An Assessment of the Clinical Acceptability of Direct Acoustic Cochlear Implantation for Adults With Advanced Otosclerosis in the United Kingdom. Issue 7 (August 2017)

• Record Type: Journal Article
• Authors: Kitterick, Pádraig Thomas; Reddy-Kolanu, Guna; Baguley, David; Lavy, Jeremey; Monksfield, Peter; Banga, Rupan; Ray, Jaydip; Snik, Ad; O'Donoghue, Gerard M.
• Is Part Of: Otology & neurotology. Volume 38:Issue 7(2017)
• Publication Date: 2017-08
• Subjects: Acceptability -- Clinical trials -- Consensus -- Delphi process -- Direct acoustic cochlear implantation -- Feasibility -- Otosclerosis; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000001450
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Hypothesis: Assess the clinical acceptability of direct acoustic cochlear implantation for patients with advanced otosclerosis and the support for conducting a controlled trial of its effectiveness in the United Kingdom. Background: Emerging evidence supports the efficacy of direct acoustic cochlear implantation in patients with advanced otosclerosis whose needs cannot be managed using the combination of stapes surgery and hearing aids. A controlled trial would provide evidence for its effectiveness and cost-effectiveness to healthcare commissioners. Methods: An online survey of clinical professionals was constructed to characterize current standard of care for patients with advanced otosclerosis and to assess whether clinicians would be willing to refer patients into a trial to evaluate direct acoustic cochlear implantation. A consensus process was conducted to define inclusion criteria for the future trial. Results: No survey respondent considered direct acoustic cochlear implantation to be inappropriate with a majority indicating that they would refer patients into a future trial. The consensus was that there is a lack of available treatment options for those patients with bone conduction thresholds worse than 55 dB HL and who did not meet current criteria for cochlear implantation. Conclusion: The present study confirms that a controlled trial to evaluate the effectiveness of direct acoustic cochlear implantation would have the support of clinicians in the United Kingdom. A feasibility study would be required to determine whether patients who meet the inclusion criteria could be recruited in a timely manner and in sufficient numbers to conduct a formal evaluation of effectiveness.