Cochlear implants can be used at any age to treat severe to profound sensorineural hearing loss which is not helped by appropriate quality hearing aids. Most people are aware of this advanced technology for children, but not for adults who can speak but have lost hearing.

New Zealand has a publicly funded service for this, allowing 40 adults (aged over 19 years) per year to have one cochlear implant fitted. Full funding for bilateral implants for children up to 19 years is available.

There is also a private service for adults; the specialist and hospital costs can be covered by medical insurance but not the device. Children have a fully funded service with separate funding.

The need for adults is thought to be many more than referred, with only 1 in 20 being identified. New Zealand has over 20,000 people with severe hearing loss which is a severe disability in terms of socialisation, employment, isolation and mental health issues.

There are two main centres for surgical assessment and implantation if appropriate, Auckland and Christchurch, and two schemes north and south.

New Zealand was one of the early adopters of cochlear implants in the world starting in the 1980s. Over the past 30 years advancements in cochlear implant technology have changed the lives of many adults giving them back hearing with improved health and quality of life outcomes. The under recognition of availability for adults is a worldwide phenomenon for a mix of reasons, the first being awareness and experience by GPs, practice nurses, audiologists and ENT specialists, and then amongst the patients themselves. Hearing loss is an invisible disability. Stigma, under-confidence and communication difficulties may hold the patient back from seeking help. Adults living with deteriorating hearing often withdraw in order to limit social embarrassment and communication difficulty - including with their regular healthcare providers. Hearing loss has been viewed by society as an inevitable consequence of ageing, by contrast we don’t regard blindness from cataracts as acceptable. In addition, most media coverage refers to children. Being aware and raising this with our patients and / or family is often the first step towards a life changing device.
WHO released figures in 2018 showing an estimated 466 million people worldwide, about 6% of the world’s population, have disabling hearing loss. They released this statement, supported by New Zealand:

“Hearing loss can no longer be ignored as a health priority. We know it affects a third of older people. Evidence reveals it will significantly impact individuals, health systems and society as people live longer.”

What is a Cochlear Implant (CI)?

A CI is a surgically implanted electronic device that provides the sensation of sound.

There are two parts:

1. The implant which is placed just under the skin behind the ear. It has an array of electrodes that are placed inside the cochlear by a specialist surgeon
2. The processor is worn behind the ear and sits lightly on the side of the head held in place by a magnet. A microphone gathers sound and the processor converts this and sends it to the implant which stimulates the auditory nerve. The brain interprets this as sound. 

What are the benefits?

• The return of hearing and the ability to converse normally.

What are the risks?

• Minimal wound with very low risk of infection.
• The usual perioperative risks associated with surgery and co-morbidities.

What are the drawbacks?

• One CI works well. Two is ideal but not publicly funded. Often an additional hearing aid will be worn to collect low tones.
• An annual check-up is required to re tune and check the device.

Cost?

• Free if meet criteria.
• Private $40,000 – $50,000

Is it waterproof?

• The processor can be removed at any time or covered with a bespoke waterproof cover.

• How a cochlear implant works (MP4, 7.5 MB)