December 20, 2005

Elderly don’t fare worse after cochlear implantation

NEW YORK (Reuters Health) - Age has no effect on outcome
after implantation of a cochlear device among people over 65, a
study suggests, leading researchers to conclude that elderly
patients "should not be discriminated against in assessments
for cochlear implant candidacy."

A cochlear implant is a small electronic device that can
help to provide a sense of sound to a person who is profoundly
deaf or severely hard of hearing. The device does not restore
or create normal hearing. Instead, under the right conditions,
it can give a deaf person a useful auditory understanding of
the environment around them and help him or her understand
speech. It is surgically placed under the skin behind the ear.

The use of cochlear implants in elderly people is
"controversial," even though there is substantial evidence that
they can benefit from the devices, researchers point out in the
Archives of Otolaryngology/Head and Neck Surgery.

To help clarify the effect of age on outcome, Dr. John K.
Niparko of The Johns Hopkins University in Baltimore, Maryland
and colleagues looked at 749 people who had undergone the
procedure and who ranged in age from 14 to 91 years.

The team found a wide variation in postoperative "word
scores" across age groups. Although those 65 years of age and
older had a 4.6 percent lower score on postoperative
monosyllabic word recognition tests, this difference was not
significant, the researchers note, and may not be "clinically

Longer duration of deafness was typically tied to worse
performance on word recognition tests. However, among people
who had been deaf for longer than 25 years, the older implant
recipients scored higher than younger patients. This suggests,
the researchers say, that variables beyond age may be involved
in implant outcome, such as early language learning and
residual hearing.

"A foundation of central auditory processing in the older
cohort," Niparko's group offers, "may actually mitigate the
disadvantage of advanced age at implantation, build on adaptive
skills, and help explain the encouraging results of this

Source: Archives of Otolayngology-Head and Neck Surgery
December 2005.