The Pakistan (Lahore) cochlear implant programme: issues relating to implantation in a developing country

• Published in: Journal of laryngology and otology Vol. 121; no. 8; pp. 745 - 750
• Main Authors: Khan, M I J, Mukhtar, N, Saeed, S R, Ramsden, R T
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.08.2007
• Subjects: Adolescent; Adult; Adults; Age; Biological and medical sciences; Child; Child, Preschool; Cochlear Implants; Correction of Hearing Impairment - organization & administration; Deafness; Developing Countries; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Families & family life; Female; General aspects; Hearing Loss, Sensorineural - rehabilitation; Humans; Infant; LDCs; Listening; Magnetic resonance imaging; Male; Medical sciences; Meningitis; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pakistan; Patients; Pediatrics; Planification. Prevention (methods). Intervention. Evaluation; Program Development; Program Evaluation; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rehabilitation; Sensorineural Deafness; Surgery; Surgical outcomes; Transplants & implants; Asia; Pakistan; Lahore Pakistan; Sensorineural Deafness; Developing Countries; Cochlear Implants; Human; Sanitary program; Treatment; Surgery; Auditory disorder; Developing countries; Cochlear implant; ENT disease; Hearing loss
• ISSN: 0022-2151; 1748-5460; 1748-5640
• DOI: 10.1017/S0022215107007463

The Pakistan cochlear implant programme was started in Lahore in August 2000. It was initially established with the technical support of the Manchester cochlear implant team. There are no government resources available for cochlear implantation in Pakistan and the cost of cochlear implantation is met by the candidates and their families. Up till December 2005, 52 individuals have been implanted. Forty-four (84.6 per cent) of these patients were children and eight (15.4 per cent) patients were adults. Congenital deafness (94 per cent) is the main aetiological factor in children. Seventy-six per cent of these children were born to blood related parents. All patients received a Med-El Combi 40+  device. The listening progress profile, the meaningful auditory integration scale and the meaningful use of speech scale were used to assess the auditory performance in children. Thirty-nine children achieved an average listening progress profile score of 37.7 after 12 months of implantation. The overall rate of major and minor complications was 11.5 per cent. Failure rate for the device itself has been 3.8 per cent. In addition to considering these preliminary outcomes and funding issues, the problems of setting up a cochlear implant programme in a developing country are discussed.