplementary contracts, an additional portion beyond Medicare payments. Probably under the best of circumstances your payment responsibility will average a minimum of 20% to 30% of charges approved by your insurance plan.

Last Reviewed 2005

Source: Department of Otolaryngology

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.