The profoundly deaf, who gain little or no benefit from conventional h
earing aids and meet various criteria are potential candidates for coc
hlear implantation. The last two decades have witnessed remarkable pro
gress in this field, and it is now a routine clinical procedure. A few
adult patients who are potential candidates for cochlear implantation
have an unacceptably high risk for hypotensive general anaesthesia du
e to other systemic conditions. This group has been successfully impla
nted under local anaesthesia in our centre. The post-implantation prog
ress of these patients was comparable to those carried out under hypot
ensive general anaesthesia. Data regarding patient selection criteria,
examination, anaesthesia, surgery and the outcome are discussed. It w
as concluded that cochlear implantation under local anaesthesia is a s
afe and effective procedure for those patients who otherwise may be de
nied an implant.