Rehabilitation of adult patients with severe-to-profound hearing impairment – why not cochlear implants?

Abstract

Background: In Sweden, an estimated prevalence of adult patients with severe-to-profound hearing loss is 0.2%, which corresponds to roughly 20,000. We know little about the use of cochlear implants (CIs) in this population and why not most of them are not offered CI.Objectives: To investigate the reasons for no rehabilitation with CI among this patient group.Materials and methods: Data were collected from 1076 patients in the Swedish Quality Register of Otorhinolaryngology. A baseline questionnaire and the reason for no CI, was evaluated.Results: Only 14.5% of the patients started a CI investigation, and 8.5% were rehabilitated with CI. Significantly more women (56.5%) than men received CI. The most common reasons for not receiving CI, were hearing reason (30.5%), indicating satisfaction with technical equipment, and unknown reason (25%). The oldest patient group (81–100 years old) had the highest risk for unknown reasons. Patients receiving extended audiological rehabilitation (53.5%) had a significantly lower risk for unknown reasons.Conclusions: It is worrying that the oldest patient group (81–100 years old) seemed to have fewer chances to start a CI investigation. An extended audiological rehabilitation increased the chances that professionals would discuss CI.Significance: This study shows that surprisingly few patients are offered CI despite their severe-to-profound hearing loss.