Decentralized Cochlear Implant Programming Network Improves Access, Maintains Quality, and Engenders High Patient Satisfaction.

Abstract

Cochlear implants have become a powerful tool in managing patients with moderate to profound sensorineural hearing loss and lack of benefit from hearing aids. Currently, less than 10% of people who would benefit from a CI receive the treatment. This lack of access is multi-factorial yet largely due in part to an inadequate referral system. The purpose of the current study was to evaluate speech outcomes and patient satisfaction for adult cochlear implant (CI) recipients in a single-surgeon, high volume CI center that uses a decentralized network (DCN) of private practice programming audiologists. Retrospective case series. Tertiary otology/neurotology practice. Adult CI recipients implanted between April 2017 and August 2019. Surgical/rehabilitative. Speech outcomes (AzBio quiet) were evaluated 6-months post implantation. Patients were surveyed to determine satisfaction with programming services, surgical services, and CI benefit. The senior author (A.J.) performed 223 CI operations: 136 (61%) were programmed at the CI center and 84 (38%) at outside audiology clinics through a DCN. The 6-month speech outcomes (AzBio, quiet) revealed similar scores regardless of where programming services were received; CI center: 25% pre-op versus 55% post-op; DCN: 24% pre-op versus 59% post-op. Additionally, patients reported high-levels of satisfaction with programming services, surgical services, and CI benefit. A decentralized network of well-trained private practice audiologists who identify CI candidates and program their devices after surgery 1) improves patient access to cochlear implantation, 2) maintains excellent speech outcomes, and 3) engenders high levels of patient satisfaction.