Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 11, pp 3089–3094 | Cite as

Cochlear implant outcomes in the elderly: a uni- and multivariate analyses of prognostic factors

  • Niccolò FavarettoEmail author
  • Gino Marioni
  • Davide Brotto
  • Flavia Sorrentino
  • Flavia Gheller
  • Alessandro Castiglione
  • Silvia Montino
  • Luciano Giacomelli
  • Patrizia Trevisi
  • Alessandro Martini
  • Roberto Bovo
Otology
  • 130 Downloads

Abstract

Purpose

To assess preoperative features that could predict the audiological outcome after cochlear implantation in the elderly, in terms of pure tone audiometry, speech audiometry, and speech perception performance.

Methods

All available records of patients with cochlear implants aged 65 or more at the time of their implantation at our Institution were reviewed (50 patients, mean age 70.76 ± 4.03 years), recording preoperative clinical features. Pure tone audiometry, speech audiometry, and speech perception performance 1 year after cochlear implant activation and fitting were used as outcome measures.

Results

No statistically significant association emerged between clinical features and pure tone audiometry. On univariate analysis, progressive sensorineural hearing loss of unknown origin was associated with a better outcome in terms of speech audiometry and speech perception performance (p = 0.035 and p = 0.033, respectively). On multivariate analysis, progressive sensorineural hearing loss retained its independent prognostic significance in terms of speech perception performance (p = 0.042). The discriminatory power of a two-variable panel (age and etiology of hearing loss) featured an AUC (ROC) of 0.738 (an acceptable discriminatory power according to the Hosmer–Lemeshow scale).

Conclusions

A progressive sensorineural hearing loss of unknown origin was associated with a better outcome in terms of speech perception in the elderly in our case study. Further features that can predict audiological outcome achievable with cochlear implants in the elderly are desirable to perform adequate counselling and rehabilitation programs.

Keywords

Cochlear implants Elderly Outcome Multivariate 

Notes

Funding

None of the authors received grants or funding for this paper.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was conducted in accordance with the principles of the Helsinki Declaration. Data were examined in agreement with the Italian privacy and sensitive data laws, and the internal regulations of Padova University’s Otolaryngology Section.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Yang Z, Cosetti M (2016) Safety and outcomes of cochlear implantation in the elderly: a review of recent literature. J Otol 11:1–6.  https://doi.org/10.1016/j.joto.2016.03.004 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Jolink C, Helleman HW, van Spronsen E et al (2016) The long-term results of speech perception in elderly cochlear implant users. Cochlear Implants Int 17:146–150.  https://doi.org/10.1080/14670100.2016.1162383 CrossRefPubMedGoogle Scholar
  3. 3.
    Gopinath B, Hickson L, Schneider J et al (2012) Hearing-impaired adults are at increased risk of experiencing emotional distress and social engagement restrictions five years later. Age Ageing 41:618–623.  https://doi.org/10.1093/ageing/afs058 CrossRefPubMedGoogle Scholar
  4. 4.
    Jiam NT-L, Li C, Agrawal Y (2016) Hearing loss and falls: a systematic review and meta-analysis. Laryngoscope 126:2587–2596.  https://doi.org/10.1002/lary.25927 CrossRefPubMedGoogle Scholar
  5. 5.
    Loughrey DG, Kelly ME, Kelley GA et al (2017) Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia. JAMA Otolaryngol Neck Surg 144:115–126.  https://doi.org/10.1001/jamaoto.2017.2513 CrossRefGoogle Scholar
  6. 6.
    Martini A, Castiglione A, Bovo R et al (2014) Aging, cognitive load, dementia and hearing loss. Audiol Neurotol 19:2–5.  https://doi.org/10.1159/000371593 CrossRefGoogle Scholar
  7. 7.
    Syrigos KN, Karachalios D, Karapanagiotou EM et al (2009) Head and neck cancer in the elderly: An overview on the treatment modalities. Cancer Treat Rev 35:237–245.  https://doi.org/10.1016/j.ctrv.2008.11.002 CrossRefPubMedGoogle Scholar
  8. 8.
    Ghiselli S, Nedic S, Montino S, et al (2016) Cochlear implantation in post-lingually deafened adults and elderly patients: analysis of audiometric and speech perception outcomes during the first year of use. Acta Otorhinolaryngol Italy 36:513–519. https://doi.org/10.14639/0392-100X-1222
  9. 9.
    Steyerberg EW, Vickers AJ, Cook NR et al (2010) Assessing the performance of prediction models: a framework for traditional and novel measures. Epidemiology 21:128–138.  https://doi.org/10.1097/EDE.0b013e3181c30fb2 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Hosmer DW, Lemeshow S (2000) Applied logistic regression, 2nd edn. John Whiley & Sons, HobokenCrossRefGoogle Scholar
  11. 11.
    Lachowska M, Pastuszka A, Glinka P, Niemczyk K (2013) Is cochlear implantation a good treatment method for profoundly deafened elderly? Clin Interv Aging 8:1339–1346.  https://doi.org/10.2147/CIA.S50698 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Wong DJY, Moran M, O’Leary SJ (2016) Outcomes after cochlear implantation in the very elderly. Otol Neurotol 37:46–51.  https://doi.org/10.1097/MAO.0000000000000920 CrossRefPubMedGoogle Scholar
  13. 13.
    Roberts DS, Lin HW, Herrmann BS, Lee DJ (2013) Differential cochlear implant outcomes in older adults. Laryngoscope 123:1952–1956.  https://doi.org/10.1002/lary.23676 CrossRefPubMedGoogle Scholar
  14. 14.
    Vashishth A, Fulcheri A, Rossi G et al (2017) Cochlear implantation in otosclerosis. Otol Neurotol 38:e345–e353.  https://doi.org/10.1097/MAO.0000000000001552 CrossRefPubMedGoogle Scholar
  15. 15.
    McRackan TR, Gifford RH, Kahue CN et al (2014) Cochlear implantation in Ménière’s disease patients. Otol Neurotol 35:421–425.  https://doi.org/10.1097/MAO.0000000000000247 CrossRefPubMedGoogle Scholar
  16. 16.
    Samy RN, Houston L, Scott M et al (2015) Cochlear implantation in patients with Meniere’s disease. Cochlear Implants Int 16:208–212.  https://doi.org/10.1179/1754762814Y.0000000104 CrossRefPubMedGoogle Scholar
  17. 17.
    Alves M, Martins JH, Moura JE et al (2014) Auditory rehabilitation after cochlear implantation in adults with hearing impairment after head trauma. Cochlear Implants Int 15:312–317.  https://doi.org/10.1179/1754762814Y.0000000074 CrossRefPubMedGoogle Scholar
  18. 18.
    de Brito R, Bittencourt A, Goffi-Gomez M et al (2014) Cochlear implants and bacterial meningitis: a speech recognition study in paired samples. Int Arch Otorhinolaryngol 17:057–061.  https://doi.org/10.7162/S1809-97772013000100010 CrossRefGoogle Scholar
  19. 19.
    Rooth MA, Dillon MT, Brown KD (2017) Prospective evaluation of patients undergoing translabyrinthine excision of vestibular Schwannoma with concurrent cochlear implantation. Otol Neurotol 38:1512–1516.  https://doi.org/10.1097/MAO.0000000000001570 CrossRefPubMedGoogle Scholar
  20. 20.
    Hoppe U, Hocke T, Digeser F (2018) Bimodal benefit for cochlear implant listeners with different grades of hearing loss in the opposite ear. Acta Otolaryngol 138:713–721.  https://doi.org/10.1080/00016489.2018.1444281 CrossRefPubMedGoogle Scholar
  21. 21.
    del Medina M, Polo R, Gutierrez A et al (2017) Cochlear implantation in postlingual adult patients with long-term auditory deprivation. Otol Neurotol 38:e248–e252.  https://doi.org/10.1097/MAO.0000000000001257 CrossRefPubMedGoogle Scholar
  22. 22.
    Liberman MC, Kujawa SG (2017) Cochlear synaptopathy in acquired sensorineural hearing loss: manifestations and mechanisms. Hear Res 349:138–147.  https://doi.org/10.1016/j.heares.2017.01.003 CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Rask-Andersen H, Ekvall L, Scholtz A, Schrott-Fischer A (2000) Structural/audiometric correlations in a human inner ear with noise-induced hearing loss. Hear Res 141:129–139CrossRefPubMedGoogle Scholar
  24. 24.
    Munro KJ, Walker AJ, Purdy SC (2007) Evidence for adaptive plasticity in elderly monaural hearing aid users. NeuroReport 18:1237–1240.  https://doi.org/10.1097/WNR.0b013e32822025f4 CrossRefPubMedGoogle Scholar
  25. 25.
    Smith L, Bartel L, Joglekar S, Chen J (2017) Musical Rehabilitation in adult cochlear implant recipients with a self-administered software. Otol Neurotol 38:e262–e267.  https://doi.org/10.1097/MAO.0000000000001447 CrossRefPubMedGoogle Scholar
  26. 26.
    Castiglione A, Benatti A, Velardita C et al (2016) Aging, cognitive decline and hearing loss: effects of auditory rehabilitation and training with hearing aids and cochlear implants on cognitive function and depression among older adults. Audiol Neurotol 21:21–28.  https://doi.org/10.1159/000448350 CrossRefGoogle Scholar
  27. 27.
    Moberly AC, Vasil K, Baxter J, Ray C (2018) What to do when cochlear implant users plateau in performance. Otol Neurotol 39:e794–e802.  https://doi.org/10.1097/MAO.0000000000001964 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Niccolò Favaretto
    • 1
    Email author
  • Gino Marioni
    • 1
  • Davide Brotto
    • 1
  • Flavia Sorrentino
    • 1
  • Flavia Gheller
    • 1
  • Alessandro Castiglione
    • 1
  • Silvia Montino
    • 1
  • Luciano Giacomelli
    • 2
  • Patrizia Trevisi
    • 1
  • Alessandro Martini
    • 1
  • Roberto Bovo
    • 1
  1. 1.Department of Neuroscience DNS, Otolaryngology SectionPadova UniversityPadovaItaly
  2. 2.Department of Medicine DIMEDPadova UniversityPadovaItaly

Personalised recommendations