(230) Hearing Preservation and Perioperative Disparities Among Elderly Cochlear Implant Recipients

Introduction: To report age-related hearing preservation (HP) rates and electroacoustic stimulation (EAS) for adult cochlear implant (CI) recipients, with emphasis on those older than 70 years.

Methods: This is a retrospective case-control from a tertiary referral center 416 adults (age: 18—91 years) with preoperative low-frequency pure-tone average (LFPTA) < 80 dB HL implanted from 2011 to 2021, looking at LFPTA, speech recognition outcomes, and EAS fitting.

Results: Postoperative ΔLFPTA demonstrates a weak positive correlation with age at implantation (r = 0.239, p < 0.001). Patients above 70 years old had significantly greater ΔLFPTA than their younger counterparts (median 32 dB HL vs 22 dB HL, p < 0.001); 74% of these patients had partial or complete HP at 1 month follow-up. Elderly patients were less likely to receive perioperative steroids. Among patients with preserved hearing, those over 70 years were less likely to be fitted with EAS (OR 1.835, 95% CI: 1.051—3.188, p = 0.037). All patients fitted with EAS had better 12-month CNC (64% vs. 52%, p = 0.014) and AzBio quiet (83% vs 67%, p < 0.001) scores, however this did not reach significance in subgroup analysis for patients over 70 years old (CNC: 49% vs 44%, p = 0.064, AzBio quiet: 72% vs 62%, p = 0.074).

Conclusions: Although age negatively correlates with LFPTA shift after CI, HP is possible for elderly patients. Unfortunately, patients with residual hearing over the age of 70 years are less likely to receive preoperative steroids or be fit with EAS. Attention to address these disparities may improve outcomes for this group.