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Case-control analysis of cochlear implant performance in elderly patients. Arch Otolaryngol Head Neck Surg 2010 May;136(5):432-8

Date

05/19/2010

Pubmed ID

20479370

DOI

10.1001/archoto.2010.57

Scopus ID

2-s2.0-77952467174   83 Citations

Abstract

OBJECTIVE: To characterize speech perception performance in elderly cochlear implant users compared with younger adult users.

DESIGN: Case-control retrospective analysis from January 1, 1999, to January 28, 2008.

SETTING: Tertiary care, academic practice cochlear implant program.

PATIENTS: Medical records for 78 patients with age at implantation of 65 years or older were analyzed for ear-specific preimplantation speech perception performance, length of deafness, age at implantation, and 1-year postimplantation speech perception performance. A subset of 28 elderly patients with complete data was matched to 28 younger adult patients (age at implantation, 18-64 years) for preimplantation performance using the Hearing in Noise Test-Quiet scores (mean, 22% and 23%, respectively).

MAIN OUTCOME MEASURE: One-year postimplantation performance on word and sentence testing.

RESULTS: Within the elderly cohort, the Consonant-Nucleus-Consonant and Hearing in Noise Test-Quiet scores were not affected by age. The Hearing in Noise Test-Noise scores trended downward with increasing age but did not reach statistical significance (P = .052). Of the matched older and younger patients, 55 of 56 showed improvement in their 1-year postimplantation compared with preimplantation Hearing in Noise Test-Quiet scores, with better preimplantation performance predictive of better postimplantation performance, independent of age at implantation (P = .02). Group comparisons, however, revealed poorer postimplantation scores overall for the elderly patients compared with the younger ones for the Hearing in Noise Test-Quiet (70% vs 83%; P = .02) and the Consonant-Nucleus-Consonant test (38% vs 53%; P = .02).

CONCLUSIONS: Elderly patients benefit significantly from cochlear implantation. Compared with a younger cohort matched for preimplantation performance, however, their postimplantation scores are significantly lower on some measures. These results may provide guidelines for candidacy and counseling regarding elderly patients with cochlear implants.

Author List

Friedland DR, Runge-Samuelson C, Baig H, Jensen J

Authors

David R. Friedland MD Associate Director, Director, Chief, Professor in the Otolaryngology department at Medical College of Wisconsin
Christina Runge PhD Associate Provost, Chief, Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Case-Control Studies
Cochlear Implants
Female
Hearing Tests
Humans
Male
Middle Aged
Retrospective Studies
Speech Perception
Statistics, Nonparametric
Treatment Outcome