Cochlear implantation outcomes in the older adult: a scoping review

Abstract

Objectives

The current study aimed to identify and map the available evidence surrounding cochlear implantation (CI) in older adults. Five outcomes were evaluated: speech perception scores, perioperative complications, neurocognitive outcomes, quality of life outcomes and vestibular dysfunction and fall rates after surgery.

Methods

A scoping review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews and included patients over the age of 60.

Results

Ninety-seven studies met inclusion criteria, encompassing 7,182 patients. Mean (SD) speech perception scores in quiet and in noise pre-and postoperatively were 7.9% (6.7) and 52.8% (14.3) and 8.0% (68.1) and 68.1% (15.9) respectively. Postoperative cardiac arrhythmias, urinary retention, and delirium occurred slightly more frequently in older adults. In terms of cognition, most studies noted stability or improvement one year after implantation. A majority of studies indicated better quality of life post-CI. Rates of fall after surgery were rarely reported, and there was a general paucity of data surrounding vestibular function changes after CI.

Discussion

This scoping review identifies many positive outcomes linked to CI in older adults. No findings suggest a single patient characteristic that would warrant refusal to consider evaluation for cochlear implantation.

KEYWORDS:

• Cochlear implants
• Older adults
• Elderly
• Performance
• Neurocognition

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Emily Kay-Rivest

Dr Emily Kay-Rivest is a neurotology fellow at NYU and will soon begin on faculty at McGill University.

Jamie Schlacter

Jamie Schlacter is a medical student at NYU.

Susan B. Waltzman

Dr Susan B. Waltzman is the Marica F. Vilcek Professor of Otolaryngology and Vice Chair, Faculty Development and Academic Affairs. Her research focuses on two main areas: the outcomes of cochlear and brainstem implants and the variables, including new technology, affecting those outcomes in children, adolescents, older adults, and special populations. Our most recent research involves investigating treatments for single-sided deafness, for preserving residual hearing, and for using auditory brainstem implants in children with compromised auditory nerves. She has been the principal investigator on numerous device-related clinical trials over the past 20 years and is the author of more than 110 peer-reviewed articles and numerous book chapters.