Journal article
Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss A Systematic Review and Consensus Statements
JAMA otolaryngology-- head & neck surgery, Vol.146(10), pp.942-953
10/01/2020
DOI: 10.1001/jamaoto.2020.0998
PMID: 32857157
Abstract
IMPORTANCE Cochlear implants are a treatment option for individuals with severe, profound, or moderate sloping to profound bilateral sensorineural hearing loss (SNHL) who receive little or no benefit from hearing aids; however, cochlear implantation in adults is still not routine.
OBJECTIVE To develop consensus statements regarding the use of unilateral cochlear implants in adults with severe, profound, or moderate sloping to profound bilateral SNHL.
DESIGN, SETTING, AND PARTICIPANTS This study was a modified Delphi consensus process that was informed by a systematic review of the literature and clinical expertise. Searches were conducted in the following databases: (1) MEDLINE In-Process & Other Non-Indexed Citations and Ovid MEDLINE, (2) Embase, and (3) the Cochrane Library. Consensus statements on cochlear implantation were developed using the evidence identified. This consensus process was relevant for the use of unilateral cochlear implantation in adults with severe, profound, or moderate sloping to profound bilateral SNHL. The literature searches were conducted on July 18, 2018, and the 3-step Delphi consensus method took place over the subsequent 9-month period up to March 30, 2019.
MAIN OUTCOMES AND MEASURES A Delphi consensus panel of 30 international specialists voted on consensus statements about cochlear implantation, informed by an SR of the literature and clinical expertise. This vote resulted in 20 evidence-based consensus statements that are in line with clinical experience. A modified 3-step Delphi consensus method was used to vote on and refine the consensus statements. This method consisted of 2 rounds of email questionnaires and a face-to-face meeting of panel members at the final round. All consensus statements were reviewed, discussed, and finalized at the face-to-face meeting.
RESULTS In total, 6492 articles were identified in the searches of the electronic databases. After removal of duplicate articles, 74 articles fulfilled all of the inclusion criteria and were used to create the 20 evidence-based consensus statements. These 20 consensus statements on the use of unilateral cochlear implantation in adults with SNHL were relevant to the following 7 key areas of interest: level of awareness of cochlear implantation (1 consensus statement); best practice clinical pathway from diagnosis to surgery (3 consensus statements); best practice guidelines for surgery (2 consensus statements); clinical effectiveness of cochlear implantation (4 consensus statements); factors associated with postimplantation outcomes (4 consensus statements); association between hearing loss and depression, cognition, and dementia (5 consensus statements); and cost implications of cochlear implantation (1 consensus statement).
CONCLUSIONS AND RELEVANCE These consensus statements represent the first step toward the development of international guidelines on best practices for cochlear implantation in adults with SNHL. Further research to develop consensus statements for unilateral cochlear implantation in children, bilateral cochlear implantation, combined electric-acoustic stimulation, unilateral cochlear implantation for single-sided deafness, and asymmetrical hearing loss in children and adults may be beneficial for optimizing hearing and quality of life for these patients.
Details
- Title: Subtitle
- Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss A Systematic Review and Consensus Statements
- Creators
- Craig A. Buchman - Washington University in St. LouisRene H. Gifford - Vanderbilt University Medical CenterDavid S. Haynes - Vanderbilt University Medical CenterThomas Lenarz - Hannover Medical SchoolGerard O'Donoghue - Nottingham University Hospitals NHS TrustOliver Adunka - The Ohio State University Wexner Medical CenterAllison Biever - Rocky Mountain MS CenterRobert J. Briggs - University of MelbourneMatthew L. Carlson - Mayo Clinic in FloridaPu Dai - Department of Otolaryngology, General Hospital of People's Liberation Army, Beijing, China.Colin L. Driscoll - Mayo ClinicHoward W. Francis - Duke UniversityBruce J. Gantz - University of IowaRichard K. Gurgel - University of Utah HospitalMarlan R. Hansen - University of IowaMeredith Holcomb - Medical University of South CarolinaEva Karltorp - Karolinska University HospitalMilind Kirtane - King Edward Memorial Hospital and Seth G.S. Medical CollegeJannine Larky - Stanford UniversityEmmanuel A. M. Mylanus - Radboud University NijmegenJ. Thomas Roland - NYU Langone Health, New York University School of Medicine, New York.Shakeel R. Saeed - UCL Ear InstituteHenryk Skarzynski - Institute of Physiology and Pathology of HearingPiotr H. Skarzynski - World Hearing Ctr, Inst Physiol & Pathol Hearing, Kajetany, Nadarzyn, PolandMark Syms - Arizona Hearing Center, Phoenix.Holly Teagle - University of AucklandPaul H. Van de Heyning - Antwerp University HospitalChristophe Vincent - Centre Hospitalier Régional et Universitaire de LilleHao Wu - Shanghai Ninth People's HospitalTatsuya Yamasoba - University of Tokyo HospitalTerry Zwolan - University of Michigan–Ann Arbor
- Resource Type
- Journal article
- Publication Details
- JAMA otolaryngology-- head & neck surgery, Vol.146(10), pp.942-953
- Publisher
- Amer Medical Assoc
- DOI
- 10.1001/jamaoto.2020.0998
- PMID
- 32857157
- ISSN
- 2168-6181
- eISSN
- 2168-619X
- Number of pages
- 12
- Grant note
- Oticon Medical Advanced Bionics MED-EL Cochlear Ltd
- Language
- English
- Date published
- 10/01/2020
- Academic Unit
- Molecular Physiology and Biophysics; Neurosurgery; Otolaryngology
- Record Identifier
- 9984297606802771
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