Audiometric Outcomes and Longitudinal Trends of Sequential Cochlear Implantation in Adults with Bilateral Deafness: A 20-Year Single-Center Study.

UNLABELLED: <p>

Introduction

In this study, we examine the outcomes and trends of second-side cochlear implant (CI) in adults as measured by change in speech perception scores, with a focus on those meeting age requirements for Medicare.

METHODS

This is a retrospective cohort study performed at a tertiary academic center. The investigation included adult patients with bilateral hearing loss receiving sequential, bilateral CI between 2001 and 2020. Bilateral speech perception scores under best aided conditions were compared following first- and second-side CI using Arizona Biomedical (AzBio) Sentence Test, Consonant-Nucleus-Consonant word (CNC-W), and Hearing in Noise Test (HINT). Individual changes in audiometric scores and trends in implant age and inter-implant interval were evaluated.

RESULTS

A total of 162 individuals were included in this study. 50 patients with AzBio scores, 40 patients with HINT scores, and 72 patients with CNC-W scores demonstrated mean improvements of 11.8 (95% CI: [5.7-17.9]), 6.7 (95% CI: [0.4-13.7]), 12.0 (SD: 25.3), and 11.5 (95% CI: [7.3-15.7]) points, respectively, following second-sided CI. Patients aged 65 and older experienced similar magnitude of improvement as younger patients (t-tests: AzBio: 95% CI: [-16.7, 17.4]; HINT: 95% CI: [-34.6, 0.5]; CNC-W: 95% CI: [-10.7, 13.1]). Longer time interval between implants was associated with reduced improvement in CNC-W in the overall population (β: -2.9, 95% CI: [-5.5 to -1.2]) and the elderly population (β: -4.24, 95% CI: [-6.1 to -2.8]) specifically. Over time, there were no significant changes in age of CI-1 implant or audiometric scores after bilateral CI, but there was a decrease in inter-implant interval.

CONCLUSIONS

Intervention with a second-sided cochlear implant was associated with improved speech recognition scores and this benefit extended to patients aged 65 and over. Decreased inter-implant interval is associated with an increase in improvement. </p>.