Long-term Speech Perception in Elderly Cochlear Implant Users

Importance: A review of a test battery presented in both quiet and noise may clarify what the progression of speech perception abilities is in older adult cochlear implant users and whether the performance declines with advancing age. Objective: To examine whether older adults (>= 65 years) with cochlear implants maintain stable speech perception performance after at least 10 years of listening experience with an external speech processor. Design and Setting: Retrospective analysis performed in an academic tertiary care center. Participants: Fourteen older adult cochlear implant recipients with at least 10 years of listening experience. Main Outcome Measures: Speech perception outcomes as measured with Consonant-Nucleus Consonant words in quiet and Hearing in Noise Test sentences in quiet and steady-state noise were analyzed retrospectively at the 6-month and 1-, 5-, and 10-year postoperative follow-up intervals. Results: Consonant-Nucleus-Consonant word scores remained stable between 6 months and 1 year of listening experience, improved significantly (P<.001) between 1 year and 5 years, and remained stable between 5 years and 10 years. Hearing in Noise Test sentence scores in quiet and noise showed a similar pattern, with stability in performance between the 6-month to 1-year and 5-year to 10-year follow-up intervals, and significantly improved performance (P=.04) between the 1-year and 5-year follow-up intervals. Conclusions and Relevance: On average, patients who undergo cochlear implantation at age 65 years or older do not experience a decline in speech perception performance with extended listening experience and may potentially continue to see improvements beyond the 1-year follow-up interval. JAMA Otolaryngol Head Neck Surg. 2013; 139(3): 279-283