Frequently asked questions

Hearing loss can significantly impact your life and the lives of those closest to you because it can make day-to-day interactions difficult, increasing the risk of isolation from family, friends and work colleagues. Hearing loss can also make it difficult to be actively involved in things you may enjoy such as socialising with family and friends, talking on the telephone, going to the movies or watching TV. 

Signs of hearing loss include:

• Asking people to repeat themselves in conversation
• Relying on lipreading
• Mishearing or incorrectly responding to questions
• Avoiding noisy situations and withdrawing from social occasions
• Turning the TV up louder than others may require and/or relying on subtitles
• Feeling stressed and annoyed from straining to hear or being unable to easily understand speech
• Feeling anxious about meeting new people or entering into situations where you anticipate it will be difficult to hear

If you or someone you care about has permanent hearing loss and experiences hearing difficulties, it’s important to seek guidance from a hearing healthcare professional. A cochlear implant may help you hear better if:

• Your hearing aids no longer provide sufficient benefit
• You are frequently missing parts of conversations or struggling to keep up
• You have difficulty understanding speech on mobile or landline phones
• You rely on lip-reading to follow conversations
• You are interested in exploring further options with expert support and guidance

If you have previously been assessed for a cochlear implant and advised not to proceed, it may be time to be reassessed if your hearing or communication abilities have declined. Furthermore, hearing implant technology is improving all the time and you may now benefit. Regular assessment ensures you receive the best possible care for your hearing needs.

Cochlear implants are recognised as an effective treatment option for Single-Sided Deafness (SSD).

SSD describes a significant hearing loss in one ear whereby minimal benefit is gained from a conventional hearing aid. Listening with one ear presents numerous challenges including:

• Difficulty determining where sounds are coming from
• Reduced awareness of sound and speech on your poorer hearing side
• Difficulty hearing and understanding speech in noisy listening environments
• Increased stress and tiredness from concentrating and straining to hear

Advances in hearing implant technology and clinical evidence supporting the benefit of hearing with two ears means a cochlear implant can now significantly reduce the impact of SSD for many people.

The experience of hearing with a cochlear implant is unique to each recipient. As the brain adapts to hearing via electrical stimulation, the sound quality evolves over time. Initially, many recipients describe the sound as mechanical, robotic, tinny, or similar to voices underwater. Occasionally, some recipients only feel the stimulation at first, with their brain needing more time to adapt and interpret it as sound.

Hearing with a cochlear implant and adapting to electrical stimulation takes time. It is a gradual process. For most recipients the sound quality continues to improve over the first 6 to 12 months with consistent daily use of their device.

For individuals with moderate to severe hearing loss, even the best hearing aids can sometimes feel like listening to a loud but distorted radio station. While hearing aids amplify sound, they don't necessarily make speech clearer if the damage to your hearing is too great.

A cochlear implant works differently. Instead of amplifying sound, a cochlear implant bypasses the damaged parts of the inner ear and directly stimulates the hearing nerve, restoring access to sound in a way that hearing aids cannot.

Many people with a cochlear implant are able to hear more easily, understand speech better and enjoy improved clarity of sound.

Cochlear implant funding options in Australia include:

• Public funding (state government-funded, no out-of-pocket costs for Medicare-eligible patients)
• Private health insurance (may involve out-of-pocket costs)
• Department of Veterans’ Affairs (DVA) (no out-of-pocket costs for eligible cardholders)
• Self-funding (for those not eligible for the above options)

Audiology costs

At Cochlear Implants SA, there are out-of-pocket costs associated with audiology services including candidacy assessments, initial activation of your cochlear implant and follow-up care in the first 12 months after surgery. Your out-of-pocket costs will depend on the Medicare rebate you are entitled to, which may vary depending on your personal circumstances and your Medicare Safety Net threshold. Beyond the first 12 months of activation, audiology services at Cochlear Implants SA are bulk billed through Medicare with a valid Medicare Card and GP referral. 

If you have a Department of Veterans' Affairs (DVA) Gold Card or a White Card with approval for Hearing Services, your costs at Cochlear Implants SA are covered in full. You will not incur any out-of-pocket expenses.

If you are an overseas client and do not have a Medicare Card, you will be required to pay the fee for the service in full on the day.

To find out more, contact us.

Surgery costs

Out of pocket costs for surgery will vary according to Surgeon, Anaesthetist and your private health insurance policy. Please discuss surgical costs directly with your ENT Specialist, Anaesthetist and private health fund.

If you have a Department of Veterans' Affairs (DVA) Gold Card or a White Card with approval for Hearing Services, surgical costs are covered in full.

Device costs

Device costs through Cochlear Implants SA are typically funded by your private health insurer. Please check with your private health fund to confirm your level of hospital cover and eligibility.

If you have a Department of Veterans' Affairs (DVA) Gold Card or a White Card with approval for Hearing Services, device costs are covered in full.

If you do not have private health insurance, we can refer you to the South Australian Public Cochlear Implant Program at Flinders Medical Centre. Alternatively, you can take out private health insurance and wait the necessary qualifying period or you can self-fund surgery and the device.

To determine whether you might gain benefit from a cochlear or bone conduction implant contact us at Cochlear Implants SA.

As cochlear implant and bone conduction implant technology improves over time, so too is candidacy criteria changing. This means a cochlear implant or bone conduction implant might now be the device of choice for you.

Your hearing aid provider, ENT Specialist, General Practitioner (GP) or any other health care professional involved in your care can refer you to Cochlear Implants SA for a candidacy assessment. You can also self-refer.

However, to claim the Medicare rebate associated with services at Cochlear Implants SA you will require a referral from your GP or Medical Specialist to one of our ENT Surgeons:

• Dr Paul Varley
• Dr Michael Schultz
• Dr Sonja Latzel
• Dr Alethea Grobler
• Dr Trish MacFarlane

Candidacy assessment

Several appointments are required to determine whether you are likely to gain benefit from a cochlear implant. Typically, this includes:

• 3 audiology appointments, including an assessment of your balance 
• 2 appointments with your Ear, Nose, and Throat (ENT) surgeon
• Medical imaging, including CT and/or MRI scans

If you are being assessed for a bone conduction implant, you will have a similar number of appointments. You will also have the opportunity to trial a bone conduction device.  You will not require an assessment of your balance.

Activation of your hearing implant

If you choose to proceed with a cochlear implant, you can expect to have 5–7 programming sessions within the first three months, starting approximately two weeks after surgery. Following this time, you will be seen for review at six months, 12 months, and then every 6-12 months as needed.

If you choose to proceed with a bone conduction implant, you can expect to have 2-3 programming sessions within the first three months, starting two to six weeks after surgery, depending on your device choice. Following this time, you will be seen for review at 6-12 months, and then every 12 months as needed.

Cochlear Implants SA is committed to providing a professional, personal and accessible hearing implant service for all South Australians. 

Cochlear Implants SA is the only hearing implant service to provide care at multiple sites across metropolitan, outer metropolitan and regional South Australia. While our Head Office is located in Norwood, we also visit to:   

• Elizabeth
• Gawler
• Morphett Vale
• Mount Barker
• Mount Gambier
• Murray Bridge
• Port Pirie
• Port Lincoln
• Renmark
• Victor Harbor
• Wallaroo

No. A cochlear or bone conduction implant candidacy assessment allows you to find out more about your hearing options so you can make an informed choice about your hearing care. The assessment process is designed to be informative and to empower you to make the choice that is right for you.

While a hearing implant may be recommended, you can step away or return to the process at any stage of your journey with Cochlear Implants SA.  The team at Cochlear Implants SA is here to support you always.

Age is no barrier. The oldest known cochlear implant recipient was 103 years old at the time of surgery. At Cochlear Implants SA the oldest person to receive a cochlear implant was 100 years old at the time of surgery.

No matter your age, if your health will allow you to undergo surgery, it is reasonable for you to consider a cochlear implant. Your fitness for surgery is carefully assessed by your Ear, Nose and Throat Surgeon and your Anaesthetist as part of the candidacy assessment process. While cochlear and bone conduction implant surgery is most commonly performed under General Anaesthetic, for some patients, surgery under local anaesthetic may also be an option. 

Cochlear implant surgery is ear surgery, not brain surgery. The procedure generally takes 1-2 hours and is commonly performed under General Anaesthetic. For some patients, surgery under local anaesthetic may also be an option.

While any surgery carries risk, complications with hearing implant surgery are rare. Your Ear, Nose and Throat Surgeon is able to explain the procedure in detail and answer any concerns.

Most hearing implant recipients stay in the hospital for only one night and experience little discomfort afterward. If needed, over-the-counter pain relief is usually enough to manage any mild discomfort.

Adapting to electrical stimulation and hearing with a cochlear implant takes time and, therefore, you can expect an adjustment period after activation. Listening exercises and rehabilitation help the brain adapt to electrical stimulation and help you gain confidence in hearing with a cochlear implant.

 Rehabilitation may include:

• In-session therapy with an audiologist
• At home exercises with a conversation partner
• App-based or computer-assisted training
• Listening to audiobooks 

At Cochlear Implants SA, rehabilitation is offered as an extension of care throughout your hearing implant journey. The team at Cochlear Implants SA is focused on your individual hearing and communication needs and can personalize rehabilitation to help you achieve your hearing and communication goals.

If you have successfully managed a hearing aid, a cochlear or bone conduction sound processor will not be difficult to learn to manage. The team at Cochlear Implants SA will instruct you on putting on and taking off your device and will practice this with you until you are comfortable doing it independently.

In most cases your sound processor will automatically adjust to the environment you are in, to optimize your hearing experience, so there is rarely a need for you to change listening programs or the volume of sound. If required, you can control listening programs, volume and other settings with a hand-held remote control or via an App on a mobile device. 

Like a hearing aid, you will be required to change or charge batteries. While the team at Cochlear Implants SA will provide hands-on training, it may also be helpful for you to bring a family member or friend to your early appointments for additional support.

While you may retain some of your natural hearing after having a cochlear implant, in most cases your hearing levels after surgery will be poorer in the ear that is implanted. The usefulness of this hearing will depend on your pre-surgery hearing levels.

If you retain usable low-frequency hearing, you may benefit from a Hybrid cochlear implant that combines acoustic and electrical hearing.

The team at Cochlear Implants SA will only recommend a cochlear implant if it is likely to offer you better hearing, even if the natural hearing in the implanted ear declines. 

It is important to remember you will still hear the 'natural' sounds from your non-implanted ear, which is unaffected by surgery.  It is also usual for your poorer hearing ear to be implanted, so your better hearing ear can support your adaptation to electrical stimulation.

Yes. In most cases, your poorer hearing ear is implanted, so your better hearing ear can support your adaptation to electrical stimulation. 

Bimodal hearing refers to the use of a cochlear implant in one ear and a hearing aid in the other.  Most of our hearing implant recipients at Cochlear Implants SA are bimodal users. 

Bimodal hearing can significantly improve overall hearing experience, making everyday conversations and activities more enjoyable and accessible. 

Bimodal hearing offers you the opportunity to combine the strengths of both technologies to obtain several advantages, including:

• Improved speech understanding – using both ears helps with clearer speech perception, especially in noisy environments.
• Better sound quality – a hearing aid can provide natural low-frequency sound, while a cochlear implant improves access and enhances clarity for high-frequency sound.
• Enhanced music enjoyment – the combination of natural hearing and electrical stimulation offers the opportunity for a fuller, richer listening experience.
• Improved localization – hearing with both ears makes it easier to determine where sounds are coming from.
• Reduced listening effort – listening with both ears can make communication feel more natural and less tiring.

A cochlear or bone conduction implant is not a treatment for tinnitus and should not be the primary reason for pursuing hearing implant technology.

Many people experience a temporary increase in tinnitus immediately after surgery. However, in the long term approximately 90% of people report their tinnitus as improved or unchanged, particularly when they are using their sound processor. A smaller group of people may experience a worsening of their tinnitus following cochlear implant surgery.

It is possible you will experience some dizziness or imbalance after cochlear implant surgery, but symptoms are usually short-term (a few days to a few weeks). Occasionally, symptoms may be longer lasting and rehabilitation with a vestibular (balance) physiotherapist may be required.

At Cochlear Implants SA, balance testing is routinely performed as part of the candidacy assessment process, before you proceed with surgery.  

Many hearing implant recipients successfully use a phone. It may take some practice, but there are helpful strategies and technologies to make phone use easier, including: 

• Direct streaming – many hearing implants can connect directly to a compatible mobile phone via Bluetooth, streaming speech to your sound processor for clearer conversations. With compatible technology, it may be possible to stream to your hearing implant sound processor as well as your hearing aid in the other ear.
• Speakerphone mode – holding the phone slightly away from your ear or using speakerphone can improve clarity. It may also allow you to hear with both ears.
• Captions & apps – phone captioning apps can provide real-time text for added support during phone calls.
• Practice & patience – listening to familiar voices or using audio books can help prepare you for phone conversations.

Many cochlear implant users can enjoy music, though it is likely to sound quite different in the early stages of hearing with your cochlear implant. And while music appreciation commonly varies from person to person, it can also improve with practice and over time. Based on our experience at Cochlear Implants SA you can expect: 

• Early experiences – initially, music may sound unfamiliar and sound quality may be poor as your brain adjusts to electrical stimulation and a new way of hearing.
• Improvement over time – with listening practice you may learn to recognize melodies, rhythms, and even lyrics more clearly. This is particularly true for familiar music.
• Helpful strategies – start with simple, familiar songs and gradually explore more complex music. Using direct audio streaming can also enhance sound quality.
• Bimodal or bilateral benefit – If you use a hearing aid in the other ear or have two cochlear implants, the combined input to both ears can make music sound richer and more natural.

No. While the team at Cochlear Implants SA recommend you wear your cochlear implant sound processor for at least 8-10 hours per day, or during waking hours, you do not have to wear it at all times. It is recommended you remove your sound processor when you are sleeping, showering or swimming (unless you are using a waterproof cover designed for your device). 

Regular and consistent daily use is recommended for you to adapt to electrical stimulation and gain optimal benefit from your cochlear implant. Over time, wearing your sound processor will feel more natural and will become a part of your daily hearing routine.

There are many factors that can influence your hearing outcomes with a cochlear implant. Based on current candidacy criteria, if a cochlear implant is recommended, you have an 85% chance of hearing better with a cochlear implant than you do with a hearing aid. 

A thorough assessment of your individual hearing needs is required, to determine if you are likely to gain benefit from a cochlear or bone conduction implant. This process includes:

• Assessment of your hearing, speech understanding and balance function
• Consultation with an ENT specialist, including CT and MRI scans
• Coordination with your Hearing Aid Provider, GP and other specialists as needed

It is also important for you to have realistic expectations of hearing implant technology. Most recipients experience significant improvements in speech clarity, especially in quiet listening situations, but outcomes can vary based on factors such as your duration of hearing loss and history of hearing aid use.

At Cochlear Implants SA you are empowered to make the choice that is best for you and your hearing.

Yes. Cochlear implant technology continues to advance, and it is possible to benefit from future improvements without the need for additional surgery. This may occur in several ways:

• Upgrading your sound Processor – while your internal implant will stay the same, if you are eligible to upgrade your sound processor you will be able to access improved sound quality, connectivity, and sound processing features. Contact us if you would like further information about upgrading your sound processor through your private health fund, the National Disability Insurance Scheme (NDIS), or Hearing Australia (if you are under < 26 years old).
• Compatibility with new accessories – many hearing implant sound processors are designed to work with the latest assistive devices, such as Bluetooth streaming accessories and smartphone apps.
• Long-term innovation – people who received cochlear implants decades ago can still upgrade to the latest sound processors, ensuring they continue to benefit from advancements in hearing technology.

By keeping up with new developments and working with the team at Cochlear Implants SA, you can make the most of future technology while enjoying the benefits of your cochlear implant today.