Leena Asfour, Michelle Coppola, Samantha Espinal, Meredith A Holcomb
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引用次数: 0
Abstract
Objective: Cochlear implantation often requires frequent post-operative programming visits which can disrupt daily life, impose financial burdens, and delay access for new cochlear implant (CI) candidates. This study evaluated the feasibility of a de-escalated schedule of four programming appointments within the first year after surgery.
Methods: A retrospective review was completed for 236 patients aged 0-100 years who received CI from July 2022 to December 2023. Explants, reimplants and second CI within the study window were excluded. Collected data included demographics, schedule adherence, additional visit reason, and Consonant-Nucleus-Consonant (CNC) word scores for adults.
Results: A total of 201 CI recipients (mean age 46.9 years; 72.6% adults) met inclusion criteria. Most were male (53%), White (88%), Non-Hispanic (54.7%), and privately insured (56.2%). Overall, 53% adhered to the 4-visit protocol, 35% required 1-2 additional visits, and 12% required 3-6. Among those requiring additional appointments (n = 95), 28.4% followed the prior protocol of up to 10+ visits. Adherence to the new streamlined protocol improved by 43% over the study period. On multivariate analysis, each additional year of age at surgery reduced the odds of adherence by 3.4% (p < 0.05). No statistical or clinical differences were observed in 12-month CNC scores between patients with ≤ 4 versus > 4 visits.
Conclusions: A de-escalated post-CI programming schedule of four visits in the first year is feasible and does not compromise adult speech perception outcomes. Older patients may require closer follow-up. Successful implementation may require time for workflows and provider adoption.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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