Determining treatment choices after the cochlear implant evaluation process

Laryngoscope Investigative Otolaryngology

article

Andrew J. Redmann MD¹  Kareem Tawfik MD³  Theresa Hammer AuD⁴  Lisa Wenstrup AuD⁴  Shawn Stevens MD⁵  Joseph T. Breen MD⁶  Ravi N. Samy MD, FACS⁶ 

[1] Department of Otolaryngology—Head and Neck Surgery, University of Minnesota;Department of Pediatric Otolaryngology;Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University;Division of Audiology, University of Cincinnati College of Medicine, Cincinnati;Barrows Neurosurgical Clinic;Department of Otolaryngology—Head and Neck Surgery, University of Cincinnati, Cincinnati

关键词: cochlear implants;    evaluation process;    treatment pathways;   

DOI  :  10.1002/lio2.546

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objectives• Determine the proportion of patients starting the cochlear implant evaluation(CIE) process proceeding to cochlear implantation.• Determine which patient factors are associated with undergoing cochlear implantationMethods: Retrospective case series of all patients scheduled for a CIE within a tertiary academic neurotology practice between January 1, 2014 and April 30, 2016.Management pathways of patients undergoing CIE were examined.Results: Two hundred thirty-seven adult patients were scheduled for CIE during the studyperiod. Two hundred twenty-six patients started the evaluation process, and 203 patientscompleted full evaluation. Of patients that completed CIE, 166/203 (82%) met criteria forimplantation and 37/203 (18%) did not meet criteria. Fifty-nine patients out of 166 patients(36%) meeting criteria did not receive implants and 107/166 (64%) underwent implantation,yielding an overall implantation rate of 47% (107/226) among patients scheduled for CIE.Common reasons for deferring CI among candidates included failure to show up for preoperative appointment (24%), choosing hearing aids as an alternative (22%), patient refusal(21%) and insurance issues (17%). Overall, CIE led to a new adjunctive hearing device (CI orhearing aid) in 113 (113/203, 56%) cases.Conclusion: Fifty-six (113/203) percent of patients who underwent CIE at an academic medical center underwent CI surgery or received an adjunctive hearing device,but 36% (59/166) of candidates did not receive a CI. Patients who forewent CIdespite meeting candidacy criteria did so due to cost/insurance issues, or due to preference for auditory amplification rather than CI.

【 授权许可】

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