LM207 - Demystifying the Complexities of Cochlear Implant Candidacy

Abstract:
In this course, we will describe current trends in cochlear implant (CI) candidacy and review practical tools to support audiologists on when to evaluate and/or refer for a CI evaluation. Case studies will be presented of patients who were referred for a CI and were or were not deemed candidates, with a review of the procedures used to determine CI candidacy. Presenters will emphasize non-traditional cases including patients who do not align with traditional candidacy criteria but still benefit from CI. Attendees will be provided with evidence-based, clinically applicable knowledge to apply in clinical practice.

Summary:
Often described as the most successful neural prosthesis developed to date, numerous investigations have substantiated the multitude of benefits of cochlear implants (CI) for both children and adults. Despite the robust body of evidence that has demonstrated the effectiveness of CI in the treatment of sensorineural hearing loss, utilization remains low. Barriers to treatment have been investigated in adult CI users in the United States and point to the absence of chronic hearing loss as a public health issue, further complicated by a fragmented and uncoordinated healthcare delivery pathway for individuals with hearing loss. In recent years, candidacy for CI has expanded appreciably, which should in theory make CI a more viable option for patients than ever before. However, there exists both within the healthcare professions and in the general population an unfamiliarity with CI candidacy criterion. Indeed, a granular view into hearing healthcare practice validates that professionals lack familiarity with both traditional and expanded criteria for CI, bolstered by poor communication between CI programs hearing aid dispensers, and diagnostic audiologists. Additionally, there are varied criteria across clinics regarding when to refer for or recommend CI as a treatment intervention for chronic hearing loss.

Guidelines such as the “60/60” have been developed in recent years to educate professionals about “when” to refer for a CI evaluation (Zwolan et al., 2020). However, even these guidelines miss potential candidates, most notably those individuals with usable low-frequency acoustic hearing and/or those with unilateral deafness. Additionally, these guidelines do not provide a framework to support patients who fall outside of FDA labeling, but who may benefit from CI based on the current evidence base and clinician experience.

In this case-based course, the presenters will describe current trends in cochlear implant (CI) candidacy and review practical tools to support audiologists on when to evaluate and/or refer for a CI evaluation. Case studies will be presented of patients who were referred for a CI and were or were not deemed candidates, with a review of the procedures used to determine CI candidacy. Presenters will emphasize non-traditional cases including patients who do not align with traditional candidacy criteria but still benefit from CI. Attendees will be provided with evidence-based, clinically applicable knowledge to apply in clinical practice.