One Cochlea is better than two – says who?

According to NICE having 2 (bilateral) cochlea implants is not recommended for adults unless they have other problems – such as blindness.  Well they’re wrong!

I spent part of yesterday at Cardiff University listening to Professor John Culling presenting some soon to be published research on the topic which clearly shows that there are significant benefits to the individual from having 2 implants.

(Jelfs, S., Talbert, A. and Backhouse, S. S. (in press) “The benefit of bilateral versus unilateral cochlear implantation to speech intelligibility in noise” Ear and Hear.”).

The figures are clear – this new research has highlighted the inadequacies of the original data and presents a compelling case for a bilateral approach – but perhaps what we’re looking at is another case of where money/budgets seems to be the primary focus not patient care and well-being.

According to the National Institute on Deafness and Other Communication Disorders: A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin (see figure).

Illustration of cochlear implant.

An implant does not restore normal hearing. Instead, it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech.

The British Cochlear Implant Group believes that if a patient meets the criteria for a cochlear implant as specified in the NICE Guidance, funding for that treatment must be provided by the appropriate healthcare commissioning body following a positive assessment by the specialist cochlear implant centre.

The data it presents on implants is stark – 28 new bilateral adult implant cases between April 1st 2010 to March 31st 2011 – but 494 unlilateral adult cases. That’s a lot of people who will still be hard pressed to separate speech from background noise!

This looks like a problem which has been parked

NICE’s guidelines clearly state a review date of February 2011 – but it would appear that this has not happened and it’s now February 2013 hmmm…….

Time to act especially when we have just witnessed David Cameron speaking in the House of Commons,  saying he was “truly sorry” for what happened at Stafford Hospital, which was “not just wrong, it was truly dreadful” and the government needed to “purge” a culture of complacency.

If I could quote Sir David Nicholson – “We need action, we need to make things happen.”

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