Cochlear Implantation in Older Adults

Abstract

Objectives To analyze the postoperative complications associated with cochlear implant (CI) surgery in a large consecutive case series of older adults (≥ 60 years) Study Design Retrospective case review Setting Tertiary referral center Patients 445 individuals ≥60 who received a first CI between1999–2011 Interventions Cochlear implantation Main Outcome Measure(s) Postoperative complications classified as major (meningitis, immediate postoperative facial weakness, device failure, flap dehiscence, surgical removal) and minor (surgical site infection, balance problems, delayed postoperative facial weakness, facial nerve stimulation) Results The mean age at implantation was 72.7 years (60–94.9) and the median duration of follow-up was 4.8 years (0.1–12.5). There were 42 minor complications in 41 patients (9.2%) and 36 major complications in 21 patients (4.7%). Seventeen patients (3.8%) required surgical device removal, 15 of whom underwent reimplantation. A Kaplan-Meier analysis of rates of device explantation demonstrated that at 5 and 10 years after CI, respectively, 95.4% and 93.1% of patients retained their original CI. When comparing complications between patients aged 60–74 years and those aged 75 years and older, there was a higher prevalence of balance problems lasting more than 1 month in the older group (9.5% vs. 4.9%, p = .05). Conclusions Our results indicate that the safety profile of cochlear implantation in an older population is comparable to that of younger adults and children. We suggest that concerns for increased postoperative complications in patients of advanced age do not need to be a primary consideration when determining CI candidacy.

Is cochlear implantation a good treatment method for profoundly deafened elderly?

“…We are in agreement with Chen et al’s21 opinion that future research and publications are needed for better understanding of differences in the benefits of CI in older patients.…”

“…Moreover, it is important that family and general physicians learn more about cochlear implants in the elderly. Following Chen et al’s21 opinion, CI in deafened elderly is still quite low. More studies on the subject, including differences in results of CI in deafened elderly, such as the results presented in our study, would contribute to help family and general physicians in more informative counseling.…”

“…Transient impairment of the vestibular system that caused vertigo resolved spontaneously within the first postoperative month. In their recent retrospective review about CI in the elderly (aged ≥60 years old), Chen et al21 reported minor complications in 9.2% of patients (surgical site infection, balance problems, delayed postoperative facial weakness, and facial nerve stimulation) and major complications in 4.7% (meningitis, immediate postoperative facial weakness, device failure, flap dehiscence, and necessity of surgical removal). Surgical removal was required in 3.8% of the analyzed patients.…”

Age-Related Differences in the Processing of Temporal Envelope and Spectral Cues in a Speech Segment

“…This has occurred because of the continued success of middle-aged CI users who are now aging into the older age range, and because the criteria for implantation have expanded to include older seniors. While CIs in older individuals improve speech understanding and quality of life without undue complications (Chen et al 2013; Clark et al 2012; Lin et al 2012), evidence suggests that that older CI users have poorer speech understanding than younger CI users (Jin et al 2014; Sladen and Zappler 2014, 2015). …”

Awareness of Hearing Loss in Older Adults: Results of a Survey Conducted in 500 Subjects Across 5 European Countries as a Basis for an Online Awareness Campaign

“…Prevalence data have shown that hearing loss increases with age, but the provision of implants in the over 65s is lower than in younger people, despite there being no clinical barriers to older adults receiving a CI. 5,9,13-15 It was encouraging that in general, respondents identified that older adults could benefit from an implant. However, the lack of access in this group to appropriate treatment is concerning, particularly as recent studies have highlighted the relationship between untreated hearing loss, general health, and dementia.…”