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Cochlear Implants in Adults and Children
NIH Consensus Development Panel on Cochlear Implants in Adults and Children;
George A. Gates, MD;
Kathleen Daly, PhD;
William J. Dichtel, MD;
Robert J. Dooling, PhD;
Aina Julianna Gulya, MD;
Joseph W. Hall III, PhD;
Susan W. Jerger, PhD;
Jacqueline E. Jones, MD;
Margaret H. Mayer, EdD;
Michael Pierschalla;
Lainie Friedman Ross, MD, MPhil;
Richard G. Schwartz, PhD;
Barbara E. Weinstein, PhD;
Eric D. Young, PhD;
Paul J. Abbas, PhD;
Peter Blarney, PhD;
Derald E. Brackmann, MD;
Judith A. Brimacombe, MA;
Patricia M. Chute, EdD;
Noel L. Cohen, MD;
Michael F. Dorman, PhD;
Donald K. Eddington, PhD;
Bruce J. Gantz, MD, FACS;
James W. Heller, PE;
Darlene R. Ketten, PhD;
John F. Knutson, PhD;
Patricia A. Leake, PhD;
Hugh J. McDermott, PhD;
Richard T. Miyamoto, MD;
Jean S. Moog, MS;
Mary Joe Osberger, PhD;
Robert V. Shannon, PhD;
Margaret W. Skinner, PhD;
Quentin Summerfield, PhD;
Emily A. Tobey, PhD;
Susan B. Waltzman, PhD;
Blake S. Wilson, BSEE;
Teresa A. Zwolan, PhD;
Amy M. Donahue, PhD;
Marin P. Allen, PhD;
Lucille B. Beck, PhD;
Elsa A. Bray;
Judith A. Cooper, PhD;
John H. Ferguson, MD;
Marilyn Neder Flack, MA;
George A. Gates, MD;
William H. Hall;
F. Terry Hambrecht, MD;
Norman Krasnegor, PhD;
Andrew A. Monjan, PhD, MPH;
Ralph F. Naunton, MD;
John H. Ferguson, MD;
James B. Snow, Jr, MD;
Richard J. Hodes, MD;
Duane F. Alexander, MD;
Zach W. Hall, PhD
JAMA. 1995;274(24):1955-1961.
Abstract
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Objective.
—To provide clinicians and other health care providers with a current consensus on the benefits, limitations, and technical and safety issues that need to be considered in the use of cochlear implants.
Participants.
—A nonfederal, nonadvocate, 14-member consensus panel representing the fields of otolaryngology, audiology, speech-language pathology, pediatrics, psychology, and education, and including a public representative. In addition, 24 experts in auditory anatomy and physiology, otolaryngology, audiology, aural rehabilitation, education, speech-language pathology, and bioengineering presented data to the consensus panel and a conference audience of 650.
Evidence.
—The literature was searched through MEDLINE and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience.
Consensus.
—The panel, answering predefined consensus questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature.
Consensus Statement.
—The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference.
Conclusions.
—Cochlear implantation improves communication ability in most adults with severe-to-profound deafness and frequently leads to positive psychological and social benefits as well. Currently, children at least 2 years old and adults with profound deafness are candidates for implantation. Cochlear implant candidacy should be extended to adults with severe hearing impairment and open-set sentence discrimination that is less than or equal to 30% in the best-aided condition. Access to optimal education and (re)habilitation services is important for adults and is critical for children to maximize the benefits available from cochlear implantation.
(JAMA. 1995;274:1955-1961)
Author Affiliations
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Conference and Panel Chairperson, Professor of Otolaryngology-Head and Neck Surgery, Director of Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle; Assistant Professor, Department of Otolaryngology, University of Minnesota, Minneapolis; Associate Clinical Professor, Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Roanoke; Professor, Department of Psychology, University of Maryland, College Park; Professor, Department of Otolaryngology-Head and Neck Surgery, Georgetown University, Washington, DC; Professor, Department of Surgery, Division of Otolaryngology, University of North Carolina at Chapel Hill; Professor and Director, Children's Special Hearing Section, Department of Otorhinolaryngology, Baylor College of Medicine, Houston, Tex; Assistant Professor, Department of Otolaryngology, Cornell University Medical College/New York Hospital, New York, NY; Coordinator for Teacher Education and Research, Northwest School for Hearing-Impaired Children, Seattle, Wash; Cambridge, Mass; Assistant Professor, Department of Pediatrics and MacLean Center for Clinical Medical Ethics, University of Chicago (Ill); Professor, PhD Program in Speech and Hearing Sciences, City University of New York (NY); Associate Professor of Audiology, Director, Audiology Program, Lehman College, City University of New York (NY); Professor, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md.; Chairperson, Acting Chief, Hearing and Balance/ Vestibular Sciences Branch, Division of Human Communication, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Md; Chief, Program Planning and Health Reports Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Md; Associate Chief, Audiology and Speech Pathology Service, Department of Veterans Affairs, Washington, DC; Program Analyst, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Deputy Director, Division of Human Communication, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Rockville, Md; Director, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Senior Scientific Reviewer/Audiologist, Ear, Nose, and Throat Devices, Center for Devices and Radiological Health, Office of Device Evaluation, Food and Drug Administration, Rockville, Md; Conference and Panel Chairperson, Professor of Otolaryngology-Head and Neck Surgery, Director of Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle; Director of Communications, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Head, Neural Prosthesis Program, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md; Chief, Human Learning and Behavior Branch, Center for Research for Mothers and Children, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md; Chief, Neurobiology of Aging Branch, Neuroscience and Neuropsychology of Aging Program, National Institute on Aging, National Institutes of Health, Bethesda, Md; Director, Division of Human Communication, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Rockville, Md.; Office of Medical Applications of Research, National Institutes of Health; National Institute on Deafness and Other Communication Disorders; National Institute on Aging; National Institute of Child Health and Human Development; National Institute of Neurological Disorders and Stroke; US Department of Veterans Affairs, Jesse Brown, Secretary.
Footnotes
NIH Consensus Development Conferences are convened to evaluate available scientific information and resolve safety and efficacy issues related to a biomedical technology. The resultant NIH Consensus Statements are intended to advance understanding of the technology or issue in question and to be useful to health professionals and the public.
NIH Consensus Statements are prepared by a non-advocate, nonfederal panel of experts, based on (1) presentations by investigators working in areas relevant to the consensus questions during a 2-day public session, (2) questions and statements from conference attendees during open discussion periods that are part of the public session, and (3) closed deliberations by the panel during the remainder of the second day and morning of the third day. This statement is an independent report of the panel and is not a policy statement of the NIH or the federal government.
Preparation and distribution of this statement is the responsibility of the Office of Medical Applications of Research of the National Institutes of Health. Free copies of this statement and bibliographies prepared by the National Library of Medicine are available from the Office of Medical Applications of Research, Federal Bldg, Room 618, 7550 Wisconsin Ave MSC 9120, Bethesda, MD 20892-9120 (William H. Hall) or the NIH Consensus Program Information Service by 24-hour voice mail at (800) NIH-OMAR (644-6627). Full-text versions of all these statements are also available on-line through the NIH Information Center Bulletin Board System at (800) NIH-BBS1 (644-2271) and through the Internet using Gopher (gopher://gopher.nih.gov/Health and Clinical Information), file transfer protocol (ftp:// public.nlm.nih.gov/hstat/nihcdcs), or the World Wide Web (http://texts.nlm.nih.gov/nih/nih.html).
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