Postlingually Deaf Adults of All Ages Derive Equal Benefits from Unilateral Multichannel Cochlear Implant

Abstract

Background: Controversy still exists regarding the impact of age on speech recognition following cochlear implant in postlingually deaf adults. In some studies elderly recipients did not perform as well as younger patients on standard speech recognition tests. Furthermore, previous studies have shown that cochlear implantation improves quality of life, as measured by self-administered questionnaires, but the sample sizes of these studies have been relatively small, thus making age stratification a challenge. Purpose: The primary objective was to assess whether the age at which a patient receives a unilateral cochlear implant affects improvements in speech recognition scores and perceived quality of life. A secondary objective was to determine whether preoperative use of hearing aids correlates with improvement in speech recognition and perceived quality of life after cochlear implantation. Research Design: A retrospective study in a tertiary referral center. Patients: A total of 161 postlingually deaf adults, who were divided based on age (<50, 50–65, >65) and on prior hearing aid(s) use. Intervention: All patients received a unilateral multichannel cochlear implant. Data Collection and Analysis: Speech recognition was quantified by percent correct scores on the Hearing in Noise Test sentences delivered in a quiet setting only (HINT%), and quality of life was quantified by the Hearing Handicap Inventory (HHI) before and 1 yr after cochlear implantation. Results: Speech recognition, as measured by HINT%, improved significantly and to similar extents in all three age groups following cochlear implantation. Similarly, quality of life as quantified by HHI improved markedly and to similar extents in all age groups. Whether hearing aids were used pre-implant, or whether the cochlear implant (CI) was implanted on the same side or contralateral to the hearing aid side, had no substantial effect on the patients’ performances on either speech recognition or quality of life. Moreover, there were no statistically significant correlations between pre-implant speech recognition scores and pre-implant quality of life scores or between postimplant speech recognition scores and postimplant quality of life scores. Conclusion: The findings of the present study demonstrate that cochlear implantation improves HINT% and HHI scores to similar extents across all age groups. This finding suggests that elderly patients may derive speech recognition and quality of life benefits similar to those of younger patients and that age should not be an essential factor in the determination of CI candidacy. Furthermore, prior use of a hearing aid, and its location in relation to the cochlear implant, does not influence the extent of improvement in speech recognition or quality of life measurements following cochlear implantation.