Department of Neuroscience DNS, Otolaryngology Section, Padova University, Via Giustiniani 2, 35128, Padova, Italy.
Department of Medicine DIMED, Padova University, Padova, Italy.
Eur Arch Otorhinolaryngol. 2019 Nov;276(11):3089-3094. doi: 10.1007/s00405-019-05613-3. Epub 2019 Aug 28.
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.
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.
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).
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.
评估与纯音测听、言语测听和言语感知性能相关的术前特征，以预测老年患者人工耳蜗植入术后的听力结果。
对在我院接受人工耳蜗植入术的 65 岁及以上患者（50 例，平均年龄 70.76±4.03 岁）的所有可用记录进行了回顾，记录了术前临床特征。术后 1 年，使用纯音测听、言语测听和言语感知性能作为术后评估指标。
术前临床特征与纯音测听结果之间无显著相关性。在单因素分析中，原因不明的进行性感音神经性听力损失与言语测听和言语感知性能的更好结果相关（p=0.035 和 p=0.033）。在多因素分析中，进行性感音神经性听力损失在言语感知性能方面仍然具有独立的预后意义（p=0.042）。两变量组（年龄和听力损失病因）的判别能力的 AUC（ROC）为 0.738（根据 Hosmer-Lemeshow 量表，具有可接受的判别能力）。
在我们的研究中，原因不明的进行性感音神经性听力损失与老年患者言语感知方面的更好结果相关。需要进一步研究能够预测老年患者人工耳蜗植入术后听力结果的特征，以便进行适当的咨询和康复计划。
