Content verified by
World-class care in paediatric hearing implant surgery
At Evelina London Children’s Hospital, our paediatric ear, nose and throat (ENT) specialists are proud to offer extensive experience, expert surgical skills and advanced facilities to our young patients. Our children’s ENT service has one of the UK’s largest specialist teams, offering life-enhancing care. We perform surgical procedures for common conditions and offer comprehensive treatments in subspecialist areas such as complex ear surgery and hearing implant insertion, where we have in-depth experience and knowledge, and an international reputation for excellence.
Learn more from Mr Nikul Amin, consultant ENT surgeon, about how the team care for young ENT patients at Evelina London.
Expertise in cochlear implant surgery
We’re proud to be one of a small number of UK centres offering a comprehensive hearing implant surgery service. This includes procedures such as bone conduction, middle ear, cochlear and auditory brainstem surgery. Further to this, our specialists also offer middle ear surgery for patients with complex diseases, for example, advanced cholesteatoma.
“We offer a cochlear implant when a patient’s hearing levels are so poor that they will not benefit from a regular hearing aid,” explains Mr Amin. “In children born with significant hearing loss, we aim to start assessments early and provide a cochlear implant by their first birthday.”
Cochlear implants work by bypassing damaged parts of the inner ear to directly stimulate the hearing nerve. The small electronic device converts sound into electrical signals which the hearing nerve then transmits to the brain, leading to the person being able to perceive sound. Standard hearing aids differ from this in that they simply amplify sound.
Cochlear implants are unsuitable for people who don’t have a hearing nerve or cochlea parts, as the cochlear implant requires these structures to transmit sound signals effectively. Patients without a hearing nerve or the necessary cochlea structures may be suitable for an auditory brainstem implant procedure instead.
Cochlear implant, showing both the inside of the ear and the external view.
Auditory brainstem implant specialism
Our ENT specialists treat young patients from both the UK and worldwide, as Evelina London is home to the UK’s leading paediatric auditory brainstem implant (ABI) service. ABI is often the best option for children with profound hearing loss, who don’t have the cochlear or auditory nerve, and therefore wouldn’t benefit from cochlear implants or hearing aids.
ABI works by bypassing damaged areas of the inner ear. It places electrodes at the first point of the hearing stem pathway in the brainstem, which then directly stimulates the auditory brainstem. This allows the brain to perceive sound, even without a functioning cochlear or auditory nerve.
Following the ABI procedure, our ENT specialists provide long-term rehabilitation to patients in collaboration with local hearing services, to assist patients with physiological adjustments, auditory training, and learning to associate signals with environment sounds and speech.
Young patients with complex syndromes
Our specialists commonly treat patients with complex syndromes, such as those with CHARGE syndrome (CS). CS affects several systems in the body, including the heart, eyes, kidney, growth and hearing. Ears in patients with CS are usually shorter and wider than would be typical, with little or no earlobe, and often have malformation of bones and structures in the middle ear. Some children with CS may be suitable for cochlear implants, while others may lack an auditory nerve or cochlea parts which prevent them from benefitting from cochlear implants.
Other patients with Down, Usher and Waardenburg syndromes may also have affected hearing and development, and can be treated by our ENT specialists too. Our consultants utilise a multidisciplinary approach and have the expertise and experience to evaluate unique cases to decide the best course of action for each child, offering tailored care and a personalised experience.
Our team have close relationships with specialist manufacturers to develop tailored devices for patients with ear anatomy that isn’t suited to standard devices. We also have contacts with all major implant manufacturers, ensuring that each patient receives a device best suited to their individual hearing requirements and lifestyle.
Specialist treatment for microtia and atresia
As one of the leading centres in Europe, a further subspecialist area of our consultants’ is hearing implant surgery for patients with:
- under-developed outer ears (microtia)
- absent ear canals (atresia)
- narrow (stenotic) ear canals
“The inner ear parts, including the auditory (hearing) nerve, are often normal, so we can provide hearing surgery that bypasses the absent ear canal,” explains Mr Amin. “However, it’s challenging because the abnormally small outer ear often means multiple abnormalities in the middle part of the ear, including the hearing bone.” ENT specialists require access to the middle ear and beyond, which includes navigating the abnormal positioning of the nerve supplying the face muscles.
These cases require a multidisciplinary approach with input from a hearing implant surgeon, plastic surgeon, audiologist and radiologist. Often, a middle ear implant or a bone conduction implant is deemed the best course of action. We’re proud to be home to one of the largest, most experienced multidisciplinary teams treating patients with complex hearing conditions, ranging from implant procedures and infections associated with hearing loss surgery, to subsequent hearing rehabilitation and recovery journeys.
When to refer to us
Research shows that children who receive cochlear implants around their first birthday have greater potential to develop strong spoken language skills and speech appropriate for their age group. However, children can be referred to our specialists up to the age of 16 for hearing implant surgery.
Evelina London has been recognised as one of the world’s best children’s hospitals in US Newsweek’s 2025 list of World’s Best Specialized Hospitals, and we’re proud of the breadth of service and expertise that our consultants offer to young ENT patients.
Get in touch
For more information on our children’s ENT service at Evelina London Children’s Hospital, please contact our customer services team. Call 020 3131 5130 or email privatepatientenquiries@gstt.nhs.uk