February 25th celebrates the device that changed the prospects for the treatment of serious and profound deafness. The new international guidelines for adults
A revolution of silence: the definition fits perfectly when it comes to cochlear implantation. Because this device, whose World Day falls on February 25 as well as the 65th anniversary of the world’s first cochlear implant surgery performed in 1957 in Paris, it really turned the therapeutic horizon upside down of severe and profound sensorineural deafness both in adults who have lost hearing during their lifetime and in children born deaf. For the latter, if identified in time, the cochlear implant totally restores hearing. And in the former, it helps to improve it significantly.
international task force
A task force of 52 global hearing experts has drafted new guidelines for the treatment of hearing problems. The recommendations underpinning these new guidelines guarantee guidance for hearing care professionals to improve standards of care for hearing problems in adults. As far as Italy is concerned, Dr Dominic Cudadirector of the Otorhinolaryngology Unit at the Piacenza hospital and professor Stephen Berrettini director of the University Otorhinolaryngology Audiology and Phoniatrics Unit of the University Hospital of Pisa and president of the Italian Audiology and Phoniatrics Society.
The recommendations
One of the nine recommendations in the guidelines states that if an adult has a average hearing threshold above 60dB in the better ear, or recognizes less than 60% of words the possibility of a cochlear implant should be considered. According to prof. Berrettini, one of the two Italian representatives in the task force, the new international guidelines represent an important step forward in defining the best standards of treatment for hearing problems in adults, both in Italy and in the rest of the world.
These new international guidelines are essential for ensure that medical decisions in the field of adult hearing problems are based on the strongest scientific evidence. Before today, there were no international patient-centred guidelines for hearing care and cochlear implants in adults. This publication is a landmark for hearing care professionals to understand the importance of communicating correct information to patients and give them access to the appropriate therapies for their hearing problems”.
Deafness in the world
According to the World Health Organization (WHO), the number of people living with hearing problems set to grow to 2.5 billion in 2050. Hearing issues are related to a reduced quality of life, cognitive impairment ea depression
. A growing number of scientific evidence suggests an association between hearing loss in adults and neurocognitive disorders such as dementia
. Furthermore, deafness can also affect the well-being of family members of people with hearing loss.
And in Italy
In Italy, most adults do not include hearing assessment in their periodic health check-ups. Furthermore, even those who, following checks, present a significant degree of deafness, often it is not addressed to the Audiology and Otorhinolaryngology departments, where all therapeutic options can be proposed, including the cochlear implant. Despite the potential benefit derived from the application of a cochlear implant in patients with significant hearing impairment, currently less than 1 in 10 adults eligible for implantation will undergo surgery in their lifetime.
The new guidelines collect recommendations regarding the programs of audiological surveillance, the timing and modalities of a specialist evaluation, rehabilitation and evaluation of post-implantation outcomes. The drafting of this document required two years of work, the analysis of more than 13,000 scientific articles and the work of a panel of 52 experts representing 58 international companies. Furthermore, these guidelines will be constantly updated in the light of new evidence.
What is the message for adults? Simple: test your hearing and know the alternatives to solve hearing problems says Professor Berrettini. Millions of adults live with an unrecognized and untreated major hearing problemwho can benefit not only from hearing aids but also from cochlear implants. When deafness is relevantIn fact, a point can be reached where simple amplification is not sufficient to improve communication performance, as it generates distortion instead of improving the intelligibility of words. QThis is the case when a cochlear implant is needed which, by bypassing the non-functioning parts of the auditory system, allows the ear to improve the perception of speech”.
Don’t put it off
But there’s more. Instead of preventing any interventions for deafness, many prefer to wait. People often put it off the search for a possible solution to their hearing problem until it becomes particularly impactful in everyday life. And even when they seek help, they often have to deal with different hearing care professionals who do not agree on a single line of treatment. Unfortunately, many are unaware of the cochlear implant and the benefits it could bring in many cases, says Professor Berrettini.
Through these guidelines, hearing-impaired adults and clinicians dealing with deafness will have evidence-based recommendations regarding who and when should be tested and referred to a cochlear implant center, and what standards of care they should receive if they are candidates for the procedure, he concludes.
February 25, 2023 (change February 25, 2023 | 16:16)
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