gms | German Medical Science

Introduction: In rural areas of Germany there is an increasing lack of not only general practitioners but also medical specialists which made the government introduce a public program to support those regions. Especially for older people hard of hearing it is difficult to get access to a cochlear implant program.

Material and methods: Retrospectiv analysis of the audiological and medical results of the patients who were implanted in Bad Hersfeld between 2003 and 2013. Special attention was laid on the subgroup of patients older than 65 years of age.

Results: So far 158 patients were implanted with a total of 195 devices. 36 patients received an implant bilaterally. The sex ratio was equal. The average age was 53.9 years with a range of 8 months and 88 years. Due to technical device failure a reimplantation was necessary in 6 cases.

The audiological results (Figure 1 [Fig. 1], Figure 2 [Fig. 2]) demonstrated a speech understanding of 78.6% in the HSM-sentence test postoperatively to 3.9% preoperatively. The Freiburger test of monosyllables showed an understanding of 51.9% at 60 dB and 70.4% at 80 dB in comparison to 0,5% and 2.6% respectively prior surgery. Comparing the adult patients it is interesting to mention that the 54 patients older than 65 years had slightly better results than the 65 recipients younger than 65 years (Figure 3 [Fig. 3], Figure 4 [Fig. 4]). We did not observe any major complication such as facial palsy or an inflammation. One malinsertion of the electrode in a dysplastic cochlea was succesfully managed by revision surgery.

Conclusion: Our results prove that cochlear implantation can be performed safely and effectively even in a rural setting. However to achieve this high quality the establishment of a competent multiprofessional team is a prerequesite. Patients appreciate the possibility of getting an individual care even at a non-university department.