Classification of Follow-up Rehabilitation (“AHB”) in the Context of Postoperative Cochlear Implant (CI) Care

This statement paper, prepared on behalf of the Presidential Board of the German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC), addresses the classification of postoperative follow-up care after cochlear implantation ("CI rehabilitation"). In September 2024, "follow-up rehabilitation (AHB)" after cochlear implant surgery was included in the indication catalog of the Deutsche Rentenversicherung Bund (DRV Bund). Based on the guideline of the Association of the Scientific Medical Societies in Germany (AWMF) (017-071) and the CI White Paper, the following assessment examines how the AHB is to be integrated within the overall care pathway. At present, the AHB procedure is applied exclusively in adults. The analysis demonstrates that the AHB represents a complementary element within basic therapy and follow-up therapy but does not replace them. A mandatory prerequisite for AHB is the early fitting of the audio processor, according to medical indication, within the first days after cochlear implantation. This alone ensures that the AHB can begin within the required 14 days after discharge from inpatient treatment. At the same time, it must be emphasized that an AHB as the sole measure would deprive patients of essential components of follow-up therapy. Accordingly, AHB is to be regarded as a structured supplement to established treatment pathways, but not as the exclusive format of postoperative care for CI patients.