Draft national guidelines have been developed for cochlear implantation (CI) in adults to address gaps in care, enhance access and outcomes, and boost the number of adults having implants.
The Australian and New Zealand Hearing Health Collaborative (ANZ HHC) has developed draft ANZ Living Guidelines for Cochlear Implant Referral, Candidacy and Outcome Evaluation in Adults.
The collaborative’s guidelines working group is seeking feedback before a final version is released mid-year.
The ANZ HHC is a ‘coalition of the willing’ led by four co-chairs. It comprises more than 70 volunteer members, including those with lived experience, expertise in audiology, ENT surgery and broader hearing health care.
“The development marks a significant milestone in hearing healthcare,” the co-chairs told HPA.
“By addressing the gaps in adult CI practices and providing a standardised framework, the ANZ HHC aims to improve outcomes and ensure equitable access to cochlear implants for all adults in Australia and New Zealand.”
The co-chairs are audiologists Dr Jaime Leigh from The Royal Victorian Eye and Ear Hospital, Professor Catherine McMahon and Professor Bamini Gopinath from Macquarie University, and ENT surgeon Associate Professor Payal Mukherjee representing the Royal Australasian College of Surgeons.
“The primary reason for developing these guidelines is to address the lack of standardised practices for adult cochlear implantation,” they said.
“To date there has been no comprehensive framework, applied nationally, to ensure consistent and effective care.
“Adults face fragmented care and inconsistent follow-up, leading to suboptimal outcomes. This initiative aims to fill that gap and provide clear, evidence-based recommendations for adult CI.”
Guidelines for children coming
The co-chairs said the experience for children being referred for cochlear implants was comparatively more streamlined and consistent due to established guidelines and protocols related to universal newborn hearing screening and the Hearing Services Program.
“There does, however, remain a need for national guidelines for CI in children to be developed and this is being progressed by a recently established Commonwealth working group,” they said.
Many adults have, however, slipped through the system, with inadequate follow-up and support, they added.
“Inquiries often lead to dead ends, and many adults who could benefit from cochlear implants are not receiving them. The guidelines will address these issues by providing a clear pathway for diagnosis, referral, and treatment.”
Lack of awareness among GPs
The co-chairs said a significant challenge had been the lack of awareness among GPs and other health professionals about the benefits of cochlear implants for adults.
“The guidelines will help raise awareness and educate healthcare providers, ensuring that more adults are referred for CI and receive the care they need,” they said.
“Only 10-11% of adults who could benefit from a CI have them in Australia. The guidelines aim to improve this adoption rate by providing a structured approach to care, making it easier for adults to access and benefit from cochlear implants.”
The area is growing, with about 45% of cochlear implants now in adults. The increasing demand underscored the urgent need for standardised guidelines to ensure adults received timely and effective care, they said.
“By standardising the process and improving the system’s preparedness to handle adult CI cases, the guidelines will encourage more adults to consider and receive cochlear implants,” the co-chairs explained.
“This will ultimately lead to better hearing outcomes and quality of life for many individuals.”
Previously, cochlear implantation for adults was not standardised, leading to varied practices and outcomes, the co-chairs said.
The draft guidelines, developed by the ANZ HHC guidelines working group, incorporate evidence-based research, clinical expertise, and feedback from people with lived experience.
Adapted from the Global Living Guidelines, which are based on global best practices and expert clinical consensus, the initiative aims to provide standardised, patient-focused practices that enhance equitable access and outcomes across Australia and New Zealand.
The group has been developing the guidelines since 2021. The process involved extensive research, consultation, and feedback to ensure they are comprehensive and effective.
“The feedback process will be open indefinitely to ensure the guidelines are truly living, consider all forms of feedback and can be adjusted when new evidence is created or shifts in practice are made, allowing clinicians, community groups, professionals, and individuals with lived experience to provide input,” the chairs said.
“This ensures the guidelines truly serve the needs of the communities they are designed to support.”
They are expected to be released in mid-2025 after feedback and final revisions.
“We invite readers to review the draft guidelines and provide feedback to ensure they align with the needs of ANZ audiology professionals and the broader hearing health community,” the co-chairs said.
People can click this link, download the document, add comments and return feedback to anzguidelines@adulthearing.com
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