Predictive factors of cochlear implant outcomes in the elderly.
OBJECTIVE
To analyze predictive factors of cochlear implant outcomes and postoperative complications in the elderly.


METHODS
Prospective, longitudinal study performed in 10 tertiary referral centers.


METHODS
Ninety-four patients aged 65-85 years with a profound, postlingual hearing loss were evaluated before implantation, at time of activation, and 6 and 12 months after cochlear implantation. Speech perception and lipreading were measured using disyllabic word recognition in quiet and noise, and lipreading using disyllabic words and sentences. The influence of preoperative factors on speech perception in quiet and noise at 12 months was tested in a multivariate analysis. Complications, presence of tinnitus and of vestibular symptoms were collected at each evaluation.


RESULTS
The effect of age was observed only in difficult noisy conditions at SNR 0 dB. Lipreading ability for words and sentences was negatively correlated with speech perception in quiet and noise. Better speech perception scores were observed in patients with shorter duration of hearing deprivation, persistence of residual hearing for the low frequencies, the use of a hearing aid before implantation, the absence of cardiovascular risk factors, and in those with implantation in the right ear. General and surgical complications were very rare, and the percentage of vestibular symptoms remained stable over time.


CONCLUSIONS
This study demonstrates that cochlear implantation in the elderly is a well-tolerated procedure and an effective method to improve communication ability. Advanced age has a low effect on cochlear implant outcome. Analyses of predictive factors in this population provide a convincing argument to recommend treatment with cochlear implantation as early as possible in elderly patients with confirmed diagnosis of a severe-to-profound hearing loss and with only limited benefit from hearing aid use in one ear.
Isabelle
I
Mosnier
Jean-Pierre
JP
Bebear
Mathieu
M
Marx
Bernard
B
Fraysse
Eric
E
Truy
Geneviève
G
Lina-Granade
Michel
M
Mondain
Françoise
F
Sterkers-Artières
Philippe
P
Bordure
Alain
A
Robier
Benoit
B
Godey
Bernard
B
Meyer
Bruno
B
Frachet
Christine
C
Poncet
Didier
D
Bouccara
Olivier
O
Sterkers
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D019929:Cochlear Implantation; D005260:Female; D006310:Hearing Aids / Q000706:statistics & numerical data; D034381:Hearing Loss / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D012307:Risk Factors; D013067:Speech Perception; D016896:Treatment Outcome