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Updated: Apr 23, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Speech perception performance as a function of age at implantation among postlingually deaf adult cochlear implant
Ahmad F Mahmoud1, Michael J Ruckenstein
1Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
Objective:
We seek to determine the extent of age-related decline in speech perception performance among cochlear implant recipients as quantified by various metrics.
Study Design:
Retrospective chart review.
Setting:
Tertiary referral center.
Patients:
The records of 70 postlingually deafened adults who received cochlear implants between 2004 and 2013 were reviewed.
Intervention(S):
Unilateral cochlear implantation.
Main Outcome Measure(S):
Postoperative AzBio and Consonant-Nucleus-Consonant (CNC) scores at greater than 3 months postactivation. Group analyses comparing patients aged 65 years and older (elderly) with younger adult patients (control). In addition, multivariate linear regression analyses were performed that incorporated preoperative pure-tone audiograms, duration of deafness, duration of follow-up, sex, and laterality of the implanted ear to quantitate the dependence of AzBio and CNC results on age at implantation (AAI).
Results:
Performance on AzBio for the control and elderly groups were 74.6% ± 4.1% and 59.5% ± 4.5% (p = 0.032), respectively. Performance on CNC scores were 63.9% ± 3.4% and 55.3% ± 3.3% (p = 0.098), respectively. Multiple linear regression showed a significant correlation of AzBio with AAI, whereas CNC did not correlate significantly (correlation coefficients = -0.006 and -0.003, p = 0.019 and 0.081, respectively).
Conclusion:
Patients implanted at a later age performed more poorly on AzBio sentences. A similar trend was noted with CNC scores although not significant. The variability in correlation coefficients and significance between both speech perception tests and AAI suggests that, as patients age, their performance on each individual test will be affected to a varying degree.
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