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Cochlear implantation in the elderly: outcomes, long-term evolution, and predictive factors

  • Otology
  • Published:
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Abstract

Objective

Our goal in this study is to find out the outcomes of cochlear implantation in elderly (> 60 years) and check if this improvement is similar to that of their younger counterparts in short- and long-term evolution. In addition, we have attempted to ascertain the predictive factors that might affect the verbal comprehension results of older patients.

Study design

Retrospective cohort study.

Methods

Ninety-four patients older than 40 years, divided into two groups. 40–60 years n = 55 and > 60 years n = 39. A pure-tone audiometry, a disyllabic word test, and the test of phonetically balanced sentences of Navarra were made in silence to each patient. These measurements were made pre-implantation and 1, 5, and 10 year post-implantation. Peri- and postoperative complications were registered. The hypothetic predictive factors of post-implanted performance were evaluated in the elderly.

Results

Our study shows no significant difference between young and old adult´s outcomes in short- and long-term evolutions, nor in the complication rate. Furthermore, we proved the significant influence of the side of implantation, use of hearing aids, and duration of hearing loss in the short- and long-term results in the elderly.

Conclusion

This study shows that cochlear implantation in the elderly is as safe, useful, and worthwhile as in young adults. Age has a low influence in cochlear implant outcomes; however, we have found the significant influence of the side of implantation, the use of hearing aids, and the duration of hearing loss in the short- and long-term results.

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References

  1. Yang Z, Cosetti M (2016) Safety and outcomes of cochlear implantation in the elderly: a review of recent literature. J Otol 11:1–6

    Article  Google Scholar 

  2. Sladen DP, Gifford RH, Haynes D et al (2017) Evaluation of a revised indication for determining adult cochlear implant candidacy. Laryngoscope 127(10):2368–2374

    Article  PubMed  Google Scholar 

  3. Alice B, Silvia M, Laura G, Patrizia T, Roberto B (2013) Cochlear implantation in the elderly: surgical and hearing outcomes. BMC Surg 13(Suppl 2):S1

    Article  PubMed  PubMed Central  Google Scholar 

  4. Otte J, Schuknecht H, Kerr A (1978) Ganglion cell populations in normal and pathological human cochleae. Implications for cochlear implantation. Laryngoscope 88:1231–1246

    Article  CAS  PubMed  Google Scholar 

  5. Lin FR (2011) Hearing loss and cognition among older adults in the United States. J Gerontol Ser A Biol Sci Med Sci. 66A(10):1131–1136. https://doi.org/10.1093/gerona/glr115

    Article  Google Scholar 

  6. Lin FR, Metter EJ, O’Brien RJ, Resnick SM, Zonderman AB, Ferrucci L (2011) Hearing loss and incident dementia. Arch Neurol 68(2):214–220

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cacioppo JT, Hawkley LC, Norman GJ, Berntson GG (2011) Social isolation. Ann N Y Acad 1231(1):17–22

    Article  Google Scholar 

  8. Lin FR, Ferrucci L, Metter EJ, An Y, Zonderman AB, Resnick SM (2011) Hearing loss and cognition in the Baltimore Longitudinal Study of Aging. Neuropsychology 25(6):763–770

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gallacher J et al (2012) Auditory threshold, phonologic demand, and incident dementia. Neurology 79(15):1583–1590

    Article  PubMed  Google Scholar 

  10. Hiel AL, Gerard JM, Decat M, Deggouj N (2016) Is age a limiting factor for adaptation to cochlear implant? Eur Arch Otorhinolaryngol 273:2495–2502

    Article  PubMed  Google Scholar 

  11. Friedland DR, Runge-Samuelson C, Baig H et al (2010) Case–control analysis of cochlear implant performance in elderly patients. Arch Otolaryngol Head Neck Surg 136:432–438

    Article  PubMed  Google Scholar 

  12. Dillon MT, Buss E, Adunka MC et al (2013) Long-term speech perception in elderly cochlear implant users. JAMA Otolaryngol Head Neck Surg 139:279–283

    Article  PubMed  Google Scholar 

  13. Vermeire K, Brokx JP, Wuyts FL et al (2005) Quality-of-life benefit from cochlear implantation in the elderly. Otol Neurotol 26:188–195

    Article  PubMed  Google Scholar 

  14. Wong PC, Ettlinger M, Sheppard JP, Gunasekera GM, Dhar S (2010) Neuroanatomical characteristics and speech perception in noise in older adults. Ear Hear 31:471e479

    Article  Google Scholar 

  15. Dillon MT, Adunka OF, Anderson ML et al (2015) Influence of age at revision cochlear implantation on speech perception outcomes. JAMA Otolaryngol Head Neck Surg 141(3):219–224

    Article  PubMed  Google Scholar 

  16. Hilly O, Hwang E, Smith L et al (2016) Cochlear implantation in elderly patients: stability of outcome over time. Laryngol Otol 13:1–6

    Google Scholar 

  17. Olze H, Grabel S, Forster U et al (2012) Elderly patients benefit from cochlear implantation regarding auditory rehabilitation, quality of life, tinnitus, and stress. Laryngoscope 122:196–203

    Article  PubMed  Google Scholar 

  18. Hast A, Schlücker L, Digeser F, Liebscher T, Hoppe U (2015) Speech perception of elderly cochlear implant users under different noise conditions. Otol Neurotol 36(10):1638–1643

    Article  PubMed  Google Scholar 

  19. Cloutier F, Bussières R, Ferron P, Côté M (2014) OCTO “outcomes of cochlear implant for the octogenarians: audiologic and quality-of-life”. Otol Neurotol 35(1):22–28

    Article  PubMed  Google Scholar 

  20. Huarte A, Lezaun R, Manrique M (2014) Quality of life outcomes for cochlear implantation in the elderly. Audiol Neurotol 19(Suppl 1):36–39

    Article  Google Scholar 

  21. Chen DS, Clarrett DM, Li L, Bowditch SP, Niparko JK, Lin FR (2013) Cochlear implantation in older adults: long-term analysis of complications and device survival in a consecutive series. Otol Neurotol 34(7):1272––77

    Article  PubMed  PubMed Central  Google Scholar 

  22. Olze H, Szczepek AJ, Haupt H et al (2011) Cochlear implantation has a positive influence on quality of life, tinnitus, and psychological comorbidity. Laryngoscope 21:2220–2227. https://doi.org/10.1002/lary.22145

    Article  Google Scholar 

  23. Olze H, Knopke S, Gräbel S, Szczepek AJ. (2016) Rapid positive influence of cochlear implantation on the quality of life in adults 70 years and older. Audiol Neurotol 21(suppl 1):43–47

    Article  Google Scholar 

  24. Rohloff K, Koopmann M, Wei D, Rudack C, Savvas E (2017) Cochlear implantation in the elderly: does age matter? Otol Neurotol 38(1):54–59

    Article  PubMed  Google Scholar 

  25. Dickstein DL, Kabaso D, Rocher AB, Luebke JI, Wearne SL, Hof PR (2007) Changes in the structural complexity of the aged brain. Aging cell 6(3):275–284

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Mosnier I, Bebear JP, Marx M et al (2014) Predictive factors of cochlear implant outcomes in the elderly. Audiol Neurootol 19(Suppl 1):15–20

    Article  PubMed  Google Scholar 

  27. Beyea JA, McMullen KP, Harris MS et al (2016) Cochlear implants in adults: effects of age and duration of deafness on speech recognition. Otol Neurotol 37(9):1238–1245

    Article  PubMed  Google Scholar 

  28. Choi JS, Contrera KJ, Betz JF, Blake CR, Niparko JK, Lin FR (2014) Long-term use of cochlear implants in older adults: results from a large consecutive case series. Otol Neurotol 35(5):815–820

    Article  PubMed  PubMed Central  Google Scholar 

  29. Bond M, Mealing S, Anderson R, Elston J, Weiner G, Taylor RS et al (2009) The effectiveness and cost-effectiveness of cochlear implants for severe to profound deafness in children and adults: a systematic review and economic model. Health Technol Assess 13(44):1–330

    Article  Google Scholar 

  30. Peñaranda A, Mendieta JC, Perdomo JA, Aparicio ML, Marín LM, García JM et al (2012) Beneficios económicos del implante coclear para la hipoacusia sensorineural profunda. Rev Panam Salud Publica 31(4):325–331

    Article  PubMed  Google Scholar 

  31. Knopke S, Gräbel S, Förster-Ruhrmann U, Mazurek B, Szczepek AJ, Olze H (2016) Impact of cochlear implantation on quality of life and mental comorbidity in patients aged 80 years. Laryngoscope 126:2811–2816. https://doi.org/10.1002/lary.25993

    Article  PubMed  Google Scholar 

  32. Ramos-Macías Á, Falcón González JC, Borkoski-Barreiro SA et al (2016) Health-related quality of life in adult cochlear implant users: a descriptive observational study. Audiol Neurootol 21(Suppl 1):36–42

    Article  PubMed  Google Scholar 

  33. Suh MW, Park KT, Lee HJ, Lee JH, Chang SO, Oh SH (2015) Factors contributing to speech performance in elderly cochlear implanted patients: an FDG-PET study: a preliminary study. J Int Adv Otol 11(2):98–103

    Article  PubMed  Google Scholar 

  34. Castiglione A, Benatti A, Velardita C et al (2016) Aging, cognitive decline and hearing loss: effects of auditory rehabilitation and training with hearing aids and cochlear implants on cognitive function and depression among older adults. Audiol Neurootol 21(Suppl 1):21–28

    Article  PubMed  Google Scholar 

  35. Leung J, Wang N, Yeagle J et al (2005) Predictive models for cochlear implantation in elderly candidates. Arch Otolaryngol Head Neck Surg 131:1049–1054

    Article  PubMed  Google Scholar 

  36. Sharpe RA, Camposeo EL, Muzaffar WK et al (2016) Effects of age and implanted ear on speech recognition in adults with unilateral cochlearimplants. Audiol Neurootol 21(4):223–230

    Article  PubMed  Google Scholar 

  37. Mosnier I, Bebear JP, Marx M et al (2015) Improvement of cognitive function after cochlear implantation in elderly patients. JAMA Otolaryngol Head Neck Surg 141:442–450

    Article  PubMed  Google Scholar 

  38. Cosetti MK, Pinkston JB, Flores JM et al (2016) Neurocognitive testing and cochlear implantation: insights into performance in older adults. Clin Interv Aging 11:603–613

    Article  PubMed  PubMed Central  Google Scholar 

  39. Alzhrani F, Lenarz T, Teschner M (2016) Facial palsy following cochlear implantation. Eur Arch Otorhinolaryngol 273:4199–4207

    Article  PubMed  Google Scholar 

  40. Thom JJ, Carlsoon ML, Olson MD, Neff BA, Beatty CW et al (2013) The prevalence and clinical course of facial nerve paresis following cochlear implant surgery. Laryngoscope 123:1000–1004

    Article  PubMed  Google Scholar 

  41. Moon IJ, Kim EY, Jeong JO, Chung WH, Cho YS, Hong SH (2012) The influence of various factors on the performance of repetition tests in adults with cochlear implants. Eur Arch Otorhinolaryngol 269(3):739–745

    Article  PubMed  Google Scholar 

  42. Budenz CL, Cosetti MK, Coelho DH et al (2011) The effects of cochlear implantation on speech perception in older adults. J Am Geriatr Soc 59(3):446–453

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Donostia University Hospital, Donostia-San Sebastian, Spain

    Leire Garcia-Iza, Zuriñe Martinez, Ane Ugarte, Mercedes Fernandez & Xabier Altuna

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  1. Leire Garcia-Iza
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  2. Zuriñe Martinez
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  3. Ane Ugarte
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  4. Mercedes Fernandez
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  5. Xabier Altuna
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Correspondence to Leire Garcia-Iza.

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Garcia-Iza, L., Martinez, Z., Ugarte, A. et al. Cochlear implantation in the elderly: outcomes, long-term evolution, and predictive factors. Eur Arch Otorhinolaryngol 275, 913–922 (2018). https://doi.org/10.1007/s00405-018-4910-y

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  • DOI: https://doi.org/10.1007/s00405-018-4910-y

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