Cochlear implants: growing pains.

Objectives/hypothesis: 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.

Study Design: 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.

Conclusion: 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.