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Cochlear Implant

We help families whose children have received a cochlear implant, and follow these children until they reach age 18.

The cochlear implant option

A cochlear implant may be an option if your child:

  • Has a bilateral severe to profound sensorineural hearing loss
  • Has restricted or no useful (limited) benefit from hearing aids


The following criteria are considered in determining a child’s candidacy for cochlear implant surgery of one ear (unilateral) and follow-up at BC Children's Hospital:

  • Age range of 12 months through 18 years. The earliest age a child can receive a cochlear implant is 12 months of age.
  • A bilateral severe to profound sensorineural hearing loss
  • Little or no benefit from consistent use of appropriately fitted hearing aids worn at least 3-6 months as shown through minimal progress in auditory development
  • Inner ear which can accommodate the implant device/ integrity of auditory nerve, as determined by MRI/ CT Scan
  • No medical contra-indications, including active middle ear disease or ossification of cochlea, which would interfere with implant surgery or the post-implant (re)habilitation process
  • Family and/or child with good motivation and realistic expectations about the cochlear implant
  • Family prepared and committed to the time and travel costs associated with cochlear implant follow-up as well as the continuing costs of sound processor supplies and upgrades
  • Enrolment in an appropriate educational program with emphasis on development of auditory/oral skills

Bilateral cochlear implants

There are many benefits to having two (bilateral) cochlear implants such as localization (knowing where a sound is coming from) and listening in noise. The clinic has been providing bilateral cochlear implants since 2008.

A second cochlear implant may be offered to all children who meet all the following conditions:

  • Meet BC Children's Cochlear Implant Services criteria for unilateral cochlear implantation
  • Fall under one of the following categories:
    • Have had meningitis
    • Have visual impairment
  • Young children with bilateral profound hearing loss who get little benefit from a hearing aid in the non implanted ear
  • Children with sudden onset or progressive hearing loss that results in poorer or limited hearing aid benefit.
  • Have no other conditions that would prevent the expectation of benefit with a second implant (e.g., lack of progress in speech-language and auditory development)

Older children who have had their first implant for many years may be offered a second implant if:

  • They have received their first implant prior to 3 years of age
  • They are 10 years of age or younger
  • They demonstrate significant benefit from the first implant shown by a minimum of 60% open set speech discrimination.
  • They do not have any other conditions which would prevent safe implantation or suggest limited benefit from a second cochlear implant.

Our team


  • Grace Cheung, MSc, RAUD
  • Alison Jones, MSc, RAUD
  • Selma Karsan, MSc, RAUD

Audiometric technician

  • Samantha Gill


  • Dr. Fred Kozak, MD, FRCSC
  • Dr. Ronak Rahmanian, MD, FRCSC
  • Dr. Mark Felton, MD, FRCS

Social worker

  • Lisa Johnson, MSW, RSW


  • Dr. Laura-Lynn Stewart, PhD, RPsych


Evaluation process

Once the Cochlear Implant Team has received a referral for your child, the team coordinator will contact you and send you an information package. If you are interested, a family meeting with the team coordinator will be arranged.

At the meeting with the team coordinator you will be provided with information about cochlear implants. The coordinator will also explain the assessment process and answer any questions you may have.

Following this, if you wish to proceed, several appointments will be booked with different members of the interdisciplinary team to help determine if a cochlear implant is an option for your child.

The Candidacy Assessment includes:

  • Audiology review to measure the child’s hearing levels, and evaluate hearing aid benefit
  • A review of the early intervention services that the child has received, and how the child has progressed
  • Medical review to ensure that the child does not have any medical conditions that might prevent the use of an implant.
  • Vaccination evaluation
  • Social work appointment
  • A CT and MRI scan of the inner ear (similar to x-rays) to ensure the inner ear is suitable for insertion of the electrode array

Families can expect a minimum of 6 appointments for the evaluation process.

For out of town families we try to coordinate appointments so that there is less travel.

Once these assessments are complete, the Cochlear Implant team will discuss the results, and determine whether a cochlear implant is recommended. If your child is a candidate for implantation, your family can then decide whether to go ahead.


The surgery is done in the operating room at BC Children’s Hospital under general anesthetic. Dr. Kozak is the pediatric cochlear implant surgeon of B.C.

The surgery usually takes about 4 hours and the children usually stay one night after the surgery for monitoring. 

One week after surgery there is a follow-up appointment with Dr. Kozak. 

It generally takes 3 to 5 weeks for the surgical incision to heal, but most children resume normal daily activities within days after the surgery. However, no active sports or climbing is recommended for 6 weeks after surgery. 

Patient handouts


After surgery

Approximately 1 month after the surgery, the child will return to BC Children’s Hospital to have the implant activated. 

At the time of activation, your Cochlear Implant audiologist will set up one or more listening programs for your child. This process is called “mapping”. For the first year after surgery, the child will need to be closely followed every 3 months. These appointments will occur at BC Children’s Hospital. 

Follow-up appointments

Generally, families can expect 6-8 follow-up appointments for the first year after the child receives the cochlear implant. After the first year, it is 2-3 appointments per year and then later once a year. 

In addition to these appointments, participation in early intervention services is an essential part of the process of learning to hear with a cochlear implant. Early interventionists are qualified professionals with experience working with babies newly identified with hearing loss. They provide families with the information they need to help their child develop early communication (including listening, language, and speech).

We encourage you to work with your early interventionists and cochlear implant audiologist to discover what communication approaches work best for your own baby and family however, it is important to have an emphasis on auditory training.

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SOURCE: Cochlear Implant ( )
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