Referral criteria for cochlear implantation assessment
Adults
- No longer obtaining significant speech understanding with maximal amplification – i.e SDS score
- Post-lingual severe to profound hearing loss
- Single sided deafness (Post-lingual acquired)
- Mid to high frequency severe to profound hearing loss in 1 or both ears with preserved low frequency hearing at 125 and 500Hz (AES)
- No upper age limit
Children
- Severe to profound unilateral or bilateral SNHL on ABR
- Referral by neonatal/infant hearing screening (AABR)
- Lack of progress in development of auditory and language skills despite adequate access to sound and amplification
- Implantation possible from the age of 6m in certain cases
Notes
- The earlier the implantation in children, the better the expected outcome
- Universal infant hearing screening should be encouraged at all hospitals with high frequency tympanometry, DPOAE and AABR assessments as per the HPCSA position statement
- Implantation after the age of 3 in a pre-lingual child is associated with a significantly decreased chance of normal language development and main-stream schooling entry
- Implantation in any pre-lingual patient >7yrs old is not likely to achieve significant speech outcomes
