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Young A, Fechtner L, Kim C, Nayak N, Kellermeyer B, Ortega C, Rende S, Rosenberg S, Wazen J. Long-term cognition and speech recognition outcomes after cochlear implantation in the elderly. Am J Otolaryngol 2024; 45:104071. [PMID: 37793300 DOI: 10.1016/j.amjoto.2023.104071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE The purpose of this study is to investigate how cognition, as measured using the Self-Administered Gerocognitive Examination Test (SAGE), and age affect speech recognition scores in older adults (age > 65) at one year and two years after cochlear implantation. STUDY DESIGN This is a prospective study. SETTING This study was conducted at a single institution. METHODS Unilateral cochlear implantation was performed by two surgeons on adult patients (>65 years) with postlingual bilateral sensorineural hearing loss. There were 230 patients who underwent cochlear implantation from January 2016 to June 2023. Fifty-five of these patients completed the SAGE questionnaire before implantation, one year after implantation, and 2 years after implantation. Paired t-test analysis was used to evaluate pre- and post-operative speech recognition scores (CNC, AzBio in Quiet). RESULTS Patients who had normal preoperative cognition on SAGE showed greater improvement in postoperative speech recognition tests at 1 year and 2 years after implantation compared with patients who showed preoperative cognitive impairment. There were no significant differences in postoperative speech outcome between age group 1 (between 65 and 80 years old) and age group 2 (over 80 years old) cochlear implant recipients. There were no changes in cognitive SAGE scores after 2 years implantation. CONCLUSION Cognitive function, as measured by SAGE, is a more reliable predictor than age in determining speech recognition improvement after cochlear implantation. Cochlear implantation did not improve postoperative cognition.
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Affiliation(s)
- Allen Young
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, USA.
| | - Linnea Fechtner
- Grand Valley ENT and Facial Plastics Surgeon, 2373 G Road, Suite 270, Grand Junction, CO 81505, USA
| | - Christine Kim
- AMC Otolaryngology, 50 New Scotland Avenue, Albany, NY 12208, USA
| | - Neil Nayak
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, USA
| | - Brian Kellermeyer
- West Virginia University Hospitals, 1 Medical Center DR, Morganton, WV 26505, USA
| | - Carmelo Ortega
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, USA
| | - Sharon Rende
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, USA
| | - Seth Rosenberg
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, USA
| | - Jack Wazen
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, USA
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Totten DJ, Saltagi A, Libich K, Pisoni DB, Nelson RF. Cochlear Implantation in US Military Veterans: A Single Institution Study. OTO Open 2023; 7:e53. [PMID: 37187572 PMCID: PMC10181857 DOI: 10.1002/oto2.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023] Open
Abstract
Objective Military veterans have high rates of noise-induced hearing loss (NIHL) which is associated with more significant spiral ganglion neuronal loss. This study explores the relationship between NIHL and cochlear implant (CI) outcomes in veterans. Study Design Retrospective case series of veterans who underwent CI between 2019 and 2021. Setting Veterans Health Administration hospital. Methods AzBio Sentence Test, Consonant-Nucleus-Consonant (CNC) scores, and Speech, Spatial, and Qualities of Hearing Scale (SSQ) were measured pre- and postoperatively. Linear regression assessed relationships between outcomes and noise exposure history, etiology of hearing loss, duration of hearing loss, and Self-Administered Gerocognitive Exam (SAGE) scores. Results Fifty-two male veterans were implanted at an average (standard deviation) age of 75.0 (9.2) years without major complications. The average duration of hearing loss was 36.0 (18.4) years. The average time of hearing aid use was 21.2 (15.4) years. Noise exposure was reported in 51.3% of patients. Objectively, AzBio and CNC scores 6 months postoperatively showed significant improvement of 48% and 39%, respectively. Subjectively, average 6-month SSQ scores showed significant improvement by 34 points (p < .0001). Younger age, SAGE score ≥17, and shorter duration of amplification were associated with higher postoperative AzBio scores. Greater improvement in AzBio and CNC scores was associated with lower preoperative scores. Noise exposure was not associated with any difference in CI performance. Conclusion Despite high levels of noise exposure and advanced age, veterans derive substantial benefits from cochlear implantation. SAGE score ≥17 may be predictive of overall CI outcomes. Noise exposure does not impact CI outcomes. Level of Evidence Level 4.
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Affiliation(s)
- Douglas J. Totten
- Department of Otolaryngology–Head and Neck SurgeryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Abdul Saltagi
- College of Medicine, Indiana University School of MedicineIndianapolisIndianaUSA
| | - Karen Libich
- Department of AudiologyRoudebush Veterans' Administration Medical CenterIndianapolisIndianaUSA
| | - David B. Pisoni
- Department of Otolaryngology–Head and Neck SurgeryIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
| | - Rick F. Nelson
- Department of Otolaryngology–Head and Neck SurgeryIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Neurological SurgeryIndiana University School of MedicineIndianapolisIndianaUSA
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Hallin K, Larsson U, Schart-Morén N. Do Patients Aged 85 Years and above Benefit from Their Cochlear Implants? Audiol Res 2023; 13:96-106. [PMID: 36825948 PMCID: PMC9952005 DOI: 10.3390/audiolres13010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
The present study aims to investigate the usage and benefits of cochlear implants (CIs) in elderly patients aged ≥85 years, including their device-handling issues, follow-ups, and the influence on their well-being. The patients answered one questionnaire regarding quality of life, EQ5D-3L, and one questionnaire, obtained from the Swedish CI quality register, regarding usage, handling, satisfaction, remaining difficulties, etc. The medical records were searched for the implantation date, implant model, speech processor model, monosyllabic (MS) word scores, infections over the implant, and compliance regarding scheduled visits to the clinic. The results show that most elderly patients are satisfied full-time users of their implants. Even though most patients had no problems handling their CI, handling issues must be considered. Recurring guidance and training on device operation are needed. We suggest that follow-up visits are essentially needed for this group of patients on a regular basis. CI surgery is considered a safe treatment, even for the elderly. Upgrads to new external equipment (e.g., sound processors) should not be excluded because of their age. The results suggested that the CI positively affected their well-being. This study was approved by the Swedish Ethical Review Authority (5/10-2021, Dnr: 2021-04970).
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Cole KL, Babajanian E, Anderson R, Gordon S, Patel N, Dicpinigaitis AJ, Kazim SF, Bowers CA, Gurgel RK. Association of Baseline Frailty Status and Age With Postoperative Complications After Cochlear Implantation: A National Inpatient Sample Study. Otol Neurotol 2022; 43:1170-1175. [PMID: 36190901 DOI: 10.1097/mao.0000000000003717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To conduct a national registry-based evaluation of the independent associations of chronological age and frailty, as measured by 5- and 11-factor modified frailty index (mFI-5, mFI-11) score, on postoperative outcomes of participants undergoing cochlear implantation (CI). STUDY DESIGN Cross-sectional analysis. SETTING Multicenter national database. PARTICIPANTS Adults 18 years or older who underwent CI during 2001 to 2018. MAIN OUTCOME MEASURES Any postoperative complications (determined as the presence of major, minor, or implant-specific), extended hospital length of stay (eLOS) (≥75th percentile of study population), and nonhome discharge destination. RESULTS There were 5,130 participants included with a median age of 60 years (interquartile range, 44-73 y) and slight female predominance (53.5%). Under mFI-5 scoring, there were 2,979 (58.1%) robust (mFI-5 = 0), 1710 (33.3%) prefrail (mFI-5 = 1), 362 (7.1%) frail (mFI-5 = 2), and 78 (1.5%) severely frail (mFI-5 ≥ 3) participants. Three hundred twenty-eight (6.49%) participants experienced a postoperative complication, with 320 (6.2%) discharged to a nonhome destination. Multivariate analysis showed no statistically significant correlation between increasing participant age or frailty status and postoperative complications; however, increasing baseline frailty tier showed an independent association with risk of eLOS (severely frail: odds ratio, 4..83; 95% confidence interval, 3.00-7.75; p < 0.001) and nonhome discharge (severely frail: odds ratio, 6.51; 95% confidence interval, 3.81-11.11; p < 0.001). The mFI-11 showed very similar trends. CONCLUSION Among those evaluated, this study demonstrates that CI is a low-risk procedure in participants of all ages. Increasing frailty does not predispose to postoperative complications. However, frail patients are at additional risk for an eLOS and nonhome discharge. Short follow-up time, hospital-coding errors, and selection bias of more robust patients may limit the true results of this study.
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Affiliation(s)
- Kyril L Cole
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Eric Babajanian
- Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA
| | - Ryan Anderson
- Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA
| | - Steve Gordon
- Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA
| | - Neil Patel
- Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA
| | | | - Syed Faraz Kazim
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA
| | - Christian A Bowers
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, USA
| | - Richard K Gurgel
- Division of Otolaryngology, University of Utah, Salt Lake City, Utah, USA
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Bourn SS, Goldstein MR, Morris SA, Jacob A. Cochlear implant outcomes in the very elderly. Am J Otolaryngol 2022; 43:103200. [PMID: 34600410 DOI: 10.1016/j.amjoto.2021.103200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 09/03/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE Managing hearing health in older adults has become a public health imperative, and cochlear implantation is now the standard of care for aural rehabilitation when hearing aids no longer provide sufficient benefit. The aim of our study was to compare speech performance in cochlear implant patients ≥80 years of age (Very Elderly) to a younger elderly cohort between ages 65-79 years (Less Elderly). MATERIALS AND METHODS Data were collected from 53 patients ≥80 years of age and 92 patients age 65-79 years who underwent cochlear implantation by the senior author between April 1, 2017 and May 12, 2020. The primary outcome measure compared preoperative AzBio Quiet scores to 6-month post-activation AzBio Quiet results for both cohorts. RESULTS Very Elderly patients progressed from an average AzBio Quiet score of 22% preoperatively to a score of 45% in the implanted ear at 6-months post-activation (p < 0.001) while the Less Elderly progressed from an average score of 27% preoperatively to 60% at 6-months (p < 0.001). Improvements in speech intelligibility were statistically significant within each of these cohorts (p < 0.001). Comparative statistics using independent samples t-test and evaluation of effect size using the Hedges' g statistic demonstrated a significant difference for average improvement of AzBio in quiet scores between groups with a medium effect size (p = 0.03, g = 0.35). However, when the very oldest patients (90+ years) were removed, the statistical difference between groups disappeared (p = 0.09). CONCLUSIONS When assessing CI performance, those over age 65 are typically compared to younger patients; however, this manuscript further stratifies audiometric outcomes for older CI recipients in a single-surgeon, high-volume practice. Our data indicates that for speech intelligibility, patients between age 65-79 perform similarly to CI recipients 80-90 years of age and should not be dismissed as potential cochlear implant candidates.
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Grimm DR, Fakurnejad S, Alyono JC. Cochlear Implantation and Risk of Falls in Older Adults. Otolaryngol Head Neck Surg 2021; 167:531-536. [PMID: 34905438 DOI: 10.1177/01945998211064981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine whether cochlear implantation (CI) increases the risk of clinically significant falls in older adults. STUDY DESIGN Retrospective analysis of deidentified administrative claims from a US commercial insurance database. SETTING Nationwide deidentified private insurance claims database (Clinformatics Data Mart; Optum). METHODS Patients undergoing CI were identified through Current Procedural Terminology codes. Number of days with falls resulting in health care expenditure were counted 1 year pre- and post-CI. Generalized estimating equation Poisson regression was used to determine medical and sociodemographic predictors for fall days, including age, sex, race, and income, with pre- vs post-CI status. RESULTS Between 2003 and 2019, 3773 patients aged >50 years underwent CI. An overall 139 (3.68%) patients recorded at least 1 fall diagnosis a year pre-CI, and 142 (3.76%) recorded at least 1 fall diagnosis post-CI. The average number of days with fall diagnoses per patient with a recorded fall was 3.12 pre-CI and 2.04 post-CI. In bivariate analysis, age (P < .0001) and Charlson Comorbidity Index (P < .0001) were predictive of falls, but sex (P < .10), race (P < .72), and income (P < .51) were not. Poisson regression demonstrated a statistically significant association between Charlson Comorbidity Index and days with fall diagnoses (risk ratio, 1.39 [95% CI, 1.30-1.49]; P < .0001]). No statistically significant difference in falls was seen pre- vs post-CI (risk ratio, 0.67 [95% CI, 0.34-1.33]; P < .25]). Age also was not predictive of falls in multivariate analysis. CONCLUSIONS CI does not appear to increase the risk of falls in older adults. Patient comorbidities correlate most strongly with fall risk and should be considered in patient selection for CI.
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Affiliation(s)
- David R Grimm
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
| | - Shayan Fakurnejad
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
| | - Jennifer C Alyono
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
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Dreyfuss M, Giat Y, Veraguth D, Röösli C, Huber AM, Laske RD. Cost Effectiveness of Cochlear Implantation in Single-Sided Deafness. Otol Neurotol 2021; 42:1129-1135. [PMID: 34191788 DOI: 10.1097/mao.0000000000003135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the cost effectiveness of cochlear implantation (CI) for the treatment of single-sided deafness (SSD). STUDY DESIGN Cost-utility analysis in an adapted Markov model. SETTING Adults with single-sided deafness in a high-income country. INTERVENTION Unilateral CI was compared with no intervention. MAIN OUTCOME MEASURE Incremental cost-effectiveness ratios were compared with different cost-effectiveness thresholds ($10,000 to $150,000) for different age, sex, and cost combinations. The calculations were based on the quality-adjusted life year (QALY), national life expectancy tables, and different cost settings. The health utility values for the QALY were either directly collected from published data, or, derived from published data using a regression model of multiple utility indices (regression estimate). RESULTS The regression estimate showed an increase of the health utility value from 0.62 to 0.74 for SSD patients who underwent CI. CI for SSD was cost effective for women up to 64 years ($50,000 per-QALY threshold), 80 years ($100,000 per-QALY threshold), and 86 years ($150,000 per-QALY threshold). For men, these values were 58, 77, and 84, respectively. Changing the discount rate by up to 5% further increased the cutoff ages up to 5 years. A detailed cost and age sensitivity analysis is presented and allows testing for cost effectiveness in local settings worldwide. CONCLUSIONS CI is a cost-effective option to treat patients with SSD.
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Affiliation(s)
- Michael Dreyfuss
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Yahel Giat
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Dorothe Veraguth
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Christof Röösli
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Alexander M Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
| | - Roman D Laske
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich
- University of Zurich
- HNO Wiedikon, Zurich, Switzerland
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Hammond-Kenny A, Borsetto D, Manjaly JG, Panova T, Vijendren A, Bance M, Tysome JR, Axon PR, Donnelly NP. Cochlear Implantation in Elderly Patients: Survival Duration, Hearing Outcomes, Complication Rates, and Cost Utility. Audiol Neurootol 2021; 27:156-165. [PMID: 34419952 DOI: 10.1159/000517315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The prevalence of hearing loss and its consequences is increasing as the elderly population grows. As the guidelines for cochlear implantation (CI) expand, the number of elderly CI recipients is also increasing. We report complication rates, survival duration, and audiological outcomes for CI recipients aged 80 years and over and discuss the cost utility of CI in this age group. METHODS A retrospective cohort study was undertaken of all CI recipients (126 cases), aged 80 years and over at the time of their surgery, implanted at our institution (Cambridge University Hospitals) during a period from January 1, 2001, to March 31, 2019. Data on survival at 1, 3, and 5 years post-implantation, post-operative complications and functional hearing outcomes including audiometric and speech discrimination outcomes (Bamford-Kowal-Bench sentence test) have been reported. RESULTS The mean age at implantation was 84 years. The mean audiometric score improved from 108 dB HL to 28 dB HL post-implantation. The mean Bamford-Kowal-Bench score improved from 14% to 66% and 73% at 2 and 12 months post-implantation, respectively. The complication rate was 15.3%. The survival probability at 1 year post-implantation was 0.95 for females and 0.93 for males, at 3 years was 0.89 for females and 0.81 for males, and at 5 years was 0.74 for females and 0.54 for males. CONCLUSION CI is safe and well-tolerated in this age group and elderly patients gain similar audiometric and functional benefit as found for younger age groups.
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Affiliation(s)
- Amy Hammond-Kenny
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Daniele Borsetto
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Joseph G Manjaly
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Tsvetemira Panova
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ananth Vijendren
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Manohar Bance
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - James R Tysome
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Patrick R Axon
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Neil P Donnelly
- Department of Otolaryngology and Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Willberg T, Sivonen V, Linder P, Dietz A. Comparing the Speech Perception of Cochlear Implant Users with Three Different Finnish Speech Intelligibility Tests in Noise. J Clin Med 2021; 10:jcm10163666. [PMID: 34441961 PMCID: PMC8397150 DOI: 10.3390/jcm10163666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/08/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background: A large number of different speech-in-noise (SIN) tests are available for testing cochlear implant (CI) recipients, but few studies have compared the different tests in the same patient population to assess how well their results correlate. Methods: A clinically representative group of 80 CI users conducted the Finnish versions of the matrix sentence test, the simplified matrix sentence test, and the digit triplet test. The results were analyzed for correlations between the different tests and for differences among the participants, including age and device modality. Results: Strong and statistically significant correlations were observed between all of the tests. No floor or ceiling effects were observed with any of the tests when using the adaptive test procedure. Age or the length of device use showed no correlation to SIN perception, but bilateral CI users showed slightly better results in comparison to unilateral or bimodal users. Conclusions: Three SIN tests that differ in length and complexity of the test material provided comparable results in a diverse CI user group.
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Affiliation(s)
- Tytti Willberg
- Department of Otorhinolaryngology, Turku University Hospital, 20521 Turku, Finland
- Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland
- Correspondence:
| | - Ville Sivonen
- Department of Otorhinolaryngology—Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland;
| | - Pia Linder
- Department of Otorhinolaryngology, Kuopio University Hospital, 70029 Kuopio, Finland; (P.L.); (A.D.)
| | - Aarno Dietz
- Department of Otorhinolaryngology, Kuopio University Hospital, 70029 Kuopio, Finland; (P.L.); (A.D.)
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Hearing Outcomes and Complications of Cochlear Implantation in Elderly Patients over 75 Years of Age. J Clin Med 2021; 10:jcm10143123. [PMID: 34300290 PMCID: PMC8306817 DOI: 10.3390/jcm10143123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: Populations are aging in many countries, and the proportion of elderly people with severe to profound hearing loss is increasing in parallel with the increasing average life span. The objective of this study was to investigate the outcomes of cochlear implant (CI) surgery in elderly patients compared to those in younger patients. Methods: The outcomes of CI surgery were retrospectively investigated for 81 adults (32 men and 49 women) who underwent CI surgery at our hospital. They were divided according to age at the time of implantation into the younger group (<75 years of age; n = 49) or elderly group (≥75 years of age; n = 32). Results: The mean sentence recognition score on the CI-2004 Japanese open-set test battery (±standard deviation) was 82.9% ± 24.1 in the younger group and 81.9% ± 23.2 in the elderly group, with no significant difference between the groups (Mann–Whitney U test). The incidence of major complications that required surgical treatment was not significantly different between the groups (4.1% vs. 6.2%, respectively). Thus, there were no severe complications that could affect general health status in either group. Three patients in each group died for reasons unrelated to CI surgery during follow-up. The proportion of patients who were alive and continued to use the CI five years after surgery was 92.8% and 91.5%, respectively. Conclusion: Our results show good speech recognition and a low incidence of major complications in elderly patients. This comprehensive report on the outcomes of CI surgery in elderly patients will be helpful to the elderly with severe to profound hearing loss when deciding whether to undergo CI surgery.
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Rogers C. Perspectives: Evaluation of Older Adult Cochlear Implant Candidates for Fall Risk in a Developing Country Setting. Front Neurol 2021; 12:678773. [PMID: 34122319 PMCID: PMC8187949 DOI: 10.3389/fneur.2021.678773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
Dizziness, vertigo, and falls are common in older adults. Data suggest that cochlear implant candidates are no different and could be argued to be at elevated risk due to the presence of hearing loss and likely vestibular involvement. Perspectives contextualizes current testing and screening paradigms for vestibular deficits and fall risk and suggests a protocol suitable for use in developing country settings.
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Affiliation(s)
- Christine Rogers
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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12
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Utility and value of pre-operative CT and MRI for cochlear implantation in the elderly. Am J Otolaryngol 2021; 42:102853. [PMID: 33460977 DOI: 10.1016/j.amjoto.2020.102853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/11/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE To determine the utility and value of pre-operative imaging among the elderly population ≥70 y.o. with bilateral progressive sensorineural hearing loss undergoing cochlear implantation. MATERIALS AND METHODS A retrospective, cross-sectional review was performed at a tertiary referral center between 2010 and 2018 including patients ≥70 y.o. with bilateral presbycusis who underwent preoperative imaging and cochlear implantation. Primary outcome was whether pre-operative imaging changed the surgeon's surgical plan such as side of implant or abort procedure entirely. Patient characteristics including age, sex, side of implant, imaging modality, whether imaging changed surgical plan, and surgical complications were reviewed. One-way analysis of variance with post-hoc tests using the Bonferroni and Fisher's exact test were used to examine differences between groups. Secondary outcome was cost of preoperative imaging. RESULTS One hundred thirty-three patients (mean age 79.38 [5.51 SD]) who underwent a total of 142 surgical cases and 147 total scans. There were 92, 27, and 14 patients who underwent CT, MRI, or both, respectfully (n=133). Of the 142 implants that were placed, preoperative imaging did not reveal a contraindication to placing implant on one side over another. Total cost of imaging was $29,694. Estimated cost if 20% of cochlear implant eligible patients ≥70 y.o. underwent imaging is $7,763,490. CONCLUSION Decreasing unnecessary preoperative imaging can potentially decrease cost in cochlear implantation. In this sample, preoperative imaging did not affect the surgeon's choice of which side to operate on. However, imaging may provide an anatomic roadmap and contribute to either surgical confidence or caution. With the increasing amount of cochlear implant eligible elderly adults, preoperative imaging needs to be more clearly defined in this unique population.
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Plontke SK, Caye-Thomasen P, Strauss C, Kösling S, Götze G, Siebolts U, Vordermark D, Wagner L, Fröhlich L, Rahne T. Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation. HNO 2021; 69:7-19. [PMID: 33044580 PMCID: PMC7862215 DOI: 10.1007/s00106-020-00919-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. Results Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80–100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1–36 months (65–85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. Conclusions Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients. Video online The online version of this article (10.1007/s00106-020-00919-9) includes a video (2D and 3D versions) of the described surgical technique. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field, the supplementary material can be found under “Ergänzende Inhalte”. ![]()
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Affiliation(s)
- S K Plontke
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
| | - P Caye-Thomasen
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - C Strauss
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - S Kösling
- Department of Radiation Medicine, Clinic for Radiology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - G Götze
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - U Siebolts
- Institute of Pathology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - D Vordermark
- Department of Radiation Medicine, Clinic for Radiotherapy, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - L Wagner
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - L Fröhlich
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - T Rahne
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
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Dazert S, Thomas JP, Loth A, Zahnert T, Stöver T. Cochlear Implantation. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 117:690-700. [PMID: 33357341 DOI: 10.3238/arztebl.2020.0690] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/12/2020] [Accepted: 07/20/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hearing impairment that is too severe to be adequately treated with conventional hearing aids can lead, in children, to severe developmental disturbances of hearing and language, and, in adults, to communicative and social deprivation. Recent advances in medical device technology and in microsurgical techniques have led to an expansion of the indications for cochlear implantation (CI) for adults with progressive hearing loss in older age, and to a restructuring of the process of care for these patients in Germany. METHODS This review is based on pertinent publications retrieved by a selective search in PubMed, as well as on the CI guidelines and CI "white book" of the German Society of Otolaryngology and Head and Neck Surgery. RESULTS Early and accurate diagnosis is crucial for the successful auditory rehabilitation of high-grade hearing impairment. In children, a key role is played by newborn auditory screening, which is mandatory in Germany and enables the provision of a CI in the first year of life when necessary. 86% of the children receiving a CI achieve linguistic comprehension of fluently spoken sentences. For adults, positive prognostic factors for hearing after the provision of a CI include a highly motivated patient, "postlingual" onset of the hearing impairment (i.e., after the acquisition of language), and a brief duration of deafness. Auditory rehabilitation is associated with significant improvement, not just of hearing and of the comprehension of spoken language, but also of quality of life, particularly in elderly patients. For patients of any age with bilateral hearing loss, CIs should be provided on both sides, if possible. The more common complications of the procedure, with a probability of 2-4% each, are technical implant defects, dizziness, and wound-healing disturbances. CONCLUSION Cochlear implantation, performed in specialized centers, is a safe and reliable technique and regularly enables the successful rehabilitation of hearing in both children and adults.
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Affiliation(s)
- Stefan Dazert
- Rhino-Laryngology, Head and Neck Surgery, St. Elisabeth Hospital, Ruhr University Bochum; Department of Oto-Rhino-Laryngology, University Hospital Frankfurt; Department of Oto- Rhino-Laryngology, University Hospital Carl Gustav Carus Dresden
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Mancini P, Dincer D'Alessandro H, Portanova G, Atturo F, Russo FY, Greco A, de Vincentiis M, Giallini I, De Seta D. Bimodal cochlear implantation in elderly patients. Int J Audiol 2020; 60:469-478. [PMID: 33174776 DOI: 10.1080/14992027.2020.1843080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Bimodal stimulation is a standard option for asymmetric hearing loss in adults. Questions have been raised whether receiving two stimulations may conflict in elderly listeners where the central integration of an acoustic/electrical signal may be very important to obtain benefit in terms of speech perception. DESIGN Clinical retrospective study. STUDY SAMPLE The outcomes from 17 bimodal cochlear implant (CI) users were analysed. The test material consisted of speech audiometry in quiet and in noise (STARR and Matrix). RESULTS Bimodal PTA and speech perception both in quiet and in noise were significantly better than CI or HA alone. Age showed a significant effect on bimodal STARR outcomes. Similarly, bimodal STARR scores improved significantly in comparison to Better Ear. CONCLUSION Both Matrix and STARR tests were very difficult for many elderly CI listeners from the present study group, especially in unilateral listening condition. The performance improved significantly, emphasising a good integration of acoustic and electric hearing in this group of elderly bimodal listeners. Overall results highlighted how a specific study, based on speech perception in noise in the elderly listeners, might shed light on the effect of speech test modality on bimodal outcomes.
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Affiliation(s)
- Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Hilal Dincer D'Alessandro
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.,Department of Audiology, Hacettepe University, Ankara, Turkey
| | - Ginevra Portanova
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Francesca Atturo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Daniele De Seta
- Department of Surgical Sciences, Section of Otolaryngology, University of Cagliari, Cagliari, Italy
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[Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation. German version]. HNO 2020; 68:734-748. [PMID: 32886128 DOI: 10.1007/s00106-020-00918-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). METHODS This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. RESULTS Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80-100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1-36 months (65-85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. CONCLUSIONS Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients.
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Savvas E, Heslinga K, Spiekermann CO, Stenner M, Rudack C. Anamnesis as a Prognostic Factor in Cochlear Implantation in Adults. ORL J Otorhinolaryngol Relat Spec 2020; 83:14-24. [PMID: 32950987 DOI: 10.1159/000509562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aims to analyze possible preoperative factors taken from the medical history that may assist the otolaryngologist in counseling an adult patient before cochlear implantation (CI). OBJECTIVE Analysis of preoperative factors taken during the initial patient presentation for a possible prognostic role in the auditory rehabilitation outcome. METHODS A cohort of 232 (272 CI implantations) postlingually deafened adults was evaluated in this study. Hearing results at 1, 2, and up to 3 years postoperatively were compared with various preoperative factors: living status, cause of deafness, gender, side of implantation, residual hearing, and duration of deafness. Postoperative hearing performance was measured based on the German Freiburg monosyllabic word test and the Oldenburg sentence test. RESULTS Duration of deafness showed a negative correlation to word recognition and a positive correlation to increased speech reception threshold in sentence testing. A significant decline in hearing outcome was shown starting around the second decade of deafness. Residual hearing as defined in our cohort and side of implantation showed limited benefit in speech understanding. Living status, gender, and cause of deafness did not show any prognostic value. CONCLUSION In this retrospective review it could be shown that simple case history information can only provide limited prognostic insight before CI. The duration of deafness is the most reliable anamnestic factor present on initial patient evaluation.
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Affiliation(s)
- Eleftherios Savvas
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany,
| | - Katharina Heslinga
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany
| | | | - Markus Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany
| | - Claudia Rudack
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany
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Age Dependent Cost-Effectiveness of Cochlear Implantation in Adults. Is There an Age Related Cut-off? Otol Neurotol 2020; 40:892-899. [PMID: 31157721 DOI: 10.1097/mao.0000000000002275] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze the impact of age at implantation on the cost-effectiveness of cochlear implantation (CI). STUDY DESIGN Cost-utility analysis in an adapted Markov model. SETTING Adults with profound postlingual hearing loss in a "high income" country. INTERVENTION Unilateral and sequential CI were compared with hearing aids (HA). MAIN OUTCOME MEASURE Incremental cost-effectiveness ratio (ICER), calculated as costs per quality adjusted life year (QALY) gained (in CHF/QALY), for individual age and sex combinations in relation to two different willingness to pay thresholds. 1 CHF (Swiss franc) is equivalent to 1.01 USD. RESULTS When a threshold of 50,000 CHF per QALY is applied, unilateral CI in comparison to HA is cost-effective up to an age of 91 for women and 89 for men. Sequential CI in comparison to HA is cost-effective up to an age of 87 for women and 85 for men. If a more contemporary threshold of 100,000 CHF per QALY is applied, sequential CI in comparison to unilateral CI is cost-effective up to an age of 80 for women and 78 for men. CONCLUSIONS Performing both sequential and unilateral CI is cost-effective up to very advanced ages when compared with hearing aids.
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Savvas E, Heslinga K, Sundermann B, Schwindt W, Spiekermann CO, Koopmann M, Rudack C. Prognostic factors in cochlear implantation in adults: Determining central process integrity. Am J Otolaryngol 2020; 41:102435. [PMID: 32107054 DOI: 10.1016/j.amjoto.2020.102435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 02/15/2020] [Indexed: 10/25/2022]
Abstract
The purpose of this study is to examine various preoperative factors that can play a role in the auditory rehabilitation outcome of cochlear implant (CI) recipients. In order to determine the level of integrity of central processing preoperatively, special attention was given to residual hearing, duration of deafness, and cochlear nerve diameter as prognostic factors. A cohort of 232 (272 CI implantations) postlingually deafened adults was evaluated in this study. Hearing results at 1, 2 and up to 3 years postoperatively were compared with various preoperative factors: promontory stimulation testing, residual hearing, duration of deafness, and magnetic resonance imaging of the cochlear nerve. Postoperative hearing performance was measured based on the German Freiburg monosyllabic word test and the Oldenburg sentence test. Postoperative hearing performance showed a significant improvement in each consecutive year after implantation. Duration of deafness showed a negative correlation to word recognition and a positive correlation to increased signal-to-noise-ratio in sentence testing. A significant decline in hearing outcome was shown starting around the second decade of deafness corresponding to 66% of life spent in deafness. MR imaging of cochlear nerve diameter shows a positive correlation of larger nerve diameter to better speech understanding. Promontory stimulation testing did not show any prognostic value. In this retrospective review it could be shown that there is an intricate interaction in the preoperative variables: duration of deafness - as well as the ratio of life spent in deafness; residual hearing; and cochlear nerve diameter.
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Trends in Age of Cochlear Implant Recipients, and the Impact on Perioperative Complication Rates. Otol Neurotol 2020; 41:438-443. [DOI: 10.1097/mao.0000000000002558] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW To evaluate the impact of cochlear implantation on hearing outcomes, quality of life, complications, and cognitive function in elderly patients. RECENT FINDINGS Nine articles published between 2014 and 2019 pertain to cochlear implantation in the elderly population. The findings conclude that cochlear implantation improves autonomy and overall quality of life in the elderly. SUMMARY Design: a pubmed search was employed with title search terms 'cochlear implant,' AND 'elderly' or 'aged.' Twenty-one articles were generated. Of the 21, articles without evidence-based findings were excluded and those published more than 5 years ago were excluded, yielding a final number of nine articles for review. RESULTS nine articles published on the use of cochlear implantation in the elderly were identified through the literature search between the years 2014-2019. Outcomes included quality of life, speech recognition improvement, improvement in cognitive function as defined by geriatric validated scales, outcomes of hearing rehabilitation, improvement in verbal comprehension, surgical complications, and the ability to manage the external components of the device. CONCLUSION cochlear implantation improves autonomy and the quality of life in the elderly. Age should not be a factor limiting surgical decision-making, and cochlear implantation can be utilized as a well tolerated, efficient treatment option for severe-to-profound hearing loss in the elderly population.
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Postoperative Healthcare Utilization of Elderly Adults After Cochlear Implantation. Otol Neurotol 2020; 41:208-213. [DOI: 10.1097/mao.0000000000002497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sorrentino T, Donati G, Nassif N, Pasini S, Redaelli de Zinis LO. Cognitive function and quality of life in older adult patients with cochlear implants. Int J Audiol 2019; 59:316-322. [DOI: 10.1080/14992027.2019.1696993] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Tommaso Sorrentino
- Adult Otorhinolaryngology Head Neck Surgery Division, ASST Spedali Civili, Brescia, Italy
| | - Giulia Donati
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Nader Nassif
- Pediatric Otorhinolaryngology Head Neck Surgery Division, Children Hospital, ASST Spedali Civili, Brescia, Italy
| | - Sara Pasini
- Adult Otorhinolaryngology Head Neck Surgery Division, ASST Spedali Civili, Brescia, Italy
| | - Luca O. Redaelli de Zinis
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Head and Neck Surgery, University of Brescia, Brescia, Italy
- Pediatric Otorhinolaryngology Head Neck Surgery Division, Children Hospital, ASST Spedali Civili, Brescia, Italy
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Dai C, Zhao Z, Shen W, Zhang D, Lei G, Qiao Y, Yang S. Evaluation of Mandarin Chinese Speech Recognition in Adults with Cochlear Implants Using the Spectral Ripple Discrimination Test. Med Sci Monit 2018; 24:3557-3563. [PMID: 29806954 PMCID: PMC6001366 DOI: 10.12659/msm.907491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to explore the value of the spectral ripple discrimination test in speech recognition evaluation among a deaf (post-lingual) Mandarin-speaking population in China following cochlear implantation. Material/Methods The study included 23 Mandarin-speaking adult subjects with normal hearing (normal-hearing group) and 17 deaf adults who were former Mandarin-speakers, with cochlear implants (cochlear implantation group). The normal-hearing subjects were divided into men (n=10) and women (n=13). The spectral ripple discrimination thresholds between the groups were compared. The correlation between spectral ripple discrimination thresholds and Mandarin speech recognition rates in the cochlear implantation group were studied. Results Spectral ripple discrimination thresholds did not correlate with age (r=−0.19; p=0.22), and there was no significant difference in spectral ripple discrimination thresholds between the male and female groups (p=0.654). Spectral ripple discrimination thresholds of deaf adults with cochlear implants were significantly correlated with monosyllabic recognition rates (r=0.84; p=0.000). Conclusions In a Mandarin Chinese speaking population, spectral ripple discrimination thresholds of normal-hearing individuals were unaffected by both gender and age. Spectral ripple discrimination thresholds were correlated with Mandarin monosyllabic recognition rates of Mandarin-speaking in post-lingual deaf adults with cochlear implants. The spectral ripple discrimination test is a promising method for speech recognition evaluation in adults following cochlear implantation in China.
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Affiliation(s)
- Chuanfu Dai
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China (mainland).,Department of Otolaryngology, Head and Neck Surgery, Chinese Peoples' Liberation Army General Hospital, Beijing, China (mainland)
| | - Zeqi Zhao
- Institute of Audiology and Balance Science, Xuzhou Medical University, Xuzhou, Jiangsu, China (mainland).,Clinical Hearing Center of Affiliated Hospital, Xuzhou Medical University, Xuzhou, Jiangsu, China (mainland)
| | - Weidong Shen
- Department of Otolaryngology, Head and Neck Surgery, Chinese Peoples' Liberation Army General Hospital, Beijing, China (mainland).,Key Laboratory of Hearing Impairment Science, Chinese Peoples' Liberation Army Medical School, Chinese Ministry of Education, Beijing, China (mainland).,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment, Beijing, China (mainland)
| | - Duo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Chinese Peoples' Liberation Army General Hospital, Beijing, China (mainland).,Key Laboratory of Hearing Impairment Science, Chinese Peoples' Liberation Army Medical School, Chinese Ministry of Education, Beijing, China (mainland).,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment, Beijing, China (mainland)
| | - Guanxiong Lei
- Department of Otolaryngology, Head and Neck Surgery, Chinese Peoples' Liberation Army General Hospital, Beijing, China (mainland).,Key Laboratory of Hearing Impairment Science, Chinese Peoples' Liberation Army Medical School, Chinese Ministry of Education, Beijing, China (mainland).,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment, Beijing, China (mainland)
| | - Yuehua Qiao
- Institute of Audiology and Balance Science, Xuzhou Medical University, Xuzhou, Jiangsu, China (mainland).,Clinical Hearing Center of Affiliated Hospital, Xuzhou Medical University, Xuzhou, Jiangsu, China (mainland)
| | - Shiming Yang
- Department of Otolaryngology, Head and Neck Surgery, Chinese Peoples' Liberation Army General Hospital, Beijing, China (mainland).,Key Laboratory of Hearing Impairment Science, Chinese Peoples' Liberation Army Medical School, Chinese Ministry of Education, Beijing, China (mainland).,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment, Beijing, China (mainland)
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Cochlear implantation in the elderly: outcomes, long-term evolution, and predictive factors. Eur Arch Otorhinolaryngol 2018; 275:913-922. [DOI: 10.1007/s00405-018-4910-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
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Cochlear Implantation in the Elderly: Review on the Clinical Effectiveness. CURRENT OTORHINOLARYNGOLOGY REPORTS 2017. [DOI: 10.1007/s40136-017-0166-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Impact of Comorbidities in the Aging Population on Cochlear Implant Outcomes. Otol Neurotol 2017; 38:e285-e288. [DOI: 10.1097/mao.0000000000001501] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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