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When to Refer for CI and What Happens Next

  • Audiology
  • General Panel

Saturday, November 12, 2022

8:00 AM - 9:00 AM

The Boca Raton Grand G-H
CEU Hours:   0.100

Session Description

Cochlear implants (CIs) have been FDA-approved for both children and adults for more than 30 years, and even though they are widely accepted as the preferred hearing treatment for patients with significant hearing loss, great confusion exists regarding when it is best to refer a patient for a CI candidacy evaluation. This is particularly true in recent years as candidacy has focused less on the patient’s best aided performance and has placed greater emphasis on the ear to be treated, as evidenced by the FDA’s recent approval for CIs in cases of single sided deafness (SSD) and asymmetric hearing loss (AHL). During this presentation, we will review basic audiometric test results that can be used to determine if a patient should be referred for a CI candidacy evaluation. The discussion will include a review of the 60/60 – a guideline developed to assist clinicians when making decisions regarding such a referral.
Once a patient is referred to a cochlear implant (CI) center, the audiologic portion of the CI evaluation is the first step in determining candidacy. While hearing aid verification, aided speech perception testing, and device counseling are key components of this appointment, it is also crucial to evaluate the whole patient and assess if they would truly benefit from CI technology. In this session, we will review the importance of each step of the CI evaluation, and how this appointment can impact patient expectations, post operative outcomes and insurance decisions.
This session will also address the medical and surgical considerations in cochlear implantation. Hearing loss may progress beyond what hearing-aid amplification can adequately address. Patients with inadequately habilitated hearing loss are at risk of social isolation, depression, and earlier dementia, necessitating appropriate intervention with cochlear implants. Several medical considerations exist, including anatomic suitability, medical fitness for surgery and device considerations. A great deal of disinformation must also be overcome as to the nature and risks of the surgery, which in experienced hands is trivial. These considerations will be presented from an ear surgeon’s perspective.

Session Objectives

Objectives • At the end of this presentation, participants will be able to describe the 60/60 Guideline for Referring Adults for a Cochlear Implant Candidacy Evaluation. • At the end of this presentation, participants will be able to discuss the medical implications of untreated or under-treated hearing loss. • At the end of this presentation, participants will be able to describe two key components of the cochlear implant evaluation.