Cochlear Implantation in the Octogenarian and Nonagenarian

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Abstract

Objective:

Previous studies have shown that cochlear implant outcomes with respect to surgical morbidity and speech perception may be poorer in elderly patients as compared with younger adults. However, recent anecdotal reports suggest that elderly cochlear implant recipients are achieving increasingly higher speech perception performance and fewer surgical complications than previously noted. Our objective is to review cochlear implant outcomes using newer generation implants and minimally traumatic cochleostomy techniques in patients 80 years and older compared with younger adult recipients.

Study Design:

Retrospective chart review.

Setting:

Tertiary referral center.

Patients:

All adult cochlear implant recipients (232 patients, 258 implants) who underwent implantation with a Nucleus Freedom, Advanced Bionics HR90k, or Med El Sonata device at a tertiary academic institution.

Intervention(s):

Postoperative speech perception scores and clinical data extraction using the electronic medical record.

Main Outcome Measure(s):

Anesthetic and surgical complications, device malfunction, operative time, admission status, length of hospital stay, and postoperative speech perception scores were collected after 50 cochlear implant procedures in patients who were implanted beyond the eighth decade and 208 among younger adults (18-79 yr).

Results:

Patients 80 years or older were more likely to have anesthetic complications and require hospital admission (p < 0.05). There was no statistical difference between groups with respect to surgical complications or device malfunction. Speech perception analysis revealed similar outcomes for older and younger patients.

Conclusion:

Cochlear implantation is well tolerated across all adult age groups with a relatively low risk for adverse surgical events or device malfunction. Given the favorable safety profile and high levels of speech perception achieved by older patients, routine implantation of octogenarian and nonagenarians seems warranted. These results also stress the need for thorough preoperative evaluation of elderly patients, given the increased likelihood for perioperative anesthetic complications.

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