Cochlear implants: growing pains.
OBJECTIVE
The objective was to make familiar the problems faced in the application of cochlear implants to the half-million to a million severe to profoundly deaf individuals who are potential beneficiaries of this technology.


METHODS
Observations accumulated during 23 years as Medical Director of the Manhattan Eye Ear Throat Hospital Cochlear Implant Center.


METHODS
The author reviewed insights gained while directing the Cochlear Implant Center since the early 1980s at Manhattan Eye, Ear and Throat Hospital (New York, NY).


RESULTS
The rapid application of cochlear implant technology for patients with severe to profound hearing losses is creating critical problems. It is being hampered by inadequate reimbursement. There is a critical shortage of cochlear implant-trained audiologists, who are an essential keystone in the application of this technology. These audiologists are required to provide lifelong audiological services to patients who have received cochlear implants. At the same time, they must evaluate the exponentially growing number of new candidates.


CONCLUSIONS
The restoration of hearing with cochlear implants provides an enormous educational and societal benefit. However, the existing health care delivery system limits the application of cochlear implant technology. University audiological training programs must expand their curricula to include cochlear implant-related courses. The existing rehabilitation audiologist delivery system could be applied to provide long-term, community-based cochlear implant services.
Parisier
Simon C
SC
Department of Otolaryngology--Head and Neck Surgery, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. sparisier@aol.com
D001298:Audiology; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants / Q000706:statistics & numerical data / Q000639:trends*; D003430:Cross-Sectional Studies; D003638:Deafness / Q000453:epidemiology / Q000534:rehabilitation*; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000639:trends; D008134:Long-Term Care; D014481:United States; D000078329:Workforce