Cochlear implantation under local anesthesia: a possible alternative for elderly patients

Area of Science:

• Otolaryngology
• Neurosurgery
• Audiology

Background:

• Increasing life expectancy necessitates improved hearing rehabilitation for elderly patients with severe-to-profound sensorineural hearing loss.
• Cochlear implantation is a safe procedure for the elderly, but general anesthesia poses higher risks.
• This study explores cochlear implantation under local anesthesia as an alternative.

Purpose of the Study:

• To evaluate the safety and efficacy of cochlear implantation under local anesthesia in elderly patients.
• To assess the feasibility of a posterior suprameatal approach for electrode insertion in this patient group.
• To determine the impact on hearing perception and speech understanding.

Main Methods:

• Four elderly patients with severe-to-profound hearing loss underwent cochlear implantation using local anesthesia.
• A posterior suprameatal approach was employed for electrode insertion.
• Pre- and postoperative audiological tests, including pure tone audiometry and speech perception tests, were performed.

Main Results:

• The average operative time was 52 minutes, with no observed complications.
• Intraoperative measurements confirmed normal impedance and neuronal response telemetry.
• Postoperative tests demonstrated a significant improvement in hearing perception.

Conclusions:

• Cochlear implantation under local anesthesia is a safe, fast, and effective procedure for carefully selected elderly patients.
• Intraoperative sound experience can enhance postoperative rehabilitation motivation.
• This technique, combined with the posterior suprameatal approach, offers a viable option for high-risk patients previously ineligible for surgery.