International Consensus Supports Wider Use of Cochlear Implants

Damian McNamara

September 02, 2020

"Awareness of cochlear implantation among primary and hearing health care clinicians is inadequate, leading to under identification of eligible candidates. Clearer referral and cochlear implantation candidacy pathways would help increase access to cochlear implants."

That is the first consensus statement in a new international document on the use of unilateral cochlear implants among adults with severe, profound, or moderate sloping to profound bilateral sensorineural hearing loss.

To arrive at the consensus statements, which was published online August 27 in JAMA Otolaryngology – Head and Neck Surgery, a panel of 31 experts conducted a systematic literature review, considered the findings in light of their own clinical expertise, and then spent 9 months reaching agreement using a Delphi consensus method. They also considered input from cochlear implant users and patient advocacy groups.

The resulting 20 consensus statements focus on unilateral cochlear implants and address the clinical effectiveness of cochlear implants, best practices from diagnosis to surgery, factors linked to post-implant outcomes, and associations of hearing loss with depression, cognition, and dementia, as well as cost.

"The recommendations for surgeons, audiology experts and health care providers are crystal clear," panel chair Craig Buchman, MD, head of the Department of Otolaryngology at Washington University School of Medicine in St. Louis, Missouri, stated in a news release.

The experts hope their international consensus article will improve awareness and help reverse global underutilization of the devices. The authors note that previous research suggests that only 1 in 20 people who could benefit from a cochlear implant have one.

Funding from Advanced Bionics, Cochlear Ltd, MED-EL, and Oticon Medical supported the Delphi process and medical writing. These funding organizations did not contribute to the design, facilitation, or content of the Delphi consensus process.

JAMA Otolaryngol Head Neck Surg. Published online August 27, 2020. Full text

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