The French Cochlear Implant Registry (EPIIC): Cochlear implant candidacy assessment of off-label indications

Quatre, R.; Fabre, Christol; Aubry, Karine; Bordure, Philippe; Bozorg-Grayeli, Alexis; Deguine, Olivier; Eyermann, C.; Franco-Vidal, V.; Godey, Benoît; Guevara, N.; Karkas, Alexandre; Klopp, Norman; Labrousse, M.; Lebreton, J.-P.; Lerosey, Y.; Lescanne, E.; Loundon, Natalie; Marianowski, R.; Merklen, F P; Mezouaghi, K.; Mom, T.; Moreau, S.; Mosnier, Isabelle; Noël-Pétroff, N.; Parietti‐Winkler, Cécile; Piller, P.; Poncet, C.; Radafy, E.; Roman, S.; Roux-Vaillard, S.; Tavernier, L; Truy, Éric; Vincent, C.; Schmerber, S.

doi:10.1016/j.anorl.2020.07.012

Cited by 9 publications

(11 citation statements)

References 59 publications

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“…In addition to our findings, previous studies investigated the effect of CI criteria expansion, either by comparing groups classified by different CI criteria or by comparing pre‐ and postoperative scores in an expanded criteria group 4,6,51–54 . An overview is provided in Supplement II ‐ Table S6.…”

Section: Discussionmentioning

confidence: 77%

“…Preliminary evidence suggests that such criteria expansion can be justified on the basis of clinical outcomes 4 . Presumably, this might be due to less profound sensory deprivation and an increased chance of post‐operative residual hearing preservation 5,6 . Research demonstrates that pre‐operative residual hearing and duration of HL correlate with post‐operative outcomes 7,8 .…”

Section: Introductionmentioning

confidence: 99%

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Impact of Expanding Eligibility Criteria for Cochlear Implantation – Dynamic Modeling Study

et al. 2022

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Objectives Eligibility criteria for cochlear implantation (CI) are shifting due to technological and surgical improvements. The aim of this study was to explore the impact of further expanding unilateral CI criteria in those with severe hearing loss (HL) (61–80 dBHL) in terms of number of CI recipients, costs, quality of life, and cost‐effectiveness. Methods A dynamic population‐based Markov model was constructed mimicking the Dutch population in three age categories over a period of 20 years. Health states included severe HL (61–80 dBHL), profound HL (>81 dBHL), CI recipients, and no‐CI recipients. Model parameters were based on published literature, (national) databases, expert opinion, and model calibration. Results If persons with severe HL would qualify and opt for CI similar to those with profound HL now, this would lead to a 6–7 times increase of new CI recipients and an associated increase in costs (€550 million) and QALYs (54.000) over a 20‐year period (incremental cost utility ratio: 10.771 euros/QALY [2.5–97.5 percentiles: 1.252–23.171]). One‐way‐sensitivity analysis indicated that model outcomes were most sensitive to regaining employment, utility associated with having a CI, and costs of surgery and testing. Conclusion Our findings suggest that expanding eligibility for CI to persons with severe HL could be a cost‐effective use of resources. Clearly, however, it would require a significant increase in diagnostic, operative, and rehabilitative capacity. Our quantitative estimates can serve as a basis for a wider societal deliberation on the question whether such an increase can and should be pursued. Level of Evidence NA Laryngoscope, 133:924–932, 2023

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Impact of Expanding Eligibility Criteria for Cochlear Implantation – Dynamic Modeling Study

et al. 2022

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“…Demographic data and audiometric evaluation of 72 patients (66 AHL, 6 SSD) are reported in Table 1. The mean follow up was 3 +-1.8 years [1][2][3][4][5][6][7]. Only three AHL candidates did not use a hearing aid on the acoustic-hearing ear: two cases with mild hearing loss (PTA: 33 and 35 dB, respectively) and one vestibular schwannoma.…”

Section: Resultsmentioning

confidence: 99%

“…In France, cochlear implantation was recommended only in case of bilateral severe-to-profound hearing loss, but SSD/AHL with incapacitating tinnitus has been added to the criteria since September 2021. However, some CI centers have added other off-label indications (7). Most patients included in our study have been implanted because of an identified ear disease, with a risk of progressive decrease of speech intelligibility of the acoustic-hearing ear.…”

Section: Discussionmentioning

confidence: 99%

Middle-term cochlear implant use in case of asymmetric hearing loss and single-sided deafness: A retrospective single-centre cohort study

Louvel

Mosnier

Lahlou

et al. 2022

Preprint

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Key points: (no abstract required) • Cochlear implant effectiveness in asymmetric hearing loss and single-sided deafness is well established, but rarely covered by health care systems. • Continuation of wearing the implant beyond the first year could be considered as an indirect indicator of subjective benefit. • Percentage of cochlear implant abandon at 5-years post-implantation was very low in patients with asymmetric hearing loss and single-sided deafness. • High education level, low audibility and good unaided speech perceptions scores of the contralateral acoustic-hearing ear were positive prognostic factors of CI use. • The low percentage of non-users is an additional strong argument to recommend cochlear implantation in patients with asymmetric hearing loss and single-sided deafness, on the ear with a profound hearing loss, especially in case of frail contralateral acoustic-hearing ear.

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“…There is no clear audiologic cut-off point for CI candidacy, resulting in variable selection criteria proposed by institutions [ 22 – 24 ]. Given the difficulty of audiologic evaluation and its relevance to language development, decision making on CI in pediatric subjects tends to be more complicated and important than in adults [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of cochlear implants in children with borderline hearing who have already achieved significant language development with hearing aids

Kim

Lee

et al. 2022

PLoS ONE

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There are still debates about timing and effectiveness of cochlear implants (CI) in pediatric subjects with significant residual hearing who do not belong to traditional indication of CI. In this study, we aimed to investigate the outcomes of CI, specifically on improvement of pronunciation, among hearing-impaired children already with a substantial degree of language skills as evaluated by Categories of Auditory Perception (CAP) scores or sentence score. Our cohort comprised pediatric CI recipients from July 2018 through October 2020. Among them, cases with CAP scores of 5 or 6 preoperatively were defined as “borderline cases”. We investigated prevalence and etiologies, and compared speech evaluation data preoperatively and postoperatively at three time points (3, 6 and 9–12 months after implantation). Among 86 pediatric CI recipients, 13 subjects (15.12%) had language development that reached CAP scores of 5 or 6 before implantation. Postoperative speech evaluation data 6 months after implantation revealed significant improvement of pronunciation (Urimal Test of Articulation and Phonation scores: UTAP), Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and word perception scores, but not of CAP and sentence perception scores. Notably, the significant improvement of pronunciation based on UTAP scores outstripped that of other speech parameters and this continued steadily up to one-year postoperatively. The result of the study serves as evidence for what to expect from cochlear implantation in hearing-impaired children who have already achieved a substantial degree of language development in terms of CAP scores or sentence perception scores, preoperatively.

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The French Cochlear Implant Registry (EPIIC): Cochlear implant candidacy assessment of off-label indications

Cited by 9 publications

References 59 publications

Impact of Expanding Eligibility Criteria for Cochlear Implantation – Dynamic Modeling Study

Impact of Expanding Eligibility Criteria for Cochlear Implantation – Dynamic Modeling Study

Middle-term cochlear implant use in case of asymmetric hearing loss and single-sided deafness: A retrospective single-centre cohort study

Efficacy of cochlear implants in children with borderline hearing who have already achieved significant language development with hearing aids

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