New consensus paper to address cochlear implant gap

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Australian experts have contributed to the development of the first-ever global consensus on the use of cochlear implants for the management of adults living with hearing loss.

The consensus paper has been published in JAMA Otolaryngology. The paper was authored by a new panel, including 31 hearing experts from surgical and audiology backgrounds, and seven representatives from patient and professional societies representing more than 13 countries including Australia.

According to Professor Robert Briggs, medical director of the cochlear implant program at The Royal Victorian Eye and Ear Hospital and a co-author of the paper, the consensus is a major landmark in the treatment of hearing loss.

“This is the first international agreement on the best way to diagnose and treat severe to profound hearing loss in adults,” said Professor Briggs. “This consensus paper provides a framework for countries around the world, including Australia, to optimise care for adults and reinforces the importance of health professionals referring people with severe to profound hearing loss for a cochlear implant assessment.”

Professor Briggs told HealthDispatch the consensus paper represents an important step forward in addressing the current gap in the number of people receiving implants and those who could benefit.

Just 10-12 per cent of Australian adults who could benefit from a cochlear implant has one.

The paper includes 20 statements covering seven categories for adults with severe, profound, or moderate sloping to profound hearing loss in both ears. Each statement was agreed upon by the panel members following consultation with a Consumer and Professional Advocacy Committee (CAPAC).

Categories include the level of awareness of cochlear implants; best practice clinical pathway for diagnosis; best practice guidelines for surgery; clinical effectiveness of cochlear implants; factors associated with post-implantation outcomes; the relationship between hearing loss and depression, cognition and dementia; and, cost implications of cochlear implants.

Associate Professor Catherine Birman, medical director at the Royal Institute of Deaf and Blind Children’s Sydney cochlear implant program, spoke of the important role that audiologists, audiometrists and other health professionals play in raising the standard of care for adults with hearing loss.

“While Australia and New Zealand have a comparatively high rate of penetration for cochlear implants, it’s still lower than it should be. It’s up to surgeons, audiology experts, primary care professionals and healthcare organisations to work together to increase referrals and make these standards a reality,” said Associate Professor Birman.

According to Ms Sue Walters, NSW President of the Australian cochlear implant user support group CICADA, the consensus paper can raise awareness of cochlear implants and improve referral and treatment pathways for adults living with severe to profound hearing loss.

“More Australians could benefit from life-changing hearing technology including cochlear implants. I’ve so often had recipients say to me," said Ms Walters.

In many countries, including Australia, adults do not have their hearing assessed as part of regular health check-ups. Of those who receive hearing checks and are diagnosed with severe to profound hearing loss, few are referred to a hearing specialist to examine whether an implantable hearing device could be the most beneficial treatment option.

Professor Briggs added, “This consensus paper could be a significant milestone for the hearing loss community locally and globally. It has laid the groundwork for surgeons, audiologists, primary care professionals and healthcare organisations to work together to make these standards a reality."