Department of Otolaryngology-Head & Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA.
Cochlear Implants Int. 2022 Sep;23(5):280-290. doi: 10.1080/14670100.2022.2091723. Epub 2022 Jun 30.
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.
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.
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.
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.
本研究旨在确定并绘制有关老年人人工耳蜗植入(CI)的现有证据。评估了五个结果:言语感知评分、围手术期并发症、神经认知结果、生活质量结果以及手术后的前庭功能障碍和跌倒率。
根据系统评价和荟萃分析扩展的首选报告项目进行了范围综述,纳入年龄在 60 岁以上的患者。
97 项研究符合纳入标准,共纳入 7182 名患者。术前和术后安静和噪声环境下的平均(标准差)言语感知评分分别为 7.9%(6.7)和 52.8%(14.3),8.0%(68.1)和 68.1%(15.9)。术后老年患者心律失常、尿潴留和谵妄的发生率略高。在认知方面,大多数研究表明植入后一年认知稳定或改善。大多数研究表明 CI 后生活质量更好。术后跌倒率很少有报道,且关于 CI 后前庭功能变化的数据普遍较少。
本范围综述确定了许多与老年人 CI 相关的积极结果。没有发现任何单一的患者特征表明有必要拒绝考虑人工耳蜗植入评估。