Assessment of the cochlear implant pathway for newborn hearing screening referrals

Abstract

Objective

To evaluate the cochlear implant (CI) assessment pathway for children referred through the newborn hearing screening programme (NHSP) and identify potential reasons for delay in CI surgery at a large UK centre.

Methods

Retrospective analysis of electronic notes of children referred through NHSP from 2016 to 2019. Key points in the assessment pathway from referral to switch-on were assessed.

Results

Of the 46 referrals, 44 went on to have CI surgery. Median age at CI surgery was 15 months (interquartile range (IQR) 13 to 17 months). Only 5% of referrals were implanted before the age of 12 months. Delayed referral and the presence of otitis media with effusion (OME) were associated with delayed implantation. The median period of monitoring for OME was 48 days (IQR 20 to 93 days), with a natural resolution rate of only 11%. The median time from surgery to switch-on was 5 weeks (IQR 4.1 to 5.4 weeks).

Conclusion

Achieving implantation prior to the age of 12 months for NHSP referrals can be challenging for a variety of reasons. The delays in the system and the steps that our implant programme has taken to address these will be highlighted.

Keywords:

• Cochlear implant
• Hearing loss
• Paediatric
• Assessment
• Otitis media with effusion
• Newborn hearing screening

Acknowledgements

We would like to acknowledge Kathryn Allen, Clinical Scientist (Audiology) for her feedback on the data and for her help in implementing changes to the pathway following this audit.

Disclaimer statements

Contributors None.

Funding Professor M. Bance has research funded by Cambridge Hearing Group, Dr D. Vickers is funded by theMedical Research Council [grant number MR/S002537/1] and National Institute for Health Research [grant number NIHR201608] and other authors have no funding to declare.

Conflicts of interest The authors report no conflict of interest.

Ethics approval None.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Notes on contributors

Rajeev Mathew

Rajeev Mathew is a Senior Clinical Fellow in Otology and Skull Base Surgery at Cambridge University Hospitals.

Fernando Rodriguez Bajo

Fernando Rodriguez Bajo is a medical student at Cambridge University.

Nicola Hatton

Nicola Hatton is a Paediatric Audiologist at Cambridge University Hospitals.

Louise Buttfield

Louise Buttfield is a Paediatric Audiologist at Cambridge University Hospitals.

Shravan Gowrishankar

Shravan Gowrishankar is a medical student at Cambridge University.

Deborah Vickers

Deborah Vickers is a Speech and Hearing Scientist and Principal Investigator leading the SOUND lab at Cambridge University.

Neil Donnelly

Neil Donnelly is a Consultant Otologist and Skull Base Surgeon at Cambridge University Hospitals.

James Tysome

James Tysome is a Consultant Otologist and Skull Base Surgeon at Cambridge University Hospitals.

Manohar Bance

Manohar Bance is Professor of Otology and Skull Base Surgery at Cambridge University.

Patrick Axon

Patrick Axon is a Consultant Otologist and Skull Base Surgeon at Cambridge University Hospitals.