Telemedicine-Enabled Multidisciplinary Preoperative Workflow for Humanitarian Cochlear Implant Delivery.

Abstract

Telemedicine may facilitate multidisciplinary cochlear implant (CI) candidate evaluation in settings where access to specialized otologic and audiologic care is limited. This study evaluated an online, multidisciplinary preoperative workflow for CI candidate selection and surgical planning during a high-volume humanitarian campaign supported by the King Salman Humanitarian Aid and Relief Centre (KSrelief). In this descriptive study, 142 children with severe-to-profound hearing loss underwent online review by a committee of otologists, audiologists, and speech-language pathologists, based on audiologic data, caregiver-submitted speech and communication videos, and high-resolution CT/MRI imaging. The primary outcome was the adequacy of online assessment for preoperative planning and case preparedness. Online assessment provided sufficient information for surgical planning across all evaluated domains, with sufficiency rates of 100% for audiologic data, 97.2% for speech-language data, and 95.1% for imaging data. Cochlear implantation was completed over three consecutive operative days (30 cases on day 1, 66 on day 2, and 46 on day 3). Preoperative online imaging review enabled early recognition of anatomical complexity and supported efficient resource preparation (including electrode availability and surgical planning), facilitating successful implantation of all scheduled children. A small proportion of cases required intraoperative electrode plan adjustment. Postoperative radiography confirmed correct array placement in all but one case, and surgical complications were infrequent and manageable. A structured online multidisciplinary preoperative workflow was essential to enabling surgical planning and coordinated cochlear implant delivery at this scale and pace in a humanitarian setting.