How are implants fitted?

The internal parts of the implant are inserted under general anaesthetic. The operation can take from two to four hours involving a few days' stay in hospital.

About four to six weeks after surgery, the speech processor is activated and programmed to suit the individual's needs. The process is known as "switch on" and is followed by an intensive period of training and testing to ensure that maximum benefit is obtained from the device.

How many people have a cochlear implant?

By the end of 2003, over 3,900 people in the UK had received a cochlear implant. In 2003 alone, over 200 adults and 250 children received implants in the UK. Worldwide, it is estimated that around 80,000 people have received a cochlear implant.

How much does the operation cost?

Cochlear implantation is available free-of-charge on the NHS for many people fitting the criteria. Though the cochlear implant device alone costs around £16,500, the actual costs, including assessment, implantation and rehabilitation, are actually much higher:

• The total cost per adult cochlear implantation after the first year is around £27,000.
• The total cost per adult cochlear implantation projected over the thirty years of expected use is around £44,000.

Costs for childhood implants can be higher due to more intensive rehabilitation:

• The total cost per childhood cochlear implantation after the first year is around £30,000.
• The total cost per childhood cochlear implantation projected over the thirty years of expected use is £60,000.

"Ear-level" v "Body-worn" processors

An ear-level processor looks like a 'behind-the-ear' hearing aid. Body-worn processors are like a small box, worn in a pocket or on a belt. The ear-level devices are much smaller and many people prefer the way they look. Most implant users can now be fitted with behind-the-ear processors, but for some people the body-worn processor is most suitable.

Processing

All the manufacturers offer a range of processing strategies (that is, the way that external sound is translated into the sensations of sound that the user experiences), of which "Continuously interleaved sampling" is one. Although there are differences in processing strategies, the difference in effectiveness between them is less significant than the large individual differences in outcome between patients. When you first get a cochlear implant, the team will try to find the processing strategy that suits you best.