Hanneke Bruijnzeel1,2, Aren Bezdjian1,2,3, Anke Lesinski-Schiedat4, Angelika Illg4, Konstance Tzifa5, Luisa Monteiro6, Antonio Della Volpe7, Wilko Grolman1,2, Vedat Topsakal2,8,9. 1. a Department of Otorhinolaryngology and Head and Neck Surgery , University Medical Center Utrecht , The Netherlands. 2. b Brain Center Rudolf Magnus , University of Utrecht , Utrecht , The Netherlands. 3. c Department of Experimental Surgery , McGill University , Montreal , Quebec , Canada. 4. d Medizinische Hochschule Hannover , Deutsches HörZentrum Hannover der HNO-Klinik , Hannover , Germany. 5. e The Midlands Hearing Implant Program - Children's Service , Birmingham Children's Hospital NHS Foundation Trust , Birmingham , UK. 6. f Pediatric Otolaryngology and Cochlear Implantation , Dona Estefânia Children's Hospital , Lisbon , Portugal. 7. g Otology and Cochlear Implant Unit , Santobono-Pausilipon Children's Hospital , Naples , Italy. 8. h Department of Otorhinolaryngology and Head and Neck Surgery , Antwerp University Hospital , Antwerp , Belgium. 9. i University of Antwerp , Antwerp , Belgium.
Abstract
OBJECTIVES: International guidelines indicate that children with profound hearing loss should receive a cochlear implant (CI) soon after diagnosis in order to optimize speech and language rehabilitation. Although prompt rehabilitation is encouraged by current guidelines, delays in cochlear implantation are still present. This study investigated whether European countries establish timely pediatric CI care based on epidemiological, commercial, and clinical data. METHODS: An estimation of the number of pediatric CI candidates in European countries was performed and compared to epidemiological (Euro-CIU), commercial (Cochlear®), and clinical (institutional) age-at-implantation data. The ages at implantation of pediatric patients in eight countries (the Netherlands, Belgium, Germany, the United Kingdom, France, Turkey, Portugal, and Italy) between 2005 and 2015 were evaluated. RESULTS: From 2010 onwards, over 30% of the pediatric CI candidates were implanted before 24 months of age. Northern European institutions implanted children on average around 12 months of age, whereas southern European institutions implanted children after 18 months of age. The Netherlands and Germany implanted earliest (between 6 and 11 months). DISCUSSION: Implemented newborn hearing screening programs and reimbursement rates of CIs vary greatly within Europe due to local, social, financial, and political differences. However, internationally accepted recommendations are applicable to this heterogeneous European CI practice. Although consensus on early pediatric cochlear implantation exists, this study identified marked delays in European care. CONCLUSION: Regardless of the great heterogeneity in European practice, reasons for latency should be identified on a national level and possibilities to prevent avoidable future implantation delays should be explored to provide national recommendations.
OBJECTIVES: International guidelines indicate that children with profound hearing loss should receive a cochlear implant (CI) soon after diagnosis in order to optimize speech and language rehabilitation. Although prompt rehabilitation is encouraged by current guidelines, delays in cochlear implantation are still present. This study investigated whether European countries establish timely pediatric CI care based on epidemiological, commercial, and clinical data. METHODS: An estimation of the number of pediatric CI candidates in European countries was performed and compared to epidemiological (Euro-CIU), commercial (Cochlear®), and clinical (institutional) age-at-implantation data. The ages at implantation of pediatric patients in eight countries (the Netherlands, Belgium, Germany, the United Kingdom, France, Turkey, Portugal, and Italy) between 2005 and 2015 were evaluated. RESULTS: From 2010 onwards, over 30% of the pediatric CI candidates were implanted before 24 months of age. Northern European institutions implanted children on average around 12 months of age, whereas southern European institutions implanted children after 18 months of age. The Netherlands and Germany implanted earliest (between 6 and 11 months). DISCUSSION: Implemented newborn hearing screening programs and reimbursement rates of CIs vary greatly within Europe due to local, social, financial, and political differences. However, internationally accepted recommendations are applicable to this heterogeneous European CI practice. Although consensus on early pediatric cochlear implantation exists, this study identified marked delays in European care. CONCLUSION: Regardless of the great heterogeneity in European practice, reasons for latency should be identified on a national level and possibilities to prevent avoidable future implantation delays should be explored to provide national recommendations.
Entities:
Keywords:
Cochlea; Cochlear implants; Deafness; Early medical intervention; Hearing loss; Pediatrics; Sensorineural; Surgical procedures; operative
Authors: Anita Gáborján; Gábor Katona; Miklós Szabó; Béla Muzsik; Marianna Küstel; Mihály Horváth; László Tamás Journal: Eur Arch Otorhinolaryngol Date: 2022-06-29 Impact factor: 3.236