Cochlear implants and hearing implants

Anyone whose ear has severe sensorineural (nerve) hearing loss that cannot be adequately rehabilitated with a conventional hearing aid. Candidacy is decided on clinical criteria by the implant surgeon with the audiologists, after hearing tests with and without well-fitted hearing aids.

Yes. Cochlear implantation is available through the public health system in Australia, although public waiting times can be an issue, and it is covered by private health insurance with appropriate hospital cover. There is no fixed Medicare restriction on who can be implanted — the decision rests on the surgeon’s clinical criteria. One practical point: funding covers the implant and the first external sound processor, but later upgrades of the processor as technology improves can be harder to fund unless you are a child or covered by the NDIS.

A bone conduction implant bypasses the outer and middle ear (the ‘conductive’ part of hearing) and delivers sound by vibration to a cochlea whose nerve function is still reasonable — or to the other ear in single-sided deafness. A cochlear implant bypasses a severe sensorineural hearing loss altogether: it stimulates the hearing nerve directly with electrical signals. Which is appropriate depends on where in the ear the hearing loss arises.

Yes, absolutely — although the rehabilitation and retraining needed to get useful hearing can be more challenging and prolonged than for someone implanted soon after losing their hearing. The general principle is that the longer an ear has been without sound, the less likely a good result. Timing relative to language matters most: an ear that lost hearing after speech and language were established (for example at age 10, implanted at 30) usually does well; an ear that has been profoundly deaf since before language developed, implanted in adulthood, has a much poorer outlook. Each case is assessed individually.

Yes. All modern cochlear implants are conditionally safe for MRI at up to 3 tesla. Over roughly the last ten years (since about 2015, depending on the brand) implants have been MRI-safe with precautions, and in the last five years the major brands can be scanned without the head bandage that used to be required. It is important to carry your implant identification card and show it to the radiology practice before any scan, so they can check the exact model and the conditions that apply to it.