Differential cochlear implant outcomes in older adults

Objectives/Hypothesis The goals of this study were to analyze whether cochlear implant (CI) users over 65 years of age have different surgical and audiological outcomes when compared to younger adult CI users and to identify reasons for these possible differences. Study Design Retrospective single-institution study. Methods Records of 113 postlingually deafened adults with unilateral cochlear implants were reviewed. Preoperative and postoperative speech perception scores, and medical and epidemiological data were recorded and analyzed. Results Speech perception ability was significantly poorer in CI users over 65 years of age compared to younger adult patients (P = .012). Patients over the age of 80 years accounted for these findings (P = .017). Older patients were less likely to have a family history of hearing deficits. A history of noise exposure and idiopathic cause of hearing loss did not correlate with audiological outcomes. A family history of hearing loss was associated with a trend toward better speech recognition (P = .062). Older patients did not experience more vestibular symptoms or other complications compared to younger patients. Conclusions Patients over the age of 80 years had lower speech perception scores than other adult CI recipients but did not have higher rates of dizziness or vertigo after surgery. A family history of hearing loss was associated with a trend toward better speech recognition, possibly representing a new prognostic variable. These findings provide important information that will aid clinicians in counseling older CI candidates.