AAA 2021 Virtual: When Is It Best to Refer My Patient for a Cochlear Implant Evaluation?

Presented at AAA 2021 Virtual

Presenter(s): Teresa A. Zwolan, PhD and Rene Gifford, PhD

Duration: 30 minutes

CEUs: 0.05 AAA CEUs

Instructional Level: Intermediate

Program Focus: Knowledge

Learning Outcomes: Upon completion, each participant in the eAudiology Web Seminar will be able to:

1. Describe the Delphi Consensus process recently used to develop consensus statements related to cochlear implants.
2. Describe the 60/60 guideline for referring adults for a traditional cochlear implant evaluation
3. List ways they can improve their clinical practice to ensure that patients who may be candidates for a cochlear implant are aware of this possibility.

Description:  

Abstract: Approximately 10% of patients who could benefit from a cochlear implant (CI) receive one. We'll review the Delphi CI process (Buchman et al., 2020) that resulted in CI consensus statements, with a focus on best practices related to awareness and identification of CI candidates.  Additionally, we'll review the 60/60 referral guideline, which recommends patients undergo a CI candidacy evaluation if they have an unaided PTA >  60 dBHL and/or an unaided word score < 60% in their better ear.

Summary: Roughly 10% of patients who could benefit from a cochlear implant (CI) actually receive one.  There are numerous possible reasons for this, including lack of awareness of CI among primary care and hearing health care professionals, lack of pure-tone audiometry screening procedures for adults, lack of clearly defined referral guidelines, and differences in test procedures performed by non-CI and CI audiologists.  

In this presentation, we will provide information regarding audiological best practices to include increased consideration of when patients should be referred for a CI candidacy evaluation (CICE).  We will review the findings from a recent International systematic review and consensus process (Buchman et al., 2020), which establishes a standard of care for the treatment of adult patients with unilateral cochlear implants.   We will describe the consensus statements developed during that process, with special focus on statements related to increasing awareness of CIs and identification of CI candidates. 

Additionally, we will discuss how the recently developed 60/60 guideline (Zwolan et al., 2020), which recommends patients  undergo a CI candidacy evaluation if they have an unaided PTA >  60 dBHL and/or an unaided word score < 60% in their better ear.  We will review how this guideline can be used in daily practice to identify patients who should be referred for a cochlear implant candidacy evaluation, including case presentations of patients who did/did not meet the 60/60 guideline. Finally, we'll discuss how counseling patients about their potential CI candidacy can impact their willingness to consider this treatment option for hearing loss.

Teresa A. Zwolan, PhD

Director, Cochlear Implant Program, Michigan Medicine

Teresa (Terry) Zwolan, Ph.D., CCC-A is a professor in the Department of Otolaryngology, Head & Neck Surgery and Director of the Cochlear Implant Program at the University of Michigan. She received her Ph.D. in Audiology from Northwestern University and has worked at the University of Michigan since 1990. She is actively involved in patient care, research, and administrative aspects of the program. She is co-founder of the American Cochlear Implant Alliance (ACIA) and served as ACIA’s vice-chair from 2011-2015. She is the Course Director for the Advanced Audiology Course for the Institute for Cochlear Implant Training (ICIT), and serves as an instructor for ICIT’s Surgeon and Auditory-Verbal therapist courses and is an adjunct faculty member for Wayne State University’s Graduate Program in Audiology. Dr. Zwolan has authored numerous papers that focus on clinical management of children and adults, and authored several book chapters related to cochlear implants.

Disclosure: Financial Disclosures: Cochlear Americas- Consultant/Advisory Board, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received; Envoy Medical- Consultant/Advisory Board; Institute for Cochlear Implant Training- Speaker/Honoraria, Course Director Advanced Audiology
Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.

Rene Gifford, PhD

Professor, Vanderbilt University Medical Center, United States

René H. Gifford, Ph.D. is a Professor in the Department of Hearing and Speech Sciences with a joint appointment in the Department of Otolaryngology at the Vanderbilt University Medical Center. She is currently the Director of the Cochlear Implant Program at the Vanderbilt Bill Wilkerson Center. Her current research interests include combined electric and acoustic stimulation (EAS) with cochlear implantation, hearing preservation with cochlear implantation, auditory and speech perception for adults and children with hearing loss, and spatial hearing abilities of individuals combining hearing aids and cochlear implants. Dr. Gifford's research has been NIH funded for nearly 20 years, she has published over 120 peer-reviewed articles, multiple book chapters, and is the author of two books entitled "Cochlear Implant Patient Assessment: Evaluation of Candidacy, Performance, and Outcomes" and "Cochlear Implants: From Principle to Practice."

Disclosure: Financial Disclosures: Advanced Bionics- Consultant/Advisory Board; Cochlear- Consultant/Advisory Board; Frequency Therapeutics- Consultant/Advisory Board; Oticon Medical- Speaker/Honoraria
Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.