The knowledge and beliefs regarding practical aspects of cochlear implants: A study of otorhinolaryngologists in a secondary setting in a multi-country study

Objective Cochlear implant is the standard treatment of choice for children and adults with severe to profound sensorineural hearing loss. The main objective of this study was to assess the knowledge, attitude and practices regarding cochlear implant among doctors other than otolaryngologists in a tertiary care academic institution. Method A 24-item knowledge, attitude and practices questionnaire was developed based on an extensive literature review and expert opinion and was administered to 100 non-otolaryngologists in a tertiary care academic institution to be completed in about 15 minutes. The data obtained was analysed to assess knowledge, attitude and practices regarding cochlear implant in this group. Results The results showed that awareness regarding the option of cochlear implants for elderly and unilateral deafness was deficient. Surgeons and doctors in higher specialties did better when it came to practice related to cochlear implant. The age and experience of doctors also improved knowledge and practice with regards to cochlear implant. Conclusion Improving awareness about cochlear implants and their benefits among non-otolaryngology colleagues can ensure that more people who could potentially benefit from cochlear implants will receive appropriate counselling and referral.

With 25% of people experiencing disabling hearing loss by the age of 70, Europe cannot afford to ignore what this would mean for its ageing population. Untreated hearing loss could result in an annual cost of 213 billion euros to Europe's economies. In addition to depriving an individual of a sense, hearing loss adversely affects the mental health, cognitive functioning, mortality and employment of an individual, while also being linked with comorbidities such as stroke, diabetes and dementia. Although cochlear implants (CIs) are recognised as cost-effective solutions for adults and children with severe to profound hearing loss, less than 10% of adults who could benefit receive a CI. Additionally, the provision varies hugely across Europe and around the world. CIs could potentially have an enormous impact on quality of life as well as providing long term savings to national health systems. However, referral guidelines for CIs across European member states lack consistency and clear referral pathways and guidelines need to be developed. The sharing of best practice and strategies for the prevention, screening, diagnosis and treatment of severe hearing loss with innovative solutions, such as cochlear implants, have the potential to maximise hearing health for all European citizens.

Some degree of disabling hearing loss is present in 466 million people worldwide, representing 5% of the world's population and the majority of these are adults over 65 years old. Hearing loss is associated with increased risks of social isolation, depression, dementia, stroke, vision loss, diabetes and mortality. It is in the top five causes of years lived with disability in 2015, 2016 and 2017 for males and top 10 for females. Hearing aids are a suitable treatment for mild to moderate loses but for some they do not provide enough benefit. Cochlear implantation is a proven and effective treatment for bilateral severe to profound hearing loss, yet despite good funding in high income countries, the utilisation of CI is poor (less than 10% of suitable patients), especially in the older adult population who arguably need it most. Prevalence data shows that hearing loss increases with age, but the provision of implants in the over 65 s is even lower, despite there being no clinical barriers to older adults receiving a CI. Survey data shows that awareness activities are needed for both professionals and the general population to improve knowledge of what a CI is and how it can help.