Frankfurt concept of early inpatient rehabilitation after cochlear implant treatment : Feasibility for aftercare.

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The Association of the Scientific Medical Societies in Germany (AWMF) clinical practice guideline on cochlear implant (CI) treatment, which was updated in 2020, defined the entire process of CI care for the first time. In the present study, the feasibility and results of very early rehabilitation were examined. The intervention group (IG) comprised 54patients in whom rehabilitation was initiated within 14(maximally28) days after implantation. Patients with asignificantly longer waiting time were included in the control group (CG, n = 21). In addition to the start and duration of rehabilitation, the speech intelligibility achieved with CI was recorded at different timepoints within a12-month period. In addition, questionnaires were used to assess the effort of fitting the CI processor and the patients' satisfaction with the outcome as well as the timing of the start of rehabilitation. Median waiting time between implantation and start of rehabilitation was 14days in the IG and 106days in the CG; 92.6% of IG patients were able to start rehabilitation within 14days. The effect of rehabilitation in the IG was 35and in the CG 25percentage points (Freiburg monosyllabic test). After 6and 12months of CI use, both groups showed comparable results in the test condition in quiet (IG/CG6months: 70%/70%; 12months: 70%/60%, Freiburg monosyllabic test) and in noise (IG/CG6months: -1.1 dB SNR/-0.85 dB SNR; 12months: -0.65 dB SNR/+0.3 dB SNR, Oldenburg sentence test). Hearing quality assessment scores collected by SSQ (Speech, Spatial and Qualities of Hearing Scale) questionnaire showed better scores in the IG at 6months, which converged to CG scores at 12months. The IG was significantly more satisfied with the timing of the start of rehab than the CG. All other data obtained from questionnaires showed no differences between the two groups. Avery early start of inpatient rehabilitation after cochlear implantation was successfully implemented. The rehabilitation was completed within 7weeks of CI surgery. Comparison of speech recognition test results before and after rehabilitation showed asignificant improvement. Aclear rehabilitation effect can therefore be demonstrated. Inclusion of CI rehabilitation in the German catalog of follow-up treatments is thus scientifically justified and therefore strongly recommended.