Background: Controversy still exists regarding the impact of age on speech recognition following
cochlear implant in postlingually deaf adults. In some studies elderly recipients
did not perform as well as younger patients on standard speech recognition tests.
Furthermore, previous studies have shown that cochlear implantation improves quality
of life, as measured by self-administered questionnaires, but the sample sizes of
these studies have been relatively small, thus making age stratification a challenge.
Purpose: The primary objective was to assess whether the age at which a patient receives a
unilateral cochlear implant affects improvements in speech recognition scores and
perceived quality of life. A secondary objective was to determine whether preoperative
use of hearing aids correlates with improvement in speech recognition and perceived
quality of life after cochlear implantation.
Research Design: A retrospective study in a tertiary referral center.
Patients: A total of 161 postlingually deaf adults, who were divided based on age (<50, 50–65,
>65) and on prior hearing aid(s) use.
Intervention: All patients received a unilateral multichannel cochlear implant.
Data Collection and Analysis: Speech recognition was quantified by percent correct scores on the Hearing in Noise
Test sentences delivered in a quiet setting only (HINT%), and quality of life was
quantified by the Hearing Handicap Inventory (HHI) before and 1 yr after cochlear
implantation.
Results: Speech recognition, as measured by HINT%, improved significantly and to similar extents
in all three age groups following cochlear implantation. Similarly, quality of life
as quantified by HHI improved markedly and to similar extents in all age groups. Whether
hearing aids were used pre-implant, or whether the cochlear implant (CI) was implanted
on the same side or contralateral to the hearing aid side, had no substantial effect
on the patients’ performances on either speech recognition or quality of life. Moreover,
there were no statistically significant correlations between pre-implant speech recognition
scores and pre-implant quality of life scores or between postimplant speech recognition
scores and postimplant quality of life scores.
Conclusion: The findings of the present study demonstrate that cochlear implantation improves
HINT% and HHI scores to similar extents across all age groups. This finding suggests
that elderly patients may derive speech recognition and quality of life benefits similar
to those of younger patients and that age should not be an essential factor in the
determination of CI candidacy. Furthermore, prior use of a hearing aid, and its location
in relation to the cochlear implant, does not influence the extent of improvement
in speech recognition or quality of life measurements following cochlear implantation.
Key Words
cochlear implant/implantation - Hearing Handicap Inventory - Hearing in Noise Test
- speech recognition
