The 2ears2hear team recently posted an article showing the strong New Zealand trend towards bilateral cochlear implants for children. Some of the key observations are:
- The majority (54%) of babies and infants (0-2years) are now getting bilateral cochlear implants. This is a lift from 32% in 2012. It is now becoming normal for babies and infants to have bilateral cochlear implants.
- Every age category has seen a lift in the percentage of children with bilateral cochlear implants over 2012.
- The number of children with bilateral cochlear implants has increased from 52 in 2012 to 81 in 2013.
- All the growth in children numbers in the last year has come from bilateral cochlear implants. The number of children with unilateral implants has decreased by 1. The number of children with bilateral implants has increased by 29.
- The number of pre-schoolers (under 5yo) with cochlear implants has increased by 3 to 50 children. The percentage of these pre-schoolers with unilateral cochlear implants has decreased by 12% while the number with bilateral cochlear implants has increased by 50%.
In New Zealand we are fortunate to have just two implant programmes whose data we can combine to get a national picture. In most countries there is very little national data because of the large numbers of implant programmes, the competitive nature of their health systems and for the majority of countries, they only really do bilateral implants (and have done for many years) for children.
Recently we came across some data that shows the international trends in bilateral implants.This data is for both children and adults, so masks to a certain extent the magnitude of the increase in children getting bilateral implants. Given the New Zealand data, the increase will be almost entirely due to children getting bilateral implants.
The data shows:
- That globally 10 years ago bilateral surgeries made up just 3% of all surgeries. They now make up 17%.
- In developed countries 10 years ago bilateral surgeries represented just 4% of all surgeries. They now represent 25% of surgeries.
This big lift is principally because of the almost universal adoption of bilateral implantation for children across the developed world.
This observation is supported anecdotally. Recently a large Australian study had to add New Zealand children to its study so that it could get enough unilaterally implanted children. They couldn’t find enough unilaterally implanted children in Australia because bilateral implantation is the standard.
On social media communities children with unilateral children are now a rarity. One Facebook community for parents has a poll which shows around 80% of children have bilateral implants. Another 13% were either waiting to get bilateral implants or were bi-modal (using a hearing aid in the other ear).
It is clear that bilateral implantation is the normal approach for bilaterally profound hearing loss in children in developed countries. In New Zealand, a developed country, we retain an archaic approach where we will provide bilateral hearing for children with moderate to severe hearing loss (NZ funds two hearing aids) but we will only provide unilateral hearing for those with severe to profound hearing loss (funding only one cochlear implant). In other words we provide less to those who have the most to catch up.