The French Cochlear Implant Registry (EPIIC): Cochlear implant candidacy assessment of off-label indications

Abstract Objective Evaluate in France the outcomes of cochlear implantation outside the selection criteria, off-label. Material and methods This is a prospective cohort study including adults and children having received a cochlear implant (CI) in an off-label indication, that is outside the criteria established by the “Haute Autorite de sante (HAS)” in 2012. The data was collected from the “EPIIC” registry on recipients who received CIs in France between 2011 and 2014. Speech audiometry was performed at 60 dB preimplantation and after one year of CI use, as well as an evaluation of the scores of the quality of life with the APHAB questionnaire, the scores for CAP and the professional/academic status in pre- and post-implantation conditions. Major and minor complications at surgery have been recorded. Results In total, 590 patients (447 adults and 143 children) with an off-label indication for CIs were included in this study from the EPIIC registry (11.7% of the whole cohort of EPIIC). For adults, the median percentage of comprehension using monosyllabic word lists was 41% in preimplantation condition versus 53% after one year of CI use (P  Conclusion These results suggest that a revision of the cochlear implantation candidacy criteria is necessary to allow more patients with severe or asymmetric hearing loss to benefit from a CI when there is an impact on quality of life despite the use of an optimal hearing aid.