Factors Affecting Auditory Performance of Postlinguistically Deaf Adults Using Cochlear Implants: An Update with 2251 Patients

TLDR

Relaxed selection criteria, better clinical management, surgical modifications, and improved devices may explain the observed differences. The study aims to update a 15‑year‑old analysis of 800 postlingually deaf adults to examine how duration of severe hearing loss, age at implantation, age at onset, etiology, and CI experience influence outcomes. A retrospective multicenter study collected data from 2251 adults implanted since 2003 across 15 centers, converting speech scores in quiet to percentile ranks to standardize across sites. Compared to 1996, the negative impact of long severe‑to‑profound hearing‑loss duration was reduced, age at implantation and onset effects shifted to older ages, etiology had a smaller influence, and CI experience produced a steeper learning curve, yet patients with longer durations were still less likely to improve with experience, indicating that the same factors remain relevant but with altered relative importance.

Abstract

<b><i>Objective:</i></b> To update a 15-year-old study of 800 postlinguistically deaf adult patients showing how duration of severe to profound hearing loss, age at cochlear implantation (CI), age at onset of severe to profound hearing loss, etiology and CI experience affected CI outcome. <b><i>Study Design:</i></b> Retrospective multicenter study. <b><i>Methods:</i></b> Data from 2251 adult patients implanted since 2003 in 15 international centers were collected and speech scores in quiet were converted to percentile ranks to remove differences between centers. <b><i>Results:</i></b> The negative effect of long duration of severe to profound hearing loss was less important in the new data than in 1996; the effects of age at CI and age at onset of severe to profound hearing loss were delayed until older ages; etiology had a smaller effect, and the effect of CI experience was greater with a steeper learning curve. Patients with longer durations of severe to profound hearing loss were less likely to improve with CI experience than patients with shorter duration of severe to profound hearing loss. <b><i>Conclusions:</i></b> The factors that were relevant in 1996 were still relevant in 2011, although their relative importance had changed. Relaxed patient selection criteria, improved clinical management of hearing loss, modifications of surgical practice, and improved devices may explain the differences.