Guidelines for referral of cochlear implant patients

Referrals

USAIS requires a referral from Ear, Nose and Throat or Audiology professionals.  The referral will be checked by a locality team lead within USAIS and if deemed to be an appropriate referral (i.e. appears to meet NICE guidelines) then the referral will be processed.

If you would like to refer a patient, please contact:

Helen Wilkinson-Tough
Auditory Implant Service
University of Southampton
Building 19
Highfield Campus
Southampton
SO17 1BJ

Email: ais.referrals@soton.ac.uk

If possible please complete the form below and send it post or by email.  For patient confidentiality we are happy to accept password protected documents if you can let us have the password in a separate email. Alternatively if you have access to an nhs.net account our address is: uhs.ais@nhs.net.

Cochlear Implant Referral Form

Age

USAIS is an all-age Centre accepting referrals for children, teenagers and adults.  Referrals for young children should be made as soon as possible following diagnosis. Children are usually implanted around the age of one year.  

Audiometric Guidelines

Unaided levels should be >= 80 dB HL at two or more frequencies (500 Hz, 1kHz, 2kHz, 3kHz and 4kHz).  For adults speech perception test scores should be in the region of <50-55% on AB word test presented at 70 dB(A).

Radiology and Electrophysiological Tests

All patients will receive a CT Scan on the basis that patients possessing retro-cochlear pathologies or cerebral defects may be excluded.  Most patients will have an MRI at the same time. The Centre prefers to carry out the necessary electrophysiological and radiological assessments in Southampton.

Fitness for Surgery

All patients referred should be fit for general anaesthesia.  Patients with chronic active ear disease are not normally accepted until this has been adequately treated.

For children we require a copy of an ECG report for congenitally deaf paediatric patients.

Aetiology

Patients will not be excluded on grounds of aetiology other than in respect of criteria covered herein.

Psychological State

Patients should be considered psychologically stable in order to participate in the rehabilitation programme.

Other disabilities

No other disability will constitute grounds for exclusion.  Patients must be capable, however, of being able to participate in, and benefit from rehabilitation and evaluation.

Duration of deafness

Referrals are accepted for patients with congenital, acquired and progressive hearing losses.  Patients will not be implanted sooner than 6 months after the onset of deafness (except in the case of acquired loss due to meningitis).

Duration of profound deafness of greater than 40 years is usually considered a contra-indication for cochlear implantation unless consistent hearing aid use is evident.

Support

For children and teenagers there needs to be strong, committed support from both parents and local professionals as they will be expected take an integral part in the programme.  Post-implant support will need to focus on developing children’s listening and oral communication skills.  For adults, local support is highly desirable but there is no absolute requirement.

Costs

NHS England (Wessex) will pay for the cost of the assessment and implant. Details of current costs are available and are updated annually. The centre will arrange for long term monitoring and maintenance of equipment; the cost of this will also be charged NHS England (Wessex).

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