Hearing preservation cochlear implantation in children: The HEARRING Group consensus and practice guide.

OBJECTIVES: To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines on who is a candidate, how to assess these children and when to implant if Med-El Flex electrode arrays are chosen for implantation. METHODS: The HEARRING group reviewed the current evidence and practice regarding the management of children to be considered for HPCI surgery emphasizing the assessment needed prior to implantation in order to demonstrate the benefits in these children over time. The consensus statement addresses following three key questions: (1) Should these children be treated? (2) How to identify these children? (3) How to manage these children? SUMMARY: The HEARRING group concludes that irrespective of the degree of residual hearing present, the concepts of hearing and structure preservation should be applied in every child undergoing cochlear implantation and that HPCI is a safe and reliable treatment option. Early detection and multidisciplinary assessment are key to the identification of children with symptomatic PD, these children should undergo HPCI as early as possible.

Patient management for cochlear implant recipients in audiology departments: A practice review.

OBJECTIVES: To determine and evaluate the time clinics needed to complete the sub-processes involved in the first-fitting and follow-up fitting of people with a cochlear implant. METHODS: Eight HEARRING clinics completed a questionnaire recording how long it took to complete the sub-processes involved in first-fitting and follow-up fitting cochlear implant recipients. The mean times of clinics and procedures were then compared. RESULTS: Questionnaires on 77 patients were completed. Clinics varied widely on time spent on each sub-process in both first- and follow-up fittings. Total first-fitting times were similar across clinics. Follow-up fitting times varied more across clinics although this may have been due to differences in questionnaire interpretation. DISCUSSION: If a patient management plan can help increasingly busy cochlear implant clinics provide high-quality care more efficiently, essential first steps are determining which procedures are generally performed and how long their performance takes. Until reliable data are gathered, constructing a patient management plan or reaping the potential benefits of its use will remain elusive; clinics will have to find what solutions they can to meet rising workload demands. CONCLUSION: The variation in time spent on each sub-process may suggest that some clinics have more efficient workflow procedures. Compiling a best practice for each process could be instrumental in creating a professional process management plan that would increase efficiency without sacrificing quality of care.

Quality standards for bone conduction implants.

CONCLUSION: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. OBJECTIVES: To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. METHOD: To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. RESULTS: Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.