CC BY-NC-ND 4.0 · Semin Hear 2021; 42(04): 311-320
DOI: 10.1055/s-0041-1739281
Review Article

Barriers to Adult Cochlear Implant Care in the United States: An Analysis of Health Care Delivery

Ashley M. Nassiri
1   Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
John P. Marinelli
2   Department of Otolaryngology - Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas
Donna L. Sorkin
3   American Cochlear Implant Alliance, McLean, Virginia
Matthew L. Carlson
1   Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
4   Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Funding No funding or other support was required for this study.


Persistent underutilization of cochlear implants (CIs) in the United States is in part a reflection of a lack of hearing health knowledge and the complexities of care delivery in the treatment of sensorineural hearing loss. An evaluation of the patient experience through the CI health care delivery process systematically exposes barriers that must be overcome to undergo treatment for moderate-to-severe hearing loss. This review analyzes patient-facing obstacles including diagnosis of hearing loss, CI candidate identification and referral to surgeon, CI evaluation and candidacy criteria interpretation, and lastly CI surgery and rehabilitation. Pervasive throughout the process are several themes which demand attention in addressing inequities in hearing health disparities in the United States.

Publication History

Publication Date:
09 December 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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