Quality of cochlear implant rehabilitation under COVID-19 conditions
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A. Aschendorff · S. Arndt · S. Kröger · T. Wesarg · M. C. Ketterer · P. Kirchem · S. Pixner · F. Hassepaß · R. Beck Department of Oto-Rhino-Laryngology, Universitätsklinikum Freiburg, Freiburg, Germany
Quality of cochlear implant rehabilitation under COVID-19 conditions Electronic supplementary material The online version of this article (https:// doi.org/10.1007/s00106-020-00923-z) includes the study questionnaire. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field, the supplementary material can be found under “Ergänzende Inhalte”.
Background The coronavirus pandemic has caused massive changes in working procedures in hospitals, general practices, and in rehabilitation clinics. With the start of the so-called lockdown, outpatient services were reduced, operations cancelled or postponed, and rehabilitation programs were nolongerconducted oronlytoa very limited extent after March 17, 2020. Curtailing of elective programs set intensive care capacities free to enable treatment of COVID-19 patients under special hygiene measures. It is estimated that up to 38.9% of surgical interventions in malignant diseases and up to 81.5% in nonThe German version of this article can be found under https://doi.org/10.1007/s00106020-00922-0.
malignant diseases were cancelled and/or postponed in the ear–nose–throat (ENT) area [1]. Disruptions to such an extent are of considerable importance both for patients and the health system. Even with operative capacities subsequently increased by 20%, it may take approximately 40 weeks to catch up with this OP backlog [1]. The effects on hearingimpaired patients in particular are not known. However, in the majority of clinics, cochlear implant (CI) surgeries were cancelled or postponed. An analogous assumption can be made for rehabilitation after CI, since at least the followup therapy was completely stopped for ca. 2 months. This means that access to auditory rehabilitation was delayed for hearing-impaired patients. Two months later, with the step-wise relaxing of hygiene measures, surgical capacities were reactivated and the rehabilitation clinics recommenced their work, although to a limited extent. In principle, special hygiene measures, social distancing, and obligatory masks were enforced, along with limited visiting rules and the resultant numerical reduction in capacities. This situation was found to be a special challenge in rehabilitation after CI. According to the guidelines, rehabilitation is an integral component in CI care [7]. The interdisciplinary treatment comprises: medical care, technical controls, step-wise optimization of the CI processor settings, intensive hearing–speech therapy, multidisciplinary diagnostics (speech and language therapy, phoniatric, pedagogic, and psychological), audiometry (threshold and speech in
quiet and in noise), consultation with the patient and their social environment, psychological support, additional training in using the CI system (care, maintenance, malfunctio
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