Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
Hearing aids, bone-conduction devices and cochlear implants
Essential points for quick revision.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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Device use does not remove clinical emergencies
A hearing-device user may have a new medical hearing problem, an implant-site complication or a hazardous battery incident.
Action: Assess a sudden unexplained hearing decline through the urgent ENT pathway rather than assuming device failure. Seek prompt implant-team advice for a painful, loose or discharging abutment or damaged skin under a magnet. Suspected swallowing or insertion of a hearing-device battery into an ear or nose requires immediate emergency-department assessment.
Synopsis
Choose and explain hearing rehabilitation according to auditory function and individual goals, recognise cochlear-implant assessment criteria, and provide practical device aftercare and safety advice.
Offer hearing aids when hearing loss affects communication, awareness of warnings or other important listening activities.
If both ears have aidable loss, offer two hearing aids and explain the likely benefits of bilateral support.
Bone-conduction devices bypass parts of the external and middle-ear route; their value depends on cochlear reserve, ear anatomy and the listening problem.
Key red flags
New sudden hearing loss, neurological signs or severe vertigo requires clinical assessment even if the person already uses hearing aids.
Investigation priorities
01
Audiological assessment and personal listening goalsFirst step
Establish the impairment, medical referral needs and desired practical outcomes.
Management branches
Conventional hearing-aid rehabilitationFit the device and support effective use
The adult has aidable loss affecting communication or other important listening activities.
Discuss the available approaches, offer bilateral aids when both ears are aidable and agree realistic goals for the fitting.
Demonstrate insertion, controls, cleaning, batteries or charging, telephone use and relevant features such as directional microphones or noise reduction.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.