Cochlear Implantation After Traumatic Brain Injury

Area of Science:

• Audiology
• Neurosurgery
• Otolaryngology

Background:

• Traumatic brain injury (TBI) can impact neurological function.
• Cochlear implantation (CI) offers hearing rehabilitation for severe hearing loss.
• The effect of TBI on CI outcomes is not well-established.

Purpose of the Study:

• To investigate if a history of TBI affects postoperative audiological performance in patients undergoing CI.
• To compare hearing outcomes between CI patients with and without a history of TBI.

Main Methods:

• Retrospective review of a Department of Defense-wide database (2005-2023).
• Identification of patients with TBI prior to CI using ICD-9/ICD-10 codes.
• 2:1 matching of TBI patients with non-TBI controls based on age and sex; comparison of preoperative and postoperative pure tone average (PTA) thresholds and AzBio scores.

Main Results:

• Nineteen TBI patients (20 ears) were matched with 39 non-TBI patients (40 ears).
• Mean follow-up was 44 months.
• Postoperative PTA and AzBio scores were comparable between groups (PTA: 37 vs. 31 dB, P=.93; AzBio: 67% vs. 69%, P=.88).
• All TBI ears achieved sound awareness; 79% achieved open-set speech perception versus 82% in the non-TBI group.

Conclusions:

• Cochlear implantation following TBI, regardless of severity, yields audiological results similar to those without a TBI history.
• TBI does not appear to be a significant factor in degrading CI audiological performance.
• CI is an effective hearing rehabilitation option for patients with a history of TBI.