Cochlear Implant Performance in Senior Citizens

Abstract

Cochlear implants are indicated for elderly patients with severe-to-profound hearing loss (sensorineural hearing loss >/=70 dB). Their use has been limited, possibly by the misconception that elderly patients will perform poorly. To document the performance of older adults (> or =65 years old), we undertook a retrospective analysis of our postlingually deafened adult patients who underwent implantation with the CLARION Multi-Strategy Cochlear Implant and underwent formal audiologic analysis (sentence recognition [Central Institute for the Deaf, CID] and monosyllabic word recognition (consonant-noun-consonant, CNC)). Both younger (n = 20; mean age = 46.9 years) and older (n = 16; mean age = 71.5 years) adults showed statistically significant increases in CID and CNC scores after cochlear implantation. No statistically significant difference could be detected in operative time, anesthesia time, length of hospitalization, or CID or CNC scores between the two age groups. We conclude that age should not be a criterion for deciding who should receive cochlear implants.

Cochlear Implantation in Elderly Patients: Surgical and Audiological Outcome

“…We have used the SMA for CI in our department since 1999 [9] . Fourteen of the twenty elderly patients who were implanted after 1999 underwent their CI by means of this technique and the mean duration of surgery was 72 min (range 60-80 min) -this is in contrast to Chatelin et al [18] and Labadie et al [4] , who reported that CI surgery usually required general anesthesia for approximately 3-4 h. In our experience, the SMA can cut this time by half, an advantage especially beneficial in a geriatric population.…”

“…Bypassing the cochlea by means of cochlear implantation (CI) not only provides considerable benefit for this population [1] but is cost effective as well [2] . It is well established by now that CI provides similar improvement in subjective quality of life and audiological benefit both in elderly and young adults [1,[3][4][5][6][7] . Elderly recipients demonstrated no difference in hours per day of implant usage, ability to discriminate environmental sounds from human voices, or ability to telephone communication compared to younger CI users [1] .…”

Older and Younger Adult Cochlear Implant Users: Speech Recognition in Quiet and Noise, Quality of Life, and Music Perception

“…Cochlear implantation carries minimal risk and has been proven to be a safe procedure in all age groups (Venail et al, 2008) including the older population (Budenz et al, 2011;Carlson et al, 2010;Chatelin et al, 2004;Coelho, Yeh, Kim, & Lalwani, 2009;Djalilian, King, Smith, & Levine, 2002;Eshraghi et al, 2009;Haensel, Ilgner, Chen, Thuerman, & Westhofen, 2005;Labadie, Carrasco, Gilmer, & Pillsbury, 2000;Orabi, Mawman, Al-Zoubi, Saeed, & Ramsden, 2006). These authors generally agree that older adults present with more comorbid conditions at the time of surgery, and the patient's preexisting medical conditions are more important for determining intra-or postoperative complications than age alone.…”

“…These authors generally agree that older adults present with more comorbid conditions at the time of surgery, and the patient's preexisting medical conditions are more important for determining intra-or postoperative complications than age alone. The outcomes of implantation in older adults are excellent such that speech understanding is significantly improved between preoperative and postoperative test intervals (Djalilian et al, 2002;Eshraghi et al, 2009;Haensel et al, 2005;Labadie et al, 2000;Migirov, Taitelbaum-Swead, Drendel, Hildesheimer, & Kronenberg, 2010;Orabi et al, 2006;Pasanisi et al, 2003;Shin et al, 2000). The benefits of improved audibility and speech recognition are expected to cascade into other areas of life such as the patient's social, psychological, and overall physical health.…”

“…Many studies report that older and younger implanted adults do equally well on tests using single words or sentences in quiet listening conditions (Budenz et al, 2011;Haensel et al, 2005;Labadie et al, 2000;Migirov et al, 2010;Noble et al, 2009;Orabi et al, 2006;Park et al, 2011;Pasanisi et al, 2003;Poissant et al, 2008;Sterkers et al, 2004), yet others demonstrate significantly lower performance for older compared with younger CI listeners (Chan et al, 2007;Friedland, RungeSamuelson, Baig, & Jensen, 2010;Noble et al, 2009;Roberts, Lin, Herrmann, & Lee, 2013;Vermeire et al, 2005). Perhaps even more surprising is that studies also disagree about the presence of age-related speech-in-noise (SIN) performance differences between older and younger implanted adults.…”