GOOD PRACTICE STATEMENT 1

To raise awareness of cochlear implants as a potential treatment option in the future, hearing healthcare specialists should be proactive in discussing cochlear implants with adults who have progressive hearing loss.

Good Practice Statement 2

Hearing healthcare specialists should endeavour to convey that cochlear implantation is part of the hearing health continuum and not an end-stage treatment. Encouraging the exploration of cochlear implantation early may improve future uptake for adults with progressive hearing loss who do not currently meet the cochlear implant eligibility criteria.

Addendum

Specialist Evaluation - addendum. Recommendations for a cochlear implant evaluation. This area is well served by existing guidelines. The CI Task Force reviewed the following existing guidelines (all linked).

1. German Weißbuch guidelines

2. AWMF Guideline S017/71 – S2k Guideline Cochlear Implantation German Society of Oto-RhinoLaryngology, Head and Neck Surgery, 2020

3. American Academy of Audiology CLINICAL PRACTICE GUIDELINE: COCHLEAR IMPLANTS

4. Turton et al. 2020 Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss

Rationale

No studies were identified that met the inclusion criteria for research question five. A review of the existing guidelines found no evidence or recommendations pertaining to the reassessment and monitoring of individuals who do not meet cochlear implant eligibility criteria. Following consultation with the CI Task Force, a consensus-based recommendation was developed.

The recommendation is focused on ensuring that adults with hearing loss who do not currently meet the cochlear implant candidacy criteria are not lost to follow-up in the future. Recent reports have observed that only 10% of adults who would benefit from cochlear implantation will actually receive one in their lifetime. While the underutilisation of cochlear implants is the product of various factors, patient loss to follow-up likely accounts for a significant proportion of potential cochlear implant candidates going untreated.

A review of current guidelines has recommended that adults should have their hearing re-evaluated every 1–3 years in order to effectively monitor their hearing level. This reassessment is necessary to ensure accurate tracking of any changes in an adult’s hearing abilities.1,2,3,4 The CI Task Force also revealed that those adults who have sensorineural hearing loss but do not meet the criteria should be reassessed more frequently. The recommended time frame for this indication was at least 6–12 months. Similarly, those adults who experience a significant change in their hearing ability or communication should also be reassessed within this time frame.