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Predictive models for cochlear implantation in elderly candidates
Janice Leung1, Nae-Yuh Wang, Jennifer D Yeagle
1Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Archives of Otolaryngology--Head & Neck Surgery
|December 21, 2005
Summary
Elderly cochlear implant recipients show minimal age-related decline in hearing performance. Duration of deafness and residual hearing are more critical factors than age for successful outcomes in older adults.
Area of Science:
- Audiology
- Gerontology
- Biomedical Engineering
Background:
- The aging population in America experiences a high prevalence of profound sensorineural hearing loss.
- Multichannel cochlear implants offer a solution for hearing restoration in adults.
Purpose of the Study:
- To examine the postoperative performance of multichannel cochlear implant recipients in an aging population.
- To determine the predictive value of age at implantation versus duration of deafness on hearing outcomes.
Main Methods:
- A nonconcurrent prospective study analyzed a national cohort of 749 adolescent and adult cochlear implant recipients (ages 14-91).
- Multivariate regression analysis was used to assess preoperative and postoperative performance variables.
- Prediction models from previous studies were applied to evaluate outcomes.
Main Results:
- Adults aged 65 and older showed a clinically insignificant 4.6% lower word score compared to younger recipients.
- Elderly recipients with over 25 years of deafness had higher word scores than younger counterparts.
- The ratio of duration of deafness to age at implantation was a significant predictor of outcomes.
Conclusions:
- Age at implantation has limited predictive value for postoperative performance in individuals 65 and older.
- The observed small decrement in speech recognition scores for elderly recipients is of questionable clinical significance.
- Duration of profound deafness and residual speech recognition are more important predictors of cochlear implant success than age.