A proposal for an International Healthcare PLATFORM for managing foreign patients of Cochlear Implantation

Cochlear implants (CI) are in the midst of the great success stories of the modern medicine and is the most successful of all neural prostheses developed to date in terms of restoration of function in people profoundly deaf or severely hard of hearing, and by the time, the number of the candidates of CI is rising and the age of the surgery in the kids reducing to 12–18 months. By the time, outstanding progression in CI development has been made but more rooms remain still for improvements. Objective: the purpose of this thesis project is to present a broad overview on human’s hearing story; the structural anatomy of the normal hearing system and a deaf ear, the recent cochlear implantation process from its A to Z as the new and only treatment for deafness, to assess the existent complications and difficulties in this pathology, and finally to propose a comprehensive solution (Platform) to reach the highest outcomes from this surgery for each candidate of CI. In this case, the vital goal is: (i) To create a new international agency of professionals, who are in exchange while working in their country of origin, "give their professionalism” for users who need to start a rehabilitation process in their native language (foreigners residing abroad). (ii) To establish an international healthcare service platform of telemedicine, for continuity assistance. (iii) To create, among different specialists, a network of training and experiential exchanges to unify rehabilitation protocols, despite the linguistic differences. Results: As a result of this activity, we consider some of the determinants of success in cochlear Implantation such as: The patients’ hearing story before implantation (being post-lingual, pre-lingual, current age, age of loosing hearing, time of using CI, ability of learning, how intensive they do training, the health and structure of their cochlea-number of nerve (spiral ganglion) cells that they have and also Intelligence and communicativeness of patient. So the goal is to prepare the best situation for patients to have their rehabilitation after surgery in it’s best way, because it’s not just about the device, it’s mostly about their brain to adopt itself to this new hearing system, analyzing the result of current situation in Italy, we clarified the complexity and importance of the process after CI surgery (Rehabilitation), beyond the surgery and the fact that there is a serious lack of public information about this issue all around the world. Finally, a potential approach to face this issue is proposed. Conclusions: Although it is unavoidable to place such a platform in a process to accelerate and improve the whole procedure, it is not possible to replace it with regular face-to-face sessions. Patients better to include this remote usage of platform in case of emergency or additional option to their regular mapping and rehabilitation.