Long-term Speech Perception in Elderly Cochlear Implant Users

IMPORTANCE: A review of a test battery presented in both quiet and noise may clarify what the progression of speech perception abilities is in older adult cochlear implant users and whether the performance declines with advancing age. OBJECTIVE: To examine whether older adults (≥65 years) with cochlear implants maintain stable speech perception performance after at least 10 years of listening experience with an external speech processor. DESIGN AND SETTING: Retrospective analysis performed in an academic tertiary care center. PARTICIPANTS: Fourteen older adult cochlear implant recipients with at least 10 years of listening experience. MAIN OUTCOME MEASURES: Speech perception outcomes as measured with Consonant-Nucleus-Consonant words in quiet and Hearing in Noise Test sentences in quiet and steady-state noise were analyzed retrospectively at the 6-month and 1-, 5-, and 10-year postoperative follow-up intervals. RESULTS: Consonant-Nucleus-Consonant word scores remained stable between 6 months and 1 year of listening experience, improved significantly (P < .001) between 1 year and 5 years, and remained stable between 5 years and 10 years. Hearing in Noise Test sentence scores in quiet and noise showed a similar pattern, with stability in performance between the 6-month to 1-year and 5-year to 10-year follow-up intervals, and significantly improved performance (P = .04) between the 1-year and 5-year follow-up intervals. CONCLUSIONS AND RELEVANCE: On average, patients who undergo cochlear implantation at age 65 years or older do not experience a decline in speech perception performance with extended listening experience and may potentially continue to see improvements beyond the 1-year follow-up interval

Influence of Age at Revision Cochlear Implantation on Speech Perception Outcomes

IMPORTANCE: This study reviewed whether advanced age should be a consideration when revision cochlear implantation is warranted. OBJECTIVE: To examine whether age at revision cochlear implantation is related to postrevision speech perception performance. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis was performed in an academic tertiary care center. Participants included 14 younger adults (<65 years) and 15 older adults (≥65 years) who underwent revision cochlear implantation. INTERVENTION: Revision cochlear implantation. MAIN OUTCOMES AND MEASURES: Speech perception performance, as measured with consonant-nucleus-consonant [CNC] words in quiet, at the best prerevision interval as well as the 3- and 6-month postrevision intervals were compared between the 2 cohorts. The CNC word test consists of 10 lists of 50 phonemically balanced monosyllabic words, scored with a range of 0% to 100% correct. RESULTS: Both cohorts experienced a restoration in speech perception scores after revision cochlear implantation compared with their best performance before the revision (mean [SD] CNC word test scores for the younger cohort: 43.9% [25.6%] before revision and 47.7% [21.3%] at 3 months and 47.6% [19.8%] at 6 months after revision; for the older cohort: 36.3% [19.1%] before revision and 35.3% [17.2%] at 3 months and 39.9% [16.3%] at 6 months after revision; F₂,₅₄= 0.93; P = .40). There was no interaction between age at revision surgery and speech perception performance at each assessment interval (F₂,₅₄= 0.51; P = .60). CONCLUSIONS AND RELEVANCE: In this study, age at revision cochlear implantation was not related to postrevision speech perception performance. Advanced age should not be considered a contraindication to revision cochlear implantation

Hearing-in-Noise Benefits After Bilateral Simultaneous Cochlear Implantation Continue to Improve 4 Years After Implantation

The purpose of this 4-year longitudinal study was to assess the stability of the binaural benefits of head shadow, summation, and squelch for bilateral cochlear implant recipients and to quantify these benefits for the understanding of speech in noise