To assess the efficacy, quality of life, and complication rate of cochlear implantation in patients over 60 years of age, we performed a retrospective chart review of 31 cochlear implant patients more than 60 years old at the time of surgery (mean, 70 years; range, 62 to 86 years). All patients had improvement in their audiological test results after operation. Twenty-eight patients (93%) are regular implant users at a median follow-up of 12 months. Major complications occurred in 2 patients (6%). We conclude that cochlear implantation in the elderly population has excellent results, with a complication rate similar to that in patients less than 60 years old, and yields an improved quality of life.KEY WORDS -cochlear implant, elderly, quality of life.

Facial stimulation appears to be less problematic in patients with otosclerosis implanted with the CHF devices.

In view of the vario us problems enco untered with the tradit ional methods of sec uring coc hlear impl ants-including dural tear and suture dissolu tionfo llow ing inf ection-we devised two alternate methods of p erfo rming this procedure. We use a titanium mesh or a Gore-Tex patch secured with two 4-mm screws tofix the receiver to the skull. No patient who has undergone either of these pro cedures at our institut ion has expe rienced any ofthe complications that are associated with the olde r silk, nylon, and Dacron sutures. Mo reove r, our two alternate methods are less technica lly difficult and can be performed in a shorter peri od of time.

OBJECTIVES: We examined the incidence of facial nerve stimulation in a population of patients with otosclerosis implanted with the Nucleus 22, Clarion 1.2, or Clarion High Focus (CHF) device. STUDY DESIGN AND SETTING: A retrospective chart review was used for 147 patients who had been implanted with electronic cochlear devices at the University of Minnesota between June 1986 and February 2001. Seventy-four patients were implanted with the Nucleus 22, 41 patients were implanted with the Clarion 1.2 (without a positioner), and 32 patients were implanted with the CHF I or II. RESULTS: Eleven (14.9%) of the 74 patients implanted with the Nucleus 22 device had facial stimulation. There were 9 patients with otosclerosis. Seven (78%) of the 9 patients with otosclerosis had facial stimulation. One (2.4%) of the 41 patients implanted with the Clarion 1.2 device (without a positioner) had facial stimulation and that 1 (100%) patient in the group had otosclerosis. There were 4 patients in the CHF group with otosclerosis. One patient experienced stimulation, but it was possible to decrease maximum current levels and still use the electrode pair. CONCLUSION: Facial stimulation appears to be less problematic in patients with otosclerosis implanted with the CHF devices.

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