Cochlear Implant Programme

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					How to find us                                               Cochlear Implant Programme

                 Contact Details
                 Department of Audiology
                 234 Great Portland Street
                 London
                 W1W 5QT
                 www.theportlandhospital.com

                 Hearing Test and Consultant Appointments:
                 T 020 7390 8060

                 Hearing Aid Appointments / Enquiries:
                 T 020 7390 8057
                                                             Overview for Professionals in the
                                                             Field of Adult and Paediatric Cochlear
                 Cochlea Implant Enquiries:
                 T 020 7390 8333                             Implant Assessment, Surgery and
                 All Audiology Enquiries:
                                                             Rehabilative Specialities
                 F 020 7390 8053
                 E audiology@portlandhealthcare.co.uk




                                                                                                       The Portland Hospital
                                                                                                      for Women & Children




                          accredited by the
                          Health Quality Service
                                                                  Programme History
                                                                  The cochlear implant programme at The Portland Hospital
                                                                  was started in 1997. At that stage several of the Surgeons
                                                                  involved had had enquiries from abroad and the feasibility of
                                                                  designing a complete package of care was investigated. The
                                                                  first child came from Kuwait and received her implant on
                                                                  April 2nd 1997. The rehabilitation package included 3
                                                                  months intensive work together with the mother, based both
                                                                  in the hospital and in Christopher Place. Her subsequent
                                                                  management was eventually taken over by the speech and
                                                                  hearing centre in Kuwait and her success has led to greater
                                                                  confidence in managing children from remote areas. The
                                                                  number of patients managed by the programme has
                                                                  increased since (Fig. 1) and increasingly both children and
                                                                  adults have received implants. The funding for this has come
                                                                  from a variety of sources (Fig. 2). Currently HCA Healthcare
                                                                  is negotiating with several of the leading insurance
                                                                  companies to form a contract for the whole package of care.
                             Sasha lives in Moscow with her
                             Russian Mother and English Father.
                             She was implanted at 14 months and
                             speaks Russian and English.
                                                                  Demographics
                                                                  As time has passed patients have been referred from a
                                                                  variety of countries (Fig. 3). We also manage patients
                                                                  implanted from many countries. Currently, we have patients
                                                                  who have received their implants in Australia, America,
                                                                  Germany, Saudi Arabia, Pakistan and Greece, (Fig. 4).
                                                                  Patients come with a variety of devices and our scientists
                                                                  have become proficient with the three major devices used
                                                                  (Fig. 5) Patients implanted on our programme are offered
                                                                  choice of device and the choice will be affected by many
                                                                  factors including availability of support at a local level.
                                                                  Patients will not be offered an implant unless this support
                                                                  has been investigated and found to be satisfactory (Fig 6).

                                                                  Patients come to our programme from the NHS for a variety
                                                                  of reasons (Fig 7). We have been able to work closely with
                                                                  several NHS implant programmes to reabsorb these patients
                                                                  for long term care.


                                                                  Future Developments
                                                                  We are increasingly mapping patients in their own homes
                                                                  and schools and have taken our portable systems to Greece.
                                                                  In the future we aim to implement remote mapping which is
                                                                  currently being developed.

                                                                  We currently have two bilateral implant users but it is too
                                                                  early to publish any data.




Cochlear Implant Programme                                                                          Cochlear Implant Programme
The Team                                      Fig. 1                History of the Programme                                               Fig. 4       Patients implanted and/or                                                              Fig. 7   Patients from or turned
                                                                                                                                                        managed by The Portland                                                                         down by NHS
On Site Staff
                                                               14
                                                                                                                                                        Hospital CI Programme                                                                           Patients considered to have too
Heather Bouchier Hayes                                                                                                              14
                                                                                                                                                                                                                                                        much residual hearing (1)
Coordinator and Speech and                                     12                                                                                Other                                     Portland
Language Therapist                                                                                                                                                                                                                                      Patients anxious to proceed to
                                                               10
                                                                                                                                                    9                                          36
                                                                                                                                                                                                                                                        implantation as soon as possible (2)
Melissa Israel




                                          Number of Implants
Speech and Language Therapist                                                                                                                                                                                                                           Patients with additional difficulties (3)
and Audiologist                                                 8

                                                                                                                                                                      Children                                   Adult

Stuart Thomas                                                   6
                                                                                                               8
                                                                                                                                                                                                                  12
Audiological Scientist and Speech                                                                                                                                          33
                                                                                                                      6
and Language Therapist                                          4


Robert Mills                                                                                             4                                 0            5     10      15           20     25          30   35       40          45        50
                                                                                                                                                                                                                                               Fig. 8   Future Developments
Hearing Aid Audiologist and                                     2
                                                                                           3                                                                                    Number of Implants
Department Manager                                                     2
                                                                                                                                                                                                                                                        Off-site mapping:
                                                                0
                                                                                                                                            ‘OTHER’ is defined as the number of patients managed by the Portland CI Program who have been
Dr. Savundra                                                          1997             1998             1999   2000   2001          2002
                                                                                                                                            implanted elsewhere. For example, we currently manage patients from Pakistan, Germany, Saudi
                                                                                                                                            Arabia, America and Australia.
                                                                                                                                                                                                                                                        (patient’s home or school, including
Neruo-otologist                                                                                                                                                                                                                                         abroad)
Dr. Hay
Paediatrician
                                                                                                                                                                                                                                                        Remote mapping:
                                                                                                                                                                                                                                                        (home and abroad)


Off Site                                  Fig. 2                    Funding                                                                Fig. 5       Devices
Angela Harding
Principle of Christopher Place &                                    Insurance:                                                                                                          MedEL

Teacher of the Deaf                                                                                                                                                                     9%
                                                                      Increasingly patients are being paid for by                                           16%
Dirk Fowler                                                           private health insurance policies.                                       Advanced
Psychologist                                                                                                                                     Bionics

Dr. Lloyd Savvy
                                                                    Self-Pay                                                               (Clarion Device)


Radiologist                                                         Embassy
                                                                    Charities
Surgeons                                                                                                                                                                                                               75%
                                                                                                                                                                                                                       Cochlear
                                                                                                                                                                                                                       (Nucleus Device)        Mr Smith was implanted on his 81st birthday and
Mr. Bailey                                                                                                                                                                                                                                     continues to enjoy life and entertain us with his wit.
Mr. Fitzgerald O’Connor
Mr. Graham
Mr. Hartley                               Fig. 3                    Patient‘s Country of Origin                                            Fig. 6       Rehabilitation
Mrs. Leighton
                                                                                               Greece                                                   Family must commit to a 2-3 months stay
                                                            India
                                                     Norway 5%
                                                                                                 9%                       England
                                                                                                                           41%                          post implantation.
                                                 Iran 2%
                                          Russia 2%
                                           2%
                                                                                                                                                        In-house and Christopher Place language
                                                                                                                                                        work and parental training.
                                                                                                                                                        Family commitment to regular
                                                                                                                                                        re-attendance for mapping and further
                                                                                                                                                        advice.
                                                                                                                                                        Named support at local level for overseas
                                                                             Middle East
                                                                                39%                                                                     patients.
                                                                                                                                                        Adult rehabilitation is tailored to individual
                                                                                                                                                                                                                                               Mohammed comes to see us regularly from Saudi
                                                                                                                                                        needs.                                                                                 Arabia where he attends a mainstream nursery.




             Cochlear Implant Programme                                                                                                                                                                                                                 Cochlear Implant Programme