(0930) Evaluation of a De-Escalated Postoperative Cochlear Implant Programming Protocol

Introduction: Cochlear implantation (CI) is an expanding treatment option for significant hearing loss but requires a time commitment from patients for device programming. CI programming appointments tend to be numerous, disrupting patients’ lives and financially burdening both patients and CI programs. At our institution, prior to July 2022, patients were scheduled for 10-16 visits in the first year, depending on whether they had unilateral or bilateral CIs. This study assesses the feasibility of a schedule deescalated to 4 programming appointments in the first year after CI.

Methods: Patients who underwent CI in the 5 months following implementation of the new schedule and were 1 year post implantation were identified. Their charts were reviewed for demographic information, schedule adherence and reasons for additional appointments. Consonant-Nucleus-Consonant (CNC) monosyllabic word scores were collected for adult patients.

Results: In total, 48 patients were implanted during the first 5 months of the new programming schedule. Half (50%) were female and 58% were adults. Unilateral implantation was underwent by 71%, 13% explant and reimplant, 8% bilateral simultaneous, and 8% bilateral sequential implant. Of patients, 38% (n=18) adhered to 4 or less programming appointments in the first year after implantation, including the activation visit. Of these patients, the average post operative CNC score for adults (n = 13) was 59.7%, which is consistent with reported averages. A third (n = 16) had 1-2 additional programming appointments that had been scheduled based on the prior schedule. The remaining 23% (n = 11) had 1-4 additional appointments for equipment issues (n = 5), programming and usage concerns (n = 3), or unclear reasons (n = 3). Two patients were lost to follow up after activation.

Conclusions: A deescalated CI programming schedule of 4 visits in the first year after implantation is feasible for most CI patients. Transition to a deescalated schedule may take several months for schedulers and audiologist to adjust to; however, most patents will likely adhere to the reduced protocol.