Hearing Benefits of Cochlear Implantation in Older Adults With Asymmetric Hearing Loss

To examine the benefit of cochlear implantation (CI) in older adults with single-sided deafness (SSD) and asymmetric hearing loss (AHL).

Retrospective chart review.

Veterans Affairs Medical Center and tertiary referral center, 2019-2023.

Adults ≥60 years with either SSD or AHL who underwent unilateral CI.

Cochlear implantation.

Audiometric testing (preoperative and postoperative pure-tone averages [PTA], sentence and word recognition), presence of hearing-related symptoms, CI utilization.

Twelve subjects were identified who underwent CI for SSD or AHL after being determined to obtain limited benefit from an appropriately fitted unilateral hearing aid (mean age 72.6 yr, 91.7% male, 100% White). Mean duration of hearing loss was 13.7 years, and the most common etiology was idiopathic (25%). Subjects were followed for a median length of 9.1 months after implantation. Mean daily CI use was 9.3 hours per day.Preoperatively, median unaided PTAs of the implanted and contralateral ear were 103.1 and 41.3 dB, respectively; median aided AZBio sentence recognition values in quiet were 0.0 and 81.5%, respectively. In the implanted ear with the CI in use, median PTA improved from 103.1 to 28.1 dB ( p = 0.002), CNC word scores improved from 0.0 to 42.0% ( p = 0.027), CNC phoneme scores improved from 0.0 to 60.0% ( p = 0.043), and AZBio improved from 0.0 to 48.0% ( p = 0.012). Seventy-five percent preoperatively, compared to 33.3% postoperatively, experienced dizziness ( p = 0.063), whereas 83.3 and 33.3% experienced tinnitus ( p = 0.375).

In this group of older adults with SSD or AHL, CI demonstrated significant benefits in hearing thresholds and speech recognition in the implanted ear. Moreover, the average of 9.3 hours of daily use suggests that patients' CI is tolerated and beneficial in this population.