A determination of candidacy is made by an audiologist and ear-nose-throat (ENT) surgeon with special training in cochlear implants. As of 2012, an adult with moderate to profound hearing loss may have up to 50% sentence discrimination (i.e. words in sentences) in the ear to be implanted — wearing hearing aids — and be an appropriate candidate.
In general, if someone wearing appropriately fit hearing aids cannot understand speech without seeing the speaker’s face, they should be evaluated for a cochlear implant.
For children, an assessment of any child with a severe to profound hearing loss should be made as early as possible as outcomes with a cochlear implant are significantly better in children who receive an implant at the earliest possible age.
Cochlear implant candidacy guidelines have changed to include children and adults with more residual hearing as well as other anatomic, health, and learning issues that would have been considered “absolute” or “relative” contraindications in the past.
Utilization of other technologies, in combination with the cochlear implant device, have provided further expansions in outcomes bringing recipients closer to “normal” hearing.
With all of these changes has come a new recognition of the quality of life changes and cost utility made possible when the right device is matched to appropriate patients.