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Is a cochlear implant a viable alternative? For older adults for whom the cost of hearing aids is prohibitive, a less expensive pocket amplifier with headphones may be a good choice. Middle ear implants, which mechanically vibrate the middle ear structures to produce amplification, are another option for patients with presbycusis.
National Institute for Health and Clinical Excellence (NICE) guidelines recommend consideration of cochlear implantation for children and adults after multidisciplinary team assessment.37 Cochlear implants are indicated for severe to profound hearing loss, and have been shown to improve speech recognition abilities equally in adolescents and older adults.39 And, unlike hearing aids, cochlear implants are covered by most health insurance plans.
CORRESPONDENCE Paul George, MD, Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02912; Paul_George@brown.edu
