Experts want a nationwide study to be carried out on devices that could help profoundly deaf adults hear.
Bilateral cochlear implants are prosthetic devices which make use of electrode arrays surgically implanted in the cochlea of the inner ear to provide a sense of sound to those how have a profound loss of hearing, reports the Guardian.
Working with therapy they allow children born without hearing to develop excellent speech and language. One implant allows users to perceive speech and sounds, and a second enables users to locate sounds which enhance speech perception in busy environments.
Currently the National Institute for Health and Care Excellence only allow bilateral implantation in adults if they have a second disability which makes them reliant on hearing.
Experts are now calling for the guidelines to be revised to allow adults, like children, access to two implants. Azhar Shaida, consultant otologist and cochlear implant surgeon at London’s Royal National Throat, Nose and Ear hospital, said: “The problem is down to money versus benefit.” One implant costs the NHS between £38,000-£45,000, however it a second implant is placed simultaneously, only one procedure takes place meaning the cost does not double.
Labour MP Lilian Greenwood said: “The criteria are based on evidence from patients who were predominantly wearing technology from the late 1990s. Since then, there have been significant advances in technology. Many clinicians would argue that the criteria do not reflect real world listening, and that more realistic tests should be deployed.”
Stuart McNaughton, a lecturer at Westminster Business School who works for cochlear implant firm Advance Bionics, has an implant in each year. He says that the second device enables adults to reach their full potential. “I understand that children need more input because they are developing language and they are developing skills, but what about all the people over the age of 18, 19, 20, 21? They should be allowed bilateral implants as well. Society puts pressures on adults too – relationships, jobs – it’s a rat race out there.”
David Selvadurai, consultant otolaryngologist surgeon at St George’s Hospital, London, and founder of their cochlear implant programme, also believes adults should have access to two implants. However he does believe that it is vitally important that enough evidence is gathered. “What we don’t have at the moment is good cost benefit data to show that there’s enough benefit to the individual to demonstrate cost effectiveness for the NHS,” he said.
Colleagues at UCL’s Ear Institute, Shakeel Saeed, Professor at UCL and the RNTNEH, are assessing a national study on bilateral cochlear implantation in adults which is expected to take four to five years to complete. “This is to create high quality evidence that Nice can then use to make a considered decision,” he said. “If we complete that study, then we will be able to answer a very simple question: does the benefit of having two [implants] in adults justify the cost? We might find it doesn’t – but I suspect that we will find that it does.”
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