Introduction: The Challenge of Low Cochlear Implant Utilization
Despite the transformative impact of cochlear implants (CIs) on the quality of life for adults with severe-to-profound sensorineural hearing loss, utilization remains strikingly low. Estimates suggest that fewer than 10% of adults who meet candidacy criteria actually receive an implant. This gap is often attributed to a combination of patient-level factors, such as a lack of awareness and fear of surgery, and provider-level factors, including the perceived complexity of the referral process. Historically, screening for CI candidacy has been a binary exercise: a patient either meets the criteria or they do not. However, this ‘all-or-nothing’ approach fails to account for the spectrum of hearing loss severity and does not provide the nuanced information necessary for effective shared decision-making.