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Otorinolaringologia 2009 June;59(2):107-17

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

The cochlear implant in foreign countries

Burdo S.

Servizio di Audiovestibologia Ospedale di Circolo e Fondazione Macchi, Varese, Italia


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Knowledge of foreign countries’ laws and welfare in the field of cochlear implants can be a useful stimulus to improve the Italian situation. However, discussions are frequently affected not only by our traditional xenophilia, not justified by objective data, but also by the comparison with countries with a different number of inhabitants. For what concerns the legislation, Italy is clearly among the few countries that have not provided guidelines or advices to organize cochlear implant Centres, the framework and extent of their activities. This weakness is probably to blame for the proliferation of centres with small number of cases, and the excessive number of adult recipients rather than pediatrics. Regarding surgical indications, all regulations considered are based on Food and Drug Administration basic candidate variables: age, degree of deafness and contraindications. As per age, most laws indicate a minimum age of 12 months, with the exception of postmeningitis deafness; there are no limits regarding maximum age, and severe deafness with little hearing aid benefit is the first level of cochlear implant candidacy. Neural aplasia is considered an absolute contraindication. Other countries have also regulated Auditory Brainstem Implants indications. Finally, the review of the literature and legislation considers the costs of cochlear implantation procedure comparing European and North American centres.

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