title: Younger- and older-age adults with unilateral and bilateral cochlear implants: speech and spatial hearing self-ratings and performance.
abstract: OBJECTIVE
  Compare results of cochlear implantation in younger and older adults in the domains of disability and handicap, as well as in tests of word recognition and localization, across unilateral implant (CI), bilateral (CI + CI), and CI with an acoustic hearing aid in the nonimplanted ear (CI + HA).
  
  
  METHODS
  Three parts: retrospective (postimplant only) analysis; prospective (preimplant versus postimplant); correlation between age and benefit from CI versus CI + CI. Two age groups, older and younger than 60 years, for the first 2 analyses; age is a continuous variable for the third analysis.
  
  
  METHODS
  Tertiary referral hospital clinic.
  
  
  METHODS
  Postlingually severely-to-profoundly hearing-impaired adults: Totals of 68 CI, 36 CI + CI, and 38 CI + HA in the retrospective part of the study; totals of 30 CI, 18 CI + CI, and 16 CI + HA in the prospective parts. Numbers vary from these totals on individual measures.
  
  
  METHODS
  Patients receive either 1 or 2 cochlear implants; some with 1 CI opt to retain a hearing aid in the nonimplanted ear.
  
  
  METHODS
  Principal measures: Hearing Handicap Inventory for the Elderly, Hearing Handicap Questionnaire, Speech, Spatial and Qualities of Hearing Scale, word recognition test, and soundfield localization test. The study is exploratory, but proceeding from a null hypothesis of no expected contrast as a function of patient age.
  
  
  RESULTS
  All patient groups show significant benefit after implantation. No significant age-related differences are observed in patients with unilateral implant, nor in CI + HA group. In the CI + CI group, the younger cohort showed very substantial increases in both performance and self-rated abilities; the older cohort provides more mixed outcomes.
  
  
  CONCLUSIONS
  Results for the CI group confirm and extend earlier research. The result for the younger group of CI + CI patients demonstrates the consistent incremental benefit obtained from a bilateral procedure. The mixed outcome observed in the older CI + CI group might be due to individual differences in interaction between effects of aging and the ability to integrate binaural cues.
authors.affiliation: University of New England, Armidale, New South Wales, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Noble
authors.forename: Richard S
authors.initials: RS
authors.lastname: Tyler
authors.forename: Camille C
authors.initials: CC
authors.lastname: Dunn
authors.forename: Navjot
authors.initials: N
authors.lastname: Bhullar
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003463:Cues; D004185:Disability Evaluation; D005260:Female; D006309:Hearing; D006312:Hearing Loss, Bilateral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013017:Sound Localization; D013067:Speech Perception; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
references.citation: Tech Rep SAM-TR. 1966 Jun;:1-12
references.pmid: 5296571
references.citation: Ear Hear. 2007 Apr;28(2 Suppl):52S-55S
references.pmid: 17496647
references.citation: Audiol Neurootol. 2008;13(5):328-34
references.pmid: 18460868
references.citation: Ann Otol Rhinol Laryngol Suppl. 1995 Apr;165:31-48
references.pmid: 7717632
references.citation: Arch Otolaryngol Head Neck Surg. 2005 Dec;131(12):1049-54
references.pmid: 16365217
references.citation: Ann Otol Rhinol Laryngol. 2002 Oct;111(10):890-5
references.pmid: 12389856
references.citation: Eur Arch Otorhinolaryngol. 2006 Mar;263(3):256-62
references.pmid: 16267683
references.citation: Otol Neurotol. 2004 May;25(3):298-301
references.pmid: 15129109
references.citation: Otolaryngol Head Neck Surg. 2000 Apr;122(4):602-6
references.pmid: 10740189
references.citation: Acta Otolaryngol. 2004 Apr;124 Suppl 552:64-7
references.pmid: 26942828
references.citation: Laryngoscope. 2005 Oct;115(10):1887-94
references.pmid: 16222216
references.citation: Int J Audiol. 2006;45 Suppl 1:S99-107
references.pmid: 16938781
references.citation: Ann Otol Rhinol Laryngol Suppl. 1982 Mar-Apr;91(2 Pt 3):59-61
references.pmid: 6805399
references.citation: Laryngoscope. 1991 Mar;101(3):284-8
references.pmid: 2000016
references.citation: Ann Otol Rhinol Laryngol. 1996 Jun;105(6):415-22
references.pmid: 8638891
references.citation: Ear Hear. 1990 Dec;11(6):430-3
references.pmid: 2073976
references.citation: Otol Neurotol. 2005 Mar;26(2):188-95
references.pmid: 15793403
references.citation: Ear Hear. 2008 Jan;29(1):112-20
references.pmid: 18091100
references.citation: Ear Hear. 1982 May-Jun;3(3):128-34
references.pmid: 7095321
references.citation: Otolaryngol Head Neck Surg. 2000 Oct;123(4):419-24
references.pmid: 11020178
references.citation: J Speech Lang Hear Res. 2005 Jun;48(3):668-80
references.pmid: 16197280
references.citation: Int J Audiol. 2004 Apr;43(4):183-92
references.pmid: 15250122
references.citation: Audiol Neurootol. 2007;12(5):285-94
references.pmid: 17536197
references.citation: Int J Audiol. 2004 Feb;43(2):85-99
references.pmid: 15035561
references.citation: Int J Audiol. 2008 Aug;47(8):505-14
references.pmid: 18608531
references.citation: Int J Audiol. 2006 Mar;45(3):172-81
references.pmid: 16579492