Deafness and Cochlear Implants

Beaumont Hospital is the centre for delivering Ireland’s national cochlear implant programme with surgical provision for patients under six (6) years carried out in the Children’s UniversityHospital at Temple Street. Since the programme commenced seventeen years ago, over 700 patients have received cochlear implants.

In 2009 the UK’s National Institute for Health and Clinical Excellence (NICE) recommended simultaneous bilateral cochlear implantation as best practice for children. For children who had already had a single implant, NICE recommended that they ‘should have the option of an additional contralateral implant only if this is considered to provide sufficient benefit by the responsible clinician after an informed discussion with the individual person and their carers’. No dedicated programme for simultaneous or sequential implantation is being carried out in Ireland at this time. However, some bilateral implantation has already occurred for patients, mainly very young children with certain medical conditions such as a history of meningitis or blindness.

Beaumont Hospital, HSE Management and the HSE’s Audiology Clinical Care Programme (ACCP)  met to discuss:
·        a joint process to identify the options for developing and resourcing a programme of simultaneous cochlear implantation in children into the future.
·        a joint planning process to identify the approach, costings and potentialavailable funding to address the sequential implantation case.   An important element of this will be the development of clear clinical criteria to prioritise clients for assessment and follow on implantation.

Background facts:

  • The current programme is delivered to an agreed number of implants/patients annually which stands currently at around 90 patients.
  • The current Beaumont Hospitalannual budget for provision of this service, inclusive of implants, is €4,098,281.
  • During 2012, 48 adults and 42 children received implants. The funding also supports the ongoing rehabilitation of over 700 patients on the programme.
  • The cost of a single implant is between €18,000 and €20,000.
  • It is estimated that there are approximately 200 children in Irelandtoday who may be suitable for a second implant.
  • Not all suitable patients proceed with the second implant when appraised of the all the issues involved.
  • Ten children have received bilateral implants due to specific medical conditions.
  • Children referred for unilateral implants are seen within four months from date of referral.
  • Depending on the multidisciplinary team assessment of the child, they normally receive their implant within six to seven months.
  • Adults referred for implants are seen within six to nine months from date of referral.
  • The waiting time for adults to receive their implant is up to two years.