Cochlear implantation in older adults: long-term analysis of complications and device survival in a consecutive series.
OBJECTIVE
To analyze the postoperative complications associated with cochlear implant (CI) surgery in a large consecutive case series of older adults (≥ 60 yr).


METHODS
Retrospective case review.


METHODS
Tertiary referral center.


METHODS
Approximately 445 individuals aged 60 years and older who received a first CI between 1999 and 2011.


METHODS
Cochlear implantation.


METHODS
Postoperative complications classified as major (meningitis, immediate postoperative facial weakness, device failure, flap dehiscence, and surgical removal) and minor (surgical site infection, balance problems, delayed postoperative facial weakness, and facial nerve stimulation).


RESULTS
The mean age at implantation was 72.7 years (60-94.9 yr), and the median duration of follow-up was 4.8 years (0.1-12.5 yr). There were 42 minor complications in 41 patients (9.2%) and 36 major complications in 21 patients (4.7%). Seventeen patients (3.8%) required surgical device removal, 15 of whom underwent reimplantation. A Kaplan-Meier analysis of rates of device explantation demonstrated that at 5 and 10 years after CI, respectively, 95.4% and 93.1% of patients retained their original CI. When comparing complications between patients aged 60 to 74 years and those aged 75 years and older, there was a higher prevalence of balance problems lasting more than 1 month in the older group (9.5% versus 4.9%, p = 0.05).


CONCLUSIONS
Our results indicate that the safety profile of cochlear implantation in an older population is comparable to that of younger adults and children. We suggest that concerns for increased postoperative complications in patients of advanced age do not need to be a primary consideration when determining CI candidacy.
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
David S
DS
Chen
Danisa M
DM
Clarrett
Lingsheng
L
Li
Steve P
SP
Bowditch
John K
JK
Niparko
Frank R
FR
Lin
D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation / Q000009:adverse effects; D015331:Cohort Studies; D020878:Device Removal / Q000706:statistics & numerical data; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D034381:Hearing Loss / Q000534:rehabilitation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome