A cochlear implant in one ear is recommended as a possible option for everyone with severe to profound deafness if they do not get enough benefit from hearing aids after trying them for 3 months. Cochlear implants in both ears are recommended for the following groups with severe to profound deafness only if they do not get enough benefit from hearing aids after trying them for 3 months and the implants are placed during the same operation:

  • children
  • adults who are blind or have other disabilities which mean that they depend upon hearing sounds for spatial awareness.

The cochlear implant team should carry out an assessment to find out if an implant would help before they consider a cochlear implant. They should take into account any disabilities or difficulties in communicating, which might mean that the usual hearing tests are not suitable. In such cases they should consider other methods for testing hearing. A later operation to place a cochlear implant in the second ear is only recommended for the following groups if they already had a cochlear implant in the other ear when the guidance was issued:

  • children
  • adults who are blind or have other disabilities which mean that they depend upon hearing sounds for spatial awareness.

In all cases, if more than one type of cochlear implant is suitable, the least expensive should be used. Costs should include the cost of the implant and the support package, and how reliable the system is. When an implant is placed in a second ear during the same operation the cost for the second implant should include currently available discounts on list prices of 40% or more.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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