Early cochlear implantation in children with complex medical needs: A multidisciplinary approach

Objectives: To determine if children with hearing loss and additional medical diagnoses are achieving early cochlear implantation when compared to their peers with hearing loss as their sole diagnosis. Study design: Retrospective study. Setting: Pediatric outpatient clinic. Patients: 43 infants diagnosed with bilateral hearing loss, at least severe to profound sensorineural hearing loss (SNHL) in one ear, by three months of age and received cochlear implant(s) between 2017 and 2022. Main outcome measure: Difference in cochlear implant (CI) evaluation time between patients with additional medical diagnoses and patients with hearing loss only. Results: 20 patients had additional diagnoses and 23 had hearing loss without other diagnoses. On average, patients with additional diagnoses had a longer CI evaluation time than patients without an additional diagnosis (13.5 months evaluation period for patients with additional diagnosis vs 12 months for patients without additional diagnosis). Appointments prior to cochlear implantation were reviewed for both groups. There was no difference in the number of appointments with the core CI team between the two groups studied. Patients with additional diagnoses had significantly more appointments with specialties outside of the core CI team prior to cochlear implantation than their peers. Conclusions: Patients with additional diagnoses had a longer CI evaluation time than those with hearing loss alone. This may be attributed to the need for appointments with medical specialties outside of the core CI team. A medical diagnosis in addition to hearing loss should not preclude a child from progressing through the candidacy evaluation process. However, it may be helpful to manage expectations regarding the potential delays in cochlear implantation.