Affiliation:
1. Department of Otolaryngology/Head & Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina U.S.A.
2. Department of Audiology UNC Health Chapel Hill North Carolina U.S.A.
Abstract
Objective(s)FDA‐approved indications for cochlear implantation include patients with severe‐to‐profound unilateral hearing loss (UHL) or asymmetric hearing loss (AHL); however, these indications are not covered for Medicare beneficiaries. We assessed the outcomes of cochlear implant (CI) use for older adults with UHL or AHL.MethodsEighteen older adults (≥65 years of age at surgery) with UHL/AHL participated in a prospective, longitudinal investigation evaluating outcomes of CI use. Speech recognition for the affected ear was evaluated with consonant‐nucleus‐consonant (CNC) words. Spatial hearing was assessed with measures of sound source localization and sentence recognition in noise. The target sentence was presented from the front and the masker was either co‐located with the target (SoNo), presented toward the affected ear (SoNci) or contralateral ear (SoNcontra). Perceived benefit was assessed with the Speech, Spatial, and Qualities of Hearing scale (SSQ) and the Tinnitus Handicap Inventory (THI).ResultsParticipants experienced significant improvements with CI use for CNC words (mean [SD]; preop: 8% [10%], 1 yr: 51% [22%], 5 yr: 50% [19%]), masked sentence recognition (SoNcontra preop: 5% [6%], 1 yr: 22% [15%], 5 yr: 41% [14%]), and localization (preop: 76° [18°], 1 yr: 40° [11°], 5 yr: 41° [14°]), and reported significant improvements in hearing abilities (SSQ Spatial Hearing preop: 3 [1], 1 yr: 6 [2], 5 yr: 6 [2]) and tinnitus severity (THI preop: 16 [18], 1 yr: 4 [14], 5 yr: 6 [12]).ConclusionOlder adults with UHL/AHL experience significant improvements in speech recognition, spatial hearing, and subjective perceptions (e.g., hearing abilities and tinnitus severity) with a CI as compared to pre‐operative abilities.Level of EvidenceIV Laryngoscope, 2024