Hearing implant candidacy criteria
Referring your client to the Ear Science Implant Clinic is the first step in their hearing implant journey and using the 60/60 guideline is the simplest and quickest way of identifying if your client is suitable for a cochlear implant.
We have included the traditional criteria we use for hearing implants as part of the assessment. The considerations and tests required for hearing implants continue to evolve as more outcomes data becomes available, so we recommend utilising a more straightforward 60/60 referral guideline.
Cochlear Implant Candidacy
Sensorineural hearing loss
- Moderately severe to profound SHNL in one or both ears
- Poor Speech Discrimination
- Limited benefit from conventional amplification
- SSD – Must have trialed non-surgical options/BCI on test-band before recommended for CI
Mixed hearing loss
- Hearing aid is medically contraindicated
- Progressive hearing loss and bone conduction thresholds are outside criteria for a BCI >65dBHL
- Such individuals must be reviewed in a team meeting to rule out the possibility of other implantable devices
Cochlear Implant Candidacy
Aided speech
CNC phonemes in quiet 65dB SPL
Better Ear | 74%
Poorer Ear | 54%
CNC words in quiet 65dB SPL
Better Ear | 50%
Poorer Ear | 26%
Open set CUNY in Quiet 65dB SPL
Better Ear | 90%
Poorer Ear | 62%
Electric-Acoustic System Candidacy
Stable SNHL
- Low Frequency: Normal – moderate loss, High Frequency – profound loss
- No air-bone gap
No medical contraindications to fitting an acoustic device to the implanted ear
Has trialed hearing aids recently with limited benefit
- Consider a trial of frequency transposition/compression amplification
- Consider the degree of difficulty candidate is experiencing in background noise
Aided speech
CNC words in quiet
Implant ear | 10 – 60%
Bone Conduction Implant Candidacy | Mixed or Conductive Hearing Loss
Main Criteria
- Stable BC thresholds (BC thresholds ≤ 65dBHL)
- Air-Bone Gap > 30 dB (PTA4)
- Good speech perception in the ear to be implanted
- Symmetrical BC thresholds (unless there is no other rehabilitation option)
- Careful consideration should be given if there is >10 dB asymmetry between BC levels due to the potential for crossover of the BC signal.
- Review at the clinical meeting if candidacy is unclear/ borderline
- Inability to use conventional hearing aids
Why a bone conduction implant over a hearing aid?
Good benefits with Bone Conduction Implant
- Air bone gap >30dB
- Ear canal allergy
- Previous surgeries
- Recurrent Otitis Media
Single Sided Deafness | Candidacy Criteria
No useable hearing in one ear, normal hearing in the other
- Stable, normal to near-normal BC thresholds (good ear)
- Average AC in good ear ≤ 20 dB HL
- Completion of a take-home trial with a device on a test band and/ or a CROS system MUST have been completed
- Dissatisfaction with results obtained with non-implantable options
- Non-surgical options (e.g. CROS/BiCROS/conventional HA) have been discussed and trialed if appropriate
Aided speech
CNC words in quiet
Implant ear | 10 – 60%
Refer now
Referring a client for an implant assessment is easy. A recent audiogram is all that is needed to ensure your client may be suitable for an implant assessment.
Call 1300 847 395 and ask for Jody
Email the client referral form along with a copy of the audiogram to hello@earscience.org.au
Complete the client referral form below and attach a copy of the audiogram