For adult postlingually deaf candidates, indication is defined by bilateral severe to profound sensorineural hearing loss with no benefit for speech perception with the use of hearing aids. Prelingually deaf adult candidates can qualify for cochlear implants; however, counseling should be integrated to aid the candidates to the realistic expectation for speech perception with cochlear implants.

Children as young as 12 months old with bilateral severe to profound sensorineural hearing loss are qualified candidates for cochlear implant.

The use of auditory brainstem response (ABR) and otoacoustic emission (OAE) testing will yield objective testing to determine candidacy in young children.

Whether children or adult, the successful outcome of cochlear implants are determined by multiple factors including duration of deafness, cause of deafness, age at first onset of deafness, age at implantation, duration of use of implant, learning ability, dedication and learning support structure, health of cochlea and cooperation of the user to adapt to the implant.

Candidates should also have a support team composed of the surgeon, audiologist, speech therapist and psychologist to work together prior to and following the implantation.

Speech and sound rehabilitation is critical to the successful outcome of sound and speech perception with a cochlear implant; therefore, candidates must be committed to a long term rehabilitation effort.