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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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Determining treatment choices after the cochlear implant evaluation process.

Andrew J Redmann1,2, Kareem Tawfik3, Theresa Hammer4

  • 1Department of Otolaryngology-Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA.

Laryngoscope Investigative Otolaryngology
|April 19, 2021
PubMed
Summary

Only 47% of patients starting cochlear implant evaluation (CIE) proceed to cochlear implantation. Many candidates forgo surgery due to cost, insurance, or preference for hearing aids.

Keywords:
cochlear implantsevaluation processtreatment pathways

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Area of Science:

  • Otolaryngology
  • Neuroscience
  • Audiology

Background:

  • Cochlear implant evaluation (CIE) is a critical step for individuals with severe to profound hearing loss.
  • Understanding patient pathways and decision-making after CIE is essential for optimizing treatment outcomes.

Purpose of the Study:

  • To determine the proportion of patients undergoing cochlear implant evaluation (CIE) who ultimately receive a cochlear implant (CI).
  • To identify patient-specific factors influencing the decision to proceed with or defer CI surgery after evaluation.

Main Methods:

  • Retrospective case series analysis of adult patients undergoing CIE at a tertiary academic neurotology practice (2014-2016).
  • Examination of patient management pathways from initial CIE scheduling through final treatment decisions.

Main Results:

  • Of 226 patients starting CIE, 107 (47%) underwent cochlear implantation.
  • 82% of patients completing CIE met implantation criteria, but 36% of these candidates deferred surgery.
  • Common reasons for deferral included missed appointments, preference for hearing aids, patient refusal, and insurance issues.

Conclusions:

  • While CIE identifies many CI candidates, a significant proportion do not proceed to surgery.
  • Cost, insurance, and patient preference for alternative amplification significantly impact CI uptake.
  • CIE successfully led to a new hearing device in 56% of patients.