Author(s)
Adam J. Van Horn, MD
Casey M. Fitzgerald, MD
Matt L. Bush, MD
Teresa R. Harmon, BS
Kenneth C. Iverson, MD
Christopher H. Azbell, MD
Affiliation(s)
Department of Otolaryngology, Univ. of Kentucky, Lexington, KY.
Abstract:
Introduction: Cochlear implantation involves a multi-disciplinary approach to care with a complex process through which patients & families must navigate. This study reviews our institution’s experience with a dedicated cochlear implant (CI) coordinator to assist with arranging appointments with otolaryngology, audiology, and necessary imaging and laboratory studies. Families’ abilities to navigate from initial otolaryngology (ENT) evaluation to implantation are assessed before and after initiation of the coordinator position. The primary objectives of this study were to compare delivery of care between pediatric patients who underwent cochlear implantation before and after the hiring of a pediatric CI coordinator.
Methods: Retrospective case-control series of pediatric cochlear implant patients. Patient-specific information along with clinical and surgical dates were recorded. Differences between pre- and post-coordinator groups were assessed with t-test and chi-squared analysis.
Results: 40 consecutive patients under 18 years old were reviewed from 2015-2018, both before and after implementation of the CI coordinator position. Among all patients, mean days from initial evaluation to implantation were decreased in the post-coordinator group, 82 v. 229 days (p=0.035). For patients who initially presented as a CI candidate in infancy, there was no difference between the groups for on-time implantation, defined as implantation prior to one year of age (p=0.71).
Conclusion: Our institution developed a CI coordinator position to help patients negotiate the intricacies of ENT and audiologic care. In our experience, duration of the preoperative work-up did not change with the start of this position. We have seen decreased time between initial ENT evaluation and surgical implantation in our pediatric CI population.