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Agency for Care Effectiveness
Ear, nose, and throat

Bilateral cochlear implants for children with severe-to-profound sensorineural hearing loss in both ears

17 February 2023

Published on 29 Mar 2018
Last Updated on 17 Feb 2023

Guidance Recommendation

The Ministry of Health’s Medical Technology Advisory Committee has recommended:

  • Bilateral cochlear implants (BCI) for the management of children (<18 years old) with severe-to-profound sensorineural hearing loss in both ears who have:

    • A hearing threshold of >70 decibels hearing level (dB HL) without acoustic hearing aids (HA),

    • A hearing aid trial of 3 to 6 months, unless contraindicated or inappropriate, and

    • Parental support in the form of motivation and commitment to rehabilitation.

  • Simultaneous BCI should be provided to the eligible child as early as clinically suitable.

  • For children who have received unilateral cochlear implant (CI), the second CI in the contralateral ear should be provided only if this is judged to provide sufficient benefit by the clinician.

    • The second CI should be provided by 6 years of age unless there are special conditions to consider (e.g. large vestibular aqueduct syndrome (LVAS), meningitis, irradiated ears).

  • Children will be eligible for subsidy for the replacement of CI sound processors, which include replacement with or without upgrade where an upgrade refers to a change to a later model than currently used by the individual, if all of the following criteria are met:

    • The child is deemed by the attending healthcare professional to be receiving sufficient benefits from the CI, and demonstrating continued need for CI; and

    • The existing CI sound processor has been used for at least 5 years, and its deterioration in performance is deemed by the attending healthcare professional to warrant replacement for achieving optimal hearing.

Subsidy status

CI is recommended for inclusion on the MOH Medical Technology Subsidy List (MTSL). Listed models are recommended for subsidy when used in line with the abovementioned recommendations.

Subsidies will not apply to devices and accessories that are not included in the standard or replacement packages of CI devices, including replacement of, or upgrades to, internal implants.

Bilateral cochlear implants for children with severe-to-profound sensorineural hearing loss in both ears [PDF, 268 KB]

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