2023 Early Hearing Detection & Intervention Conference
March 5-7, 2023 • Cincinnati, OH
10/26/2019 | 2:15 PM - 3:15 PM | Breaking Down Walls: Initiation and Maturation of a Cochlear Implant Program in a Developing Country | Ventana Ballroom C
Breaking Down Walls: Initiation and Maturation of a Cochlear Implant Program in a Developing Country
There has been much controversy concerning the use of the cochlear implant (CI) as a viable option for hearing habilitation in developing countries. The high cost of the CI device, surgery and post-implantation support, and lack of specialized otology and audiology services have been cited as the most likely causes for failure of a CI program in the developing world. Skepticism amongst medical professionals and the public regarding the usefulness of the device must also be considered.
After careful consideration and planning, a CI program was started in La Vega, Dominican Republic in 2006. When our CI program began, there were already 10 implanted patients in the country (5 cochlear, 3 Advanced Bionics and 2 Med El). Two patients were being followed in the USA. The remaining 8 patients had been lost to follow-up largely due to financial reasons.
Barriers that we have encountered include:
- Training of surgeon, audiologist, and speech therapist
- Team Assembly (otologist, audiologist, speech therapist, radiologist, psychologist, geneticist, neurologist)
- Follow-up issues related to travel distance and poverty
- Cost of the device
- Opposition from colleagues
Over 13 years the program has grown to include 84 implanted patients, and we provide follow-up care to an additional 14 patients operated outside the Dominican Republic. In these 13 years, we have had to educate our colleagues and sensitize our government about the early detection of hearing loss. We collaborate with other CI clinics in the USA for patients who choose to have surgery elsewhere and then return for initial mapping and follow-up. Our efforts have reduced costs and improved patient follow-up to a rate of more than 95%.
We believe that our CI program has provided a necessary and sustainable option for this patient population. While there are certainly limitations when compared to CI programs in developed countries, we continue to focus our efforts on improving patient outcomes and improving the hearing health of citizens of the Dominican Republic.
- How to Form the Cochlear Implant Team
- How the Family Members and the Patient Should be educated
- how to educate the medical and political staff of the developing country
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Presenters/Authors
Edward Dodson
(), 1. OSU Otolaryngology - Head & Neck Surgery LLC 2. Project EAR, edward.dodson@osumc.edu;
Dr. Dodson is a Professor of Otology, Neurotology & Cranial Base Surgery in the Department of Otolaryngology at The Ohio State University. A faculty member since 1996, Dr. Dodson completed all of his education (undergraduate through Neurotology Fellowship) at the University of Virginia. Dr. Dodson also has adjunct faculty appointments in the Department of Speech and Hearing Science and the Department of Neurosurgery.
In 1995, Dr. Dodson joined his mentor, Paul Lambert, on the inaugural Project EAR medical mission to the Dominican Republic, providing hearing healthcare to the underserved population in the country and educating local doctors and healthcare workers. Since then he has led 41 of the 50 Project EAR trips, and has served as president of the organization since it became an official non-profit organization in 2000. In 2006 Dr. Dodson helped establish the first (and only) cochlear implant program in the Dominican Republic.
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Roberto Batista
(), Project EAR, batista.genao@gmail.com;
Dr Roberto Batista Genao was born in la Vega Dominican Republic , he attended in the Pontificia Universidad Catolica del Cibao and obtained his medical degree in the 1990. He completed his otolaryngology residency in the 1995 Hospital Salvador B. Gautier. Universidad Autonoma de Santo Domingo. He returned to la Vega and has been in private practice for 24 years. He has a specialty interest in otology and began working with Project Ear, a humanitarian otology mission, in 1995. He continues to donate many hours each year helping the underserved hearing impaired population in Dominican Republic. He has the cochlear implant clinic from 2006.
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Nonfinancial -