Hearing Preservation in Elderly Cochlear Implant Recipients

Objective: Examine hearing preservation rates in cochlear implant recipients 72 years and older. Study Design: Retrospective case series. Setting: Tertiary otology/neurotology practice. Patients: Cochlear implant recipients 72 years and older who are candidates for hearing preservation and were implanted between April 2017 and June 2018 Intervention: Surgical/rehabilitative. Main Outcome Measures: Hearing was measured preoperatively and 6 months after cochlear implantation. Results: Between April 2017 and June 2018, 125 cochlear implant operations were performed by the senior author (A.J.). Of these patients, 62 were over age 72 and comprehensive pre- and postoperative residual hearing data were available on 24 patients. Although several methods for calculating hearing preservation are evaluated, our practice has found that hearing preservation techniques should be used in all patients having even a single frequency <= 85dB HL between 125 and 2000Hz before surgery. Using this method, 60% of recipients had at least one postoperative threshold <= 85dB HL, and more importantly, over 80% of these patients subsequently used an electroacoustic MAP. Conclusion: Despite concerns about cochlear fragility in elderly patients, preservation of residual hearing is feasible in cochlear implant recipients 72 years and older. This suggests that the vast majority of patients, including an elderly cohort, can benefit from soft surgery techniques.