Cochlear Implantation in the Very Elderly

Abstract

Objectives:

Evaluate the outcomes following cochlear implantation in the very elderly population (age ≥ 85), with a particular emphasis on peri-operative surgical course, mobility, dizziness, and speech perception outcomes.

Methods:

A retrospective cohort study was conducted from June 2001 to May 2012 comparing groups aged 85+ to 80-84, and 75-79 at the time of first cochlear implantation. Retrospective collection of parameters was done by reviewing medical records and outpatient notes at the RVEEH in Melbourne. Parameters of interest included: speech recognition testing pre- and post-implantation, symptomatic dizziness and effects upon independent living post-operatively, pre-operative vestibular tests, and post-operative tests if symptomatic, presence of dementia in medical records, and incidence of perioperative medical and surgical complications.

Results:

Two hundred twenty-six patients over age 70 at the time of surgery were identified to have a CI512 or CI24RE implanted. The oldest patient was 93 at the time of surgery. Speech recognition testing gradually improved after implantation in this population with a low incidence of postoperative complications.

Conclusions:

Geriatric patients can still benefit from cochlear implantation, and age should not be a limitation for cochlear implantation (CI) surgery. The population ≥ 85 years tend to have greater difficulty with mobility and are at greater risk of dementia and cognitive impairment, but they still benefit, with improved speech perception following cochlear implantation. Although the presence of co-morbidities increases the risk of perioperative complications with age, cochlear implantation can be done safely and provides significant patient benefits.