Younger- and Older-Age Adults With Unilateral and Bilateral Cochlear Implants

Abstract

Objective Compare results of cochlear implantation in younger and older adults in the domains of disability and handicap, as well as in tests of word recognition and localization, across unilateral implant (CI), bilateral (CI+CI) and CI with an acoustic hearing aid in the non-implanted ear (CI+HA). Design Three parts: retrospective (post-implant only) analysis; prospective (pre-versus post-implant); correlation between age and benefit from CI versus CI+CI. Two age groups, above and below 60 years, for the first two analyses; age is a continuous variable for the third analysis. Setting Tertiary referral hospital clinic Patients Postlingually severely-to-profoundly hearing impaired adults: Totals of 68 CI, 36 CI+CI, and 38 CI+HA in the retrospective part of the study; totals of 30 CI, 18 CI+CI and 16 CI+HA in the prospective parts. Numbers vary from these totals on individual measures. Interventions Patients receive either one or two cochlear implants; some with one CI opt to retain a hearing aid in the non-implanted ear. Outcome measures Principal measures: Hearing Handicap Inventory for the Elderly, Hearing Handicap Questionnaire, Speech, Spatial and Qualities of Hearing scale, word recognition test, and soundfield localization test. The study is exploratory, but proceeding from a null hypothesis of no expected contrast as a function of patient age. Results All patient groups show significant benefit following implantation. No significant age-related differences are observed in patients with unilateral implant, nor in CI+HA group. In the CI+CI group, the younger cohort showed very substantial increases in both performance and self-rated abilities; the older cohort provides more mixed outcomes. Conclusion Results for the CI group confirm and extend earlier research. The result for the younger group of CI+CI patients demonstrates the consistent incremental benefit obtained from a bilateral procedure. The mixed outcome observed in the older CI+CI group might be due to individual differences in interaction between effects of aging and the ability to integrate binaural cues.

Older and Younger Adult Cochlear Implant Users: Speech Recognition in Quiet and Noise, Quality of Life, and Music Perception

“…That is, some studies have demonstrated that older implanted adults perform lower on SIN than younger implanted adults (Lin, Thorpe, Gordon-Salant, & Ferrucci, 2011;Roberts et al, 2013) yet others have reported that age-related differences are absent (Budenz, et al, 2011;Friedland et al, 2010, Orabi et al, 2006Poissant et al, 2008). Adding to the complexity of aging effects on implant use are studies such as Noble et al (2009) Ventry & Weinstein, 1982), the Hearing Handicap Questionnaire (HHQ; Noble, Tyler, Dunn, & Bhullar, 2008), and Speech, Spatial, and Qualities of Hearing Scale (SSQ; Gatehouse & Noble, 2004). Results showed age-related differences on the SSQ but only with the bilateral CI group and not the bimodal CI+hearing aid group.…”

“…The benefits of improved audibility and speech recognition are expected to cascade into other areas of life such as the patient's social, psychological, and overall physical health. In fact, studies unanimously demonstrate significantly higher health-related quality of life (HRQoL) scores among older CI users at postoperative compared with preoperative intervals (Djalilian et al, 2002;Noble, Tyler, Dunn, & Bhullar, 2009;Orabi, Mawman, Al-Zoubi, Saeed, & Ramsden, 2006;Park, Shipp, Chen, Nedzelski, & Lin, 2011;Poissant, Beaudoin, Huang, Brodsky, & Lee, 2008;Vermeire et al, 2005).…”

“…Many studies report that older and younger implanted adults do equally well on tests using single words or sentences in quiet listening conditions (Budenz et al, 2011;Haensel et al, 2005;Labadie et al, 2000;Migirov et al, 2010;Noble et al, 2009;Orabi et al, 2006;Park et al, 2011;Pasanisi et al, 2003;Poissant et al, 2008;Sterkers et al, 2004), yet others demonstrate significantly lower performance for older compared with younger CI listeners (Chan et al, 2007;Friedland, RungeSamuelson, Baig, & Jensen, 2010;Noble et al, 2009;Roberts, Lin, Herrmann, & Lee, 2013;Vermeire et al, 2005). Perhaps even more surprising is that studies also disagree about the presence of age-related speech-in-noise (SIN) performance differences between older and younger implanted adults.…”

Tradução e Adaptação Transcultural para o Português Brasileiro do Questionário Hearing Implant Sound Quality Index - (HISQUI19)

“…Self-assessment questionnaires provide subjective data that enable practicing professionals the knowledge of difficulties in hearing impaired patients in specific daily (17) situations, allowing CI mapping in the rehabilitation process in accordance with different technologies and performance of each individual in particular. One can minimize or even solve some of these difficulties in order to provide the CI users a better quality of life.…”

Qualidade de vida em adultos usuários de implante coclear

“…O implante coclear se tornou um tratamento cada vez mais comum e eficaz para as pessoas com deficiência auditiva profunda pós-lingual e cada vez mais as pesquisas mostram que os usuários deste dispositivo podem atingir melhorias significativas em suas habilidades auditivas (LEUNG et al, 2005;COELHO et al, 2009;NOBLE et al, 2009 Nos adultos com perda auditiva pós-lingual um fator importante a ser considerado é o tempo de privação sensorial. As pesquisas mostram que quanto menor o tempo de vida com a deficiência auditiva, maiores escores de reconhecimento da fala serão alcançados em pouco tempo no pós-operatório.…”