Department of Otolaryngology-Head and Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA.
Cochlear Implants Int. 2021 Sep;22(5):296-302. doi: 10.1080/14670100.2021.1913331. Epub 2021 Apr 19.
Untreated hearing loss is risk factor for dementia, depression and falls in the elderly population. The present study evaluated the outcomes of cochlear implantation in adults over age 85, including surgical outcomes, speech perception, and implant use.
Retrospective chart review of 78 patients implanted at a tertiary academic medical center. Co-morbidities, pre-operative hearing thresholds and speech perception scores at 4 time points (pre-operative, and 3 months, 1, 2, and 3 years post-operatively) were collected from charts. Linear mixed models were used to account for missing data points.
Medical comorbidities such as hypertension (56%) and heart disease (53%) were common. Surgical complications were rare (5% or less) and minor. Local anesthesia was used for 71% of study patients implanted in the last three years. Significant improvements were seen for speech perception scores on monosyllabic words (37 percentage points), sentences in quiet (45 percentage points) and sentences in noise (28 percentage points). These improvements remained stable to at least two years post-activation. Seventy-one percent of patients wore their implant full time.
Cochlear implantation is safe and effective for very elderly adults. The use of local anesthesia may increase adoption of cochlear implantation and thus improve the quality of life for this population.
未经治疗的听力损失是老年人痴呆、抑郁和跌倒的危险因素。本研究评估了 85 岁以上成年人接受人工耳蜗植入的结果，包括手术结果、言语感知和植入物的使用。
回顾性分析了在一家三级学术医疗中心接受植入的 78 名患者的图表。从图表中收集了合并症、术前听力阈值和言语感知评分（术前和术后 3 个月、1 年、2 年和 3 年）4 个时间点的数据。使用线性混合模型来解释缺失数据点。
常见的合并症有高血压（56%）和心脏病（53%）。手术并发症罕见（<5%）且轻微。在过去 3 年接受研究的 71%的患者中使用了局部麻醉。在单音节词（37 个百分点）、安静环境中的句子（45 个百分点）和噪声环境中的句子（28 个百分点）方面，言语感知评分均有显著提高。这些改善至少在激活后两年内保持稳定。71%的患者全天佩戴植入物。
人工耳蜗植入对于非常高龄的成年人是安全有效的。局部麻醉的使用可能会增加人工耳蜗植入的采用率，从而提高这一人群的生活质量。
