Outpatient rehabilitation after cochlear implant

Background and objective. This study compares the results of the outpatient -based program of the Cochlear Implant Center Ruhr with in patient-based re habilitation, which is almost exclusively performed in Germany. Patients/methods. The Department of Otorhinolaryngology at the University o f Essen in Germany provided 52 patients with either 22- or 24-channel Nucle us cochlear implants from March 1996 to July 1999. Almost all patients (n=4 9) were rehabilitated on an outpatient basis, which is the standard in ma n y cochlear implant centers outside Germany. Results. The longest follow-up period at the University of Essen Department of Otorhinolaryngology was 36 months. Minor complications occurred in 10% of the patients. After 24 months, the first three implanted patients were a ble to discriminate 100% of numbers and over 60% of syllables in the Freibu rg speech discrimination test. The patients who developed an understanding of open speech were able to discriminate 31 words per minute with cochlear implant and without lipreading after 24 months. Children were seen to doubl e their Schmid-Giovannini scores at 6 months postimplantation. Conclusions. The Essen outpatient-based cochlear implant program demonstrat es results in speech development and speech understanding equal to those of centers providing inpatient rehabilitation. A special advantage is continu ous rehabilitation with professionals known to the child for several years. In children especially, exhaustive commuting reduces school attendance and is a burden on the accompanying guardians. As an inpatient, however, the c hild is torn from his familiar environment. Parents with several children h ave particular difficulties in accompanying their child and indeed this may not always be possible.