Remote Programming a Viable Option for the Adult and Pediatric CI Populations

Clinical Question

What are the effects and outcomes of remote cochlear implant (CI) programming in terms of burden and costs, feasibility and satisfaction, and comparability to traditional in-person CI management, for patients and families within the adult and pediatric CI populations?

Bottom Line

Remote programming is a feasible and effective service delivery model for the adult and pediatric CI population.

Background: Technological advances and greater equipment access have enabled more audiologists to practice remote care, saving patients time and expense. Cochlear implant recipients require up to eight visits within the first year.  Current literature suggests that remote CI care is feasible for adult patients, but fewer studies have evaluated the pediatric population.

Study design: Prospective study

Setting: University of Miami in Miami

Synopsis: Researchers enrolled 15 pediatric patients (mean age 4.17 years) and 15 adult patients (mean age 56.73 years), all of whom were CI recipients. Thirteen of the children and seven of the adults were bilateral CI users. All underwent CI programming via in-person and remote visits. Researchers administered questionnaires assessing participants’ comfort with technology and their satisfaction with in-person and remote programming visits, plus estimated time and money expenditures. In-person and remote programming sessions yielded comparable results for measuring CI programming parameters. Adult and parent participants were highly satisfied with remote programming and reported receiving excellent care. For adults, listening effort was significantly less for the remote visit as compared to the in-person visit. The burden of care to attend the in-person visit was greater for the pediatric population in terms of expenses incurred, unpaid time off work, and coordination of care for other children. Authors note that although remote care has numerous advantages for reducing barriers to CI care, the current virtual CI platform does not incorporate eSRT testing in programming, and, overall, in-person visits will still be necessary.

Citation: Holcomb MA, et al. Remote care: the future of cochlear implants. Otol Neurotol. 2025;46:372-380. doi:10.1097/MAO.0000000000004432.

Comment: This article demonstrates the feasibility of remote programming for cochlear implant patients and the potential benefits (particularly to the pediatric population) for decreasing the burden of care of in-person visits. Rob Hong, MD