Surgical Hearing Implant Program Otolaryngology ANNUAL REPORT Department Name

Transcription

1 Surgical Hearing Implant Program Otolaryngology ANNUAL REPORT 2016 Department Name

2 Surgical Hearing Implant Program Program Personnel Darren Leitao MD: Jordan Hochman MD: Les Garber MD: Justyn Pisa AuD: Co-Director and Pediatric Cochlear Implant Surgeon Co-Director and Adult Cochlear Implant Surgeon Pediatric and Adult Bone Anchored Implant Surgeon Program Coordinator and Audiologist for Bone Anchored Implants Executive Summary 2016 has been a highly progressive year for the Surgical Hearing Implant Program. We continue to address the needs of patients who can benefit from implantable hearing solutions. We continue our mandate of furthering hearing related research with a substantial impact in simulation. Most significantly the WRHA and Health Sciences Centre are supporting increased implant activity in attempt to address patient wait times. We are thrilled and thankful for the endorsement. Dr. Darren Leitao, Co-Director Pediatric Otolaryngology - Head and Neck Surgery Assistant Professor, University of Manitoba Section Head - Pediatric Otolaryngology Dr. Jordan Hochman, Co-Director Otologic and Neurotologic Surgery Assistant Professor, University of Manitoba Associate Director, Surgical Modeling Simulation and Robotics Lab

3 1 SHIP Coordinator Program Summary The following report was completed by Justyn Pisa, AuD and will outline the current status of the Surgical Hearing Implant Program (SHIP) of the department of Otolaryngology Head & Neck Surgery at Health Sciences Centre (HSC) as of December 31, This report will provide summary information on both cochlear and bone anchored implant programs, including the number of surgeries performed, the number of devices implanted and the surgical wait list for the 2016 calendar year. Program Finances (FY ): Bone Anchored Implants in 2016: 13 = $95,121 Cochlear Implants in 2016: 33 = $766,289 Annual Program Device Budget: $ 1,185,629 Amount Spent in 2016: $ 861,410 Program Budget Surplus/Deficit $ 324,219 Program Achievements: Cochlear Implant Program Implanted 183 cochlear implant devices since program inception (2011). Implanted 33 cochlear implant devices in the 2016 calendar year. Obtained permission to utilize entire SHIP budget to increase annual cochlear implant output by 9 devices. Hosted a provincial cochlear implant seminar for 40 private and public audiologists. Presented an original research paper on effects of Neurofibromatosis Type 2 on cochlear implant outcomes at international conference (ACI) in May Co-authored two publications on 3D temporal bone modeling and haptic surgical simulations. Bone Anchored Implant Program Completed 87 bone anchored implants since program inception (2011). Completed 13 bone anchored implants in the 2016 calendar year. Successfully transferred outpatient audiological services for bone anchored implant recipients to the Central Speech and Hearing Clinic in February Led a national implant centre letter writing campaign to the Ministries of Health and Indigenous and Northern Affairs to highlight lack of processor upgrade funding for treaty status individuals through the national Non-Insured Health Benefits (NIHB) program. Conducted national implant centre survey with the Canadian Academy of Audiology (CAA) and Speech-Language Pathology and Audiology Canada (SAC) to highlight lack of processor upgrade funding by the NIHB program. Program Goals: Secure funding for the development of a pediatric baha processor upgrade program. Initiate routine objective/subjective data collection on all implant candidates. Reduce adult cochlear implant wait times to national standard of 12 months. Reduce average pediatric cochlear implant age from 26 months to 12 months.

4 2 Cochlear Implant Program Summary The Cochlear Implant Program completed 31 surgical procedures on 22 adult and 10 pediatric patients in 2016 implanting a total of 33 devices. There are currently 48 patients who have passed audiological candidacy criteria for surgery and are awaiting consultation for surgery, consistent with the previous year. The program continues to generate an average of 3.1 new surgical candidates per month. The average waiting time for adult patients is now 19.8 months, which is an increase of 1.4 months from the previous year. The Cochlear Implant program has a caseload of 177 active participants currently implanted and approximately 48 patients awaiting surgery. The program has a 44% binaural implant rate for pediatric patients and <1% for adult patients. There is no pediatric waiting list; however average pre-operative processing time (from diagnosis to surgery) is currently 7.1 months. The cochlear implant program received permission to utilize its entire medical device budget in 2016 in order to maximize surgical output and decrease the adult waiting list. An additional 8 cochlear implant devices are anticipated due to this adjustment and any improvement to wait times will be reported in the next annual report. Cochlear Implant Program Summary: Jan. 1, 2016 Dec. 31, 2016 Total number of cochlear implant since program inception (2011) 183 Number of cochlear implants used in Adult cochlear implant patients 22 Pediatric cochlear implant patients 10 Candidacy: Number of new patients cleared for cochlear implant candidacy in Average number of new candidates cleared per month 3.1 Wait Times: Number of adult patients on the waiting list for cochlear implant surgery 48 (+8) Average adult wait time for cochlear implant surgery (months) 19.8 (+1.4) Finances: Average cost per cochlear implant surgery $24,719 Total spent on cochlear implants program $766,289 Table 1. Summary of the cochlear implant program for 2016.

5 3 Cochlear Implant Program Summary The cochlear implant surgical production and average adult wait time are displayed below. Figure 1. Cochlear implant production for fiscal year Red markers are projected values based on current surgical slate. Figure 2. Cochlear implant average adult wait time for fiscal year compared to previous years since program inception.

6 4 Bone Anchored Implant Program Summary The Bone Anchored Implant Program completed 12 surgeries in The unilateral surgeries included 10 adult patients and 2 pediatric patients. There are currently 15 patients awaiting trial for audiological candidacy and 24 patients awaiting implant surgery. The bone anchored implant program generated and average of 2.2 new surgical candidates per month. The current surgical wait time is 18.9 months for bone anchored implant procedures, representing an increase of 4.3 months from the previous year. The bone anchored implant program has a current caseload of 158 active participants currently implanted and 38 awaiting surgery. Approximately 30% of patients were implanted out-ofprovince prior to program initiation while 70% were implanted in-province since The program has seen an increase in patients from other provinces seeking post-implant rehabilitative services in Manitoba. Average wait times are expected to rise to 20 months in Due to resource limitations at Health Sciences Centre, all bone anchored implant recipients are now seen for rehabilitation services at the Central Speech & Hearing Clinic. Bone Anchored Implant Program Summary: Jan. 1, 2016 Dec. 31, 2016 Total number of bone anchored implants since program inception (2011) 87 Number of bone anchored implant surgeries in Adult bone anchored implant patients 10 Pediatric bone anchored implant patients 2 Candidacy: Number of new patients cleared for bone anchored implant candidacy in Average number of new candidates cleared per month 2.2 Wait Times: Number of adult patients on the waiting list for baha surgery 38 (+7) Average adult wait time for bone anchored implant surgery (months) 18.9 (+4.3) Finances: Average cost per bone anchored implant surgery $7,317 Total spent on bone anchored implant program $95,121 Table 2. Summary of the bone anchored implant program for 2016.

7 5 Bone Anchored Implant Program Summary The bone anchored implant surgical production and average adult wait time are displayed below. Figure 3. Bone anchored implant production for fiscal year Red markers are projected values based on current surgical slate. The bone anchored implant program is capped at 14 devices per fiscal year. Figure 4. Bone anchored implant average adult wait time for fiscal year compared to previous years since program inception.

8 6 Publications and Presentations Publications Stereotactic Radiosurgery Does Not Impact Cochlear Implant Performance in Patients with Neurofibromatosis Type 2 Pisa J, Sulkers J, Butler J, West M, Hochman JB Journal of Otolaryngology Head and Neck Surgery publication pending. Increasing Haptic Force Resolution is Less Important than Active Manipulandum in Virtual Temporal Bone Surgery Unger B, Sephari N, Rampersad V, Pisa J, Gousseau M, Hochman JB Journal of Otolaryngology Head and Neck Surgery publication pending. Presentations Impact of Stereotactic Radiosurgery on Cochlear Implant Performance Pisa J and Hochman JB Podium presentation at the American Cochlear Implant Alliance International Conference (2016) Cochlear Implant Benefit By Age: Comparing Speech Perception Outcomes In Adults Implanted Prior To and After 70 Years of Age Sulkers J, Mackie K, Stangherlin D, Pisa J, Hochman JB Poster presentation at the American Cochlear Implant Alliance International Conference (2016) Spoken Language Outcomes Following Cochlear Implantation in Two Siblings with Chudley-McCullough Syndrome Kent J, Sulkers J, Mackie K, Oomah J, Stangherlin D Poster presentation at the American Cochlear Implant Alliance International Conference (2016) Benefits of Group Information Sessions Prior to Cochlear Implantation Mackie K, Sulkers J, Stangherlin D, Pisa J Poster presentation at the American Cochlear Implant Alliance International Conference (2016) Pediatric Diagnosis and Cochlear Implant Candidacy Assessment Mackie K, Sulkers J, Stangherlin D, Pisa J Podium presentation at the provincial Cochlear Implant Seminar hosted by SHIP (2016) Pre and Post Op Outcome Measures for Pediatric Cochlear Implant Recipients Sulkers J, Mackie K, Stangherlin D, Pisa J Podium presentation at the provincial Cochlear Implant Seminar hosted by SHIP (2016) Group Cochlear Implant Candidacy Information Sessions for Adults Stangherlin D, Mackie K, Sulkers J, Pisa J Podium presentation at the provincial Cochlear Implant Seminar hosted by SHIP (2016)