Cochlear implants remain vastly underutilized despite decades of evidence showing their ability to restore hearing and improve quality of life. In this episode, neurotologist Dr. Varun Varadarajan joins host Brian Taylor to explore the clinical, logistical, and cultural barriers that continue to limit access to cochlear implant care. Drawing on his background in music and neuroscience, Dr. Varadarajan shares his journey into hearing restoration surgery and offers insights into early intervention, the 60/60 referral guideline, and why timing matters for long-term outcomes.The discussion highlights several misconceptions that often delay or prevent patients from seeking cochlear implant evaluation—from concerns about age, surgery, and cost to misunderstandings about candidacy and device function. Dr. Varadarajan stresses the importance of individualized counseling, collaborative decision-making, and helping patients understand that cochlear implantation is a process, not a one-size-fits-all solution. He also addresses myths within the professional community, including hesitancy around residual hearing loss and outdated assumptions about surgical complexity.Beyond clinical considerations, Dr. Varadarajan shares practical strategies for building and expanding cochlear implant programs, including the importance of audiology partnerships, reimbursement planning, and aligning institutional goals. He also explains the value of the Cochlear Provider Network in connecting rural or underserved patients to implant services, and discusses how remote care and virtual follow-up are reshaping postoperative management.

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