title: Cochlear implantation in developing countries as humanitarian service: physician attitudes and recommendations for best practice.
abstract: OBJECTIVE
  To make recommendations concerning cochlear implantation during humanitarian medical trips by exploring the attitudes of US cochlear implant surgeons.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Academic.
  
  
  METHODS
  Questionnaires were sent to 405 members of the William House Cochlear Implant Study Group. The 198 respondents (49%), all active cochlear implant surgeons, were divided into 3 groups depending on their level of experience working in a developing country.
  
  
  RESULTS
  Eighty-nine percent of respondents supported cochlear implants in these environments, although 42% of these cochlear implant surgeons stated that they would modify their criteria for implantation considering the challenges in developing countries. There was strong support for cochlear implants in postlingual deafened patients and prelingual deafened patients under the age of 3 years, although nearly half of respondents (48%) would not implant prelingual deafened patients after they reached the age of 3 years. Three-quarters of respondents (74%) believed that developing countries should have the same access to current multichannel devices used in developed countries, as opposed to simpler, possibly lower cost devices. A local audiologist was deemed the most important personnel requirement (83%), and limited audiology and rehabilitative resources were the greatest postoperative concern rather than lack of postoperative care or infection.
  
  
  CONCLUSIONS
  . This survey strongly supports the practice of performing cochlear implants during humanitarian trips to developing countries and makes best-practice recommendations to make outcomes successful.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. james.saunders@hitchcock.org
authors.forename: James
authors.initials: J
authors.lastname: Saunders
authors.forename: David
authors.initials: D
authors.lastname: Barrs
mesh_terms: D000328:Adult; D000367:Age Factors; D000533:Altruism; D001291:Attitude of Health Personnel; D019985:Benchmarking; D002675:Child, Preschool; D019929:Cochlear Implantation; D003430:Cross-Sectional Studies; D003638:Deafness / Q000534:rehabilitation*; D003906:Developing Countries; D006302:Health Services Research; D006801:Humans; D007223:Infant; D011795:Surveys and Questionnaires; D014481:United States