Building the Cochlear Implant Program of the Future

PROGRAM DESCRIPTION: Cochlear implants are the most successful neuroprosthesis in medicine. However, there are numerous areas for us to improve the field of cochlear implantation. This panel will address several topics to expand, optimize, and improve how we manage our patients with hearing loss, with a focus on approaching our patients as a multi-disciplinary team. First, research has estimated that just 2% to 13% of adults meeting cochlear implant candidacy actually become implant users. We will discuss approaches to expand access to cochlear implantation such as through same-day implantation programs and bundling approaches. Second, our current clinical programs deliver excellent care, but through a complicated and multi-step process. We will discuss evidence-based approaches to streamline the evaluation and post-operative management process to decrease demands on our patients, and free up clinician schedules for new CI candidates and CI patients with complex needs. Third, our field needs to expand what we consider cochlear implant “outcomes” to align better with the needs of our patients. We will discuss approaches to broaden outcomes assessments in the clinic and in the laboratory, such as through use of patient-reported outcome measures and behavioral measures beyond speech recognition, including discussion of evidence-based approaches to implant programming. Finally, music continues to be a challenging area for cochlear implant patients. Seeing as our meeting this year is in “Music City,” we will provide an update on music perception and appreciation in cochlear implant users along with new data showing how incorporation of image-based cochlear implant programming, estimates of electrical spread of excitation, and personalized counseling may help optimize music for our patients.

OUTCOME OBJECTIVE 1: Recognize limitations in the field of cochlear implantation that impair optimizing access and outcomes.

OUTCOME OBJECTIVE 2: Discuss methods to increase cochlear implant access and streamline our clinical care.

OUTCOME OBJECTIVE 3: Discuss broader ways to measure cochlear implant outcomes.

BACKGROUND STATEMENT: Despite their success, cochlear implants are thoroughly underutilized. The future of cochlear implantation needs to consider how to broaden and streamline access and to broaden how we assess outcomes to be more relevant to real-world performance.