Sequential and Simultaneous Bilateral Cochlear Implantation in the Elderly Population.

OBJECTIVE

Bilateral cochlear implantation (CI) is not routinely recommended in patients of advanced age due to concerns regarding cost-effectiveness and the medical risks of multiple operations in this population. This study seeks to evaluate outcomes of bilateral CI in post-lingually deafened adults over 65 years old.

STUDY

DESIGN

Retrospective cohort study.

SETTING

Tertiary referral center.

PATIENTS: Thirty-five post-lingually deafened adults over 65 years at the time of second implantation (CI2) and 11 post-lingually deafened adults over 65 years at the time of simultaneous implantation.

INTERVENTIONS: Bilateral cochlear implantation.

MAIN OUTCOME MEASURES: Bilateral CNC word scores at 1 year postoperatively.

RESULTS

Bilateral CNC scores were significantly improved compared with preoperative scores 1 year postoperatively in both sequentially implanted patients (d=9.2%, P <0.001) and simultaneously implanted patients (d=44%, P =0.028). No significant correlations were observed between changes in bilateral CNC word scores at 1 year and age at the time of CI1 ( r =0.095, P =0.665), age at the time of CI2 ( r =0.034, P =0.879), or length of time between implantations ( r =0.164, P =0.453) in sequentially implanted patients, nor was age at implantation correlated with changes in bilateral CNC scores at 1 year in simultaneously implanted patients (r=0.548, P =0.452). Finally, bilateral CNC scores of sequentially and simultaneously implanted patients were not found to be different at 1 year (d=4.5%, P =0.8905).

CONCLUSIONS

Patients older than 65 years who underwent both sequential and simultaneous bilateral cochlear implantation showed similar and significant improvements in speech perception scores compared with preoperative scores. These outcomes were not correlated with age at the time of implantation or time between implantations in the case of sequentially implanted patients. This suggests that significant benefit can be seen even with advanced age at the time of implantation and longer time between implantations.