Case-control analysis of cochlear implant performance in elderly patients

January 01, 0001

Case-control analysis of cochlear implant performance in elderly patients

These US authors conducted a retrospective case-control analysis to characterize speech perception performance in elderly cochlear implant users compared with younger adult users. They examined the medical records for 78 patients with age at implantation of 65 years or older 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).

They found: "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. 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. 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) and the Consonant-Nucleus-Consonant test (38% vs 53)."

The authors concluded: "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."

These data demonstrate both benefits and the limits to be expected with cochlear implantation in elderly patients.

For the full abstract, click here.

Arch Otolaryngol Head Neck Surg 136(5):432-438, May 2010
© 2010 to the American Medical Association
Case-Control Analysis of Cochlear Implant Performance in Elderly Patients. David R. Friedland, Christina Runge-Samuelson, Humera Baig, Jamie Jensen. Correspondence to Dr. Friedland:

Category: H. Ear. Keywords: hearing, speech perception, cochlear implant, elderly, retrospective case-control study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 8 June 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.