Development of an Optimized Protocol for Cochlear Implant Care to Increase Cochlear Implant Access

Area of Science:

• Audiology
• Otolaryngology
• Biomedical Engineering

Background:

• Cochlear implant (CI) programming requires regular audiology follow-up for optimal device performance.
• Current protocols involve multiple visits in the first year post-activation, potentially increasing patient burden and healthcare costs.

Purpose of the Study:

• To develop an evidence-based protocol for audiology-based cochlear implant programming in the first year after activation.
• To evaluate the necessity of specific follow-up intervals based on patient outcomes.

Main Methods:

• Retrospective case review of 171 patients (178 ears) implanted between 2016 and 2021.
• Analysis of consonant-nucleus-consonant monosyllabic word recognition scores at preoperative, 1, 3, 6, and 12 months post-activation.
• Programming optimization based on CI-aided thresholds and electrically evoked stapedial reflex thresholds.

Main Results:

• Significant improvements in word recognition were observed from preoperative to all post-activation time points for both CI-alone and bilateral best-aided conditions.
• No significant differences in CI-alone scores were found between 3-6 months or 6-12 months post-activation.
• Significant differences in bilateral best-aided scores were observed between 1-3 months and 3-6 months, with no difference between 6-12 months.

Conclusions:

• Clinical follow-up schedules for adult cochlear implant patients could potentially be optimized.
• Eliminating either the 3- or 6-month audiology visit may be feasible if stimulation levels are validated.
• This could streamline care without compromising auditory rehabilitation outcomes.