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Lost to follow up: Exploring patients who initially fail cochlear implant evaluation
Natalie Schauwecker1, Anthony M Tolisano2, Jacob B Hunter2
1University of Texas Southwestern Medical School, Dallas, TX, USA.
Cochlear Implants International
|August 12, 2020
Summary
Many individuals initially not qualifying for cochlear implantation (CI) later do. Patients recommended re-evaluation within a year and properly fitted with personal hearing devices showed higher return rates for CI testing.
Area of Science:
- Audiology
- Otolaryngology
- Biomedical Engineering
Background:
- Cochlear implantation (CI) is a complex procedure for severe to profound hearing loss.
- Some patients initially do not meet CI candidacy criteria.
- Understanding factors influencing return for repeat evaluation is crucial for optimizing patient selection.
Purpose of the Study:
- To identify predictors of return for repeat cochlear implantation (CI) evaluation among adults who initially failed to qualify.
- To analyze demographic, audiometric, and speech perception variables associated with re-evaluation.
Main Methods:
- Retrospective chart review of adult CI evaluations from 2007-2017.
- Analysis of demographics, pure tone audiometry (PTA), speech perception testing (including Word Recognition Scores - WRS), and use of evaluation hearing aids.
- Multivariate analysis to determine predictors of return for subsequent evaluations.
Main Results:
- Of 135 patients initially failing CI criteria, 37 returned for re-evaluation, with 72.9% subsequently qualifying.
- No significant difference in PTA or speech perception scores between those who returned and those who did not.
- Evaluation with personal hearing devices (P=0.012) and recommendations for re-evaluation within 6 months (P=0.001) predicted higher return rates.
Conclusions:
- A significant proportion of patients initially ineligible for CI will qualify upon repeat testing.
- Scheduled re-evaluations and proper fitting with personal hearing devices increase patient return rates.
- Recommending repeat CI evaluation within one year for initially ineligible patients is advised.
