Is cochlear implantation a good treatment method for profoundly deafened elderly?

Abstract

Purpose: To assess the benefits of cochlear implantation in the elderly.

Patients and methods: A retrospective analysis of 31 postlingually deafened elderly (≥60 years of age) with unilateral cochlear implants was conducted. Audiological testing included preoperative and postoperative pure-tone audiometry and a monosyllabic word recognition test presented from recorded material in free field. Speech perception tests included Ling's six sound test (sound detection, discrimination, and identification), syllable discrimination, and monosyllabic and multisyllabic word recognition (open set) without lip-reading. Everyday life benefits from cochlear implantation were also evaluated.

Results: The mean age at the time of cochlear implantation was 72.4 years old. The mean postimplantation follow-up time was 2.34 years. All patients significantly improved their audiological and speech understanding performances. The preoperative mean pure-tone average threshold for 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz was 110.17 dB HL. Before cochlear implantation, all patients scored 0% on the monosyllabic word recognition test in free field at 70 dB SPL intensity level. The postoperative pure-tone average was 37.14 dB HL (the best mean threshold was 17.50 dB HL, the worst was 58.75 dB HL). After the surgery, mean monosyllabic word recognition reached 47.25%. Speech perception tests showed statistically significant improvement in speech recognition.

Conclusion: The results of this study showed that cochlear implantation is indeed a successful treatment for improving speech recognition and offers a great help in everyday life to deafened elderly patients. Therefore, they can be good candidates for cochlear implantation and their age alone should not be a relevant or excluding factor when choosing candidates for cochlear implantation.

Keywords: audiometry; cochlear implantation; elderly; hearing aid; hearing loss; speech perception; speech recognition.

Figure 1

Results of free field audiometric tests in elderly patients before and after cochlear implantation. Notes: In panel (A) pure-tone audiogram thresholds are shown. In panel (B) speech recognition test scores measured using the Polish phonetically balanced monosyllabic word test in quiet from recorded material are presented. In panel (B) the plain curve represents normal hearing results as a reference. The plain curve in panel (B) represents normal hearing results as a reference. Abbreviations: CI, cochlear implantation; FF, free field; PTA, pure-tone average.

Figure 2

Speech perception tests results of Ling’s six sound test, syllable discrimination, monosyllabic and multisyllabic word recognition tests without lip-reading before cochlear implantation, and 3, 6, and 12 months after implantation. Note: In each test, the improvement over time is easily noted. Abbreviations: CI, cochlear implantation; m, months.

Figure 3

Results of free field audiometric tests in elderly patients before and after cochlear implantation with regard to the three groups of patients. Notes: The patients were grouped according to implantation benefits as follows. Group 1: almost no benefits. Group 2: good benefits. Group 3: very good benefits. In panel (A) pure-tone audiogram mean thresholds are shown. In panel (B) speech perception test scores measured using the Polish phonetically balanced monosyllabic word test in quiet from recorded are presented. The plain curve in panel (B) represents normal hearing results as a reference. Abbreviation: PTA, pure-tone average.