Authors' objectives:

This study has two objectives. First, to review, in light of the existing scientific evidence, the costs, effectiveness, benefit or utility of the cochlear implants (CI). This report aims to answer if this technology is able to provide a benefit to the implanted patients compared to other available technologies, improving their deafness, and to determine the health and economic costs (efficiency).

The second objective is to update an AETS previous report and to review the state of the art of CI in pre and post-lingually deaf adults and children in order to define safety, efficacy and indications, contra-indications with emphasis in the limitations of this technique, epidemiological aspects and costs.

Authors' recommendations: The multichannel CI is a technique which allows acquisition of hearing in congenitally, prelingually deaf children, and improvement also in postlingually deaf children and adults, in a significant way when compared with patients without them. CI is indicated in patients with deep bilateral neurosensory deafness located in the cochlea, with adecuate motivation and unsuitable for any other prosthetic alternative, although maybe the criteria will be expanded in future. It is absolutely necessary to have a multi-disciplinary well integrated team and a program that permits the different phases (correct selection and follow-up of the patients, implantation, programation and rehabilitation). In the prelingually deaf children we deem that the age of implantation should be at its best at the interval of 2 and 5 years. Parents and patients should be informed of the potential benefits and risks of the technique in order to maximize rehabilitation benefits. The preventive vaccination of all patients is recommended before treatment to reduce the number of meningitis cases. With more experience, it is hoped that the number of complications will decrease. Costs and health quality of life from the different studies have proved the cost-utility of the CI, with a very good position in the cost-effective technologies ranking.

Authors' methods: Systematic review, Cost study

Project Status: Completed

URL for project: http://www.isciii.es/aets/

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias (AETS)