In:
Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 9 ( 2023-10), p. 866-872
Abstract:
To examine the effect of patient age on longitudinal speech understanding outcomes after cochlear implantation (CI) in bilateral hearing loss. Study Design Retrospective cohort study. Setting Tertiary academic center Patients One thousand one hundred five adult patients with bilateral hearing loss receiving a unilateral CI between 1987 and 2022 Interventions None. Main Outcome Measures Postoperative speech recognition outcomes, including AzBio sentences, consonant-nucleus-consonant word, and Hearing in Noise Test in quiet were analyzed at short-term ( 〈 2 yr), medium-term (2–8 y), and long-term ( 〉 8 yr) term postoperative intervals. Results Eighty-six very elderly ( 〉 80 yr), 409 elderly (65–80 yr), and 709 nonelderly (18–65 yr) patients were included. Short-term postoperative AzBio scores demonstrated similar magnitude of improvement relative to preoperative scores in the very elderly (47.6, 95% confidence interval [CI], 28.9–66.4), elderly (49.0; 95% CI, 39.2–58.8), and nonelderly (47.9; 95% CI, 35.4–60.4). Scores for those older than 80 years remained stable after 2 years after implant, but in those 80 years or younger, scores continued to improve for up to 8 years (elderly: 6.2 [95% CI, 1.5–12.4] ; nonelderly: 9.9 [95% CI, 2.1–17.7]) after implantation. Similar patterns were observed for consonant-nucleus-consonant word scores. Across all age cohorts, patients with preoperative Hearing in Noise Test scores between 40 and 60% had similar scores to those with preoperative scores of less than 40%, at short-term (82.4, 78.9; 95% CI, −23.1 to 10.0), medium-term (77.2, 83.9; 95% CI, −15.4 to 8.2), or long-term (73.4, 71.2; 95% CI, −18.2 to 12.2) follow-up. Conclusions Patients older than 80 years gain significant and sustained auditory benefit after CI, including those meeting expanded Centers for Medicare & Medicaid Service criteria for implantation. Patients younger than 80 years demonstrated continued improvement over longer periods than older patients, suggesting a role of central plasticity in mediating CI outcomes as a function of age.
Type of Medium:
Online Resource
ISSN:
1537-4505
,
1531-7129
DOI:
10.1097/MAO.0000000000003983
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2023
detail.hit.zdb_id:
2058738-7
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