A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery—Are We Doing Better?. Issue 9 (1st October 2022)

• Record Type: Journal Article
• Authors: Patro, Ankita; Lindquist, Nathan R.; Tawfik, Kareem O.; O'Malley, Matthew R.; Bennett, Marc L.; Haynes, David S.; Gifford, René H.; Holder, Jourdan T.; Perkins, Elizabeth L.
• Is Part Of: Otology & neurotology. Volume 43:Issue 9(2022)
• Page Start: e992
• Page End: e999
• Publication Date: 2022-10-01
• Subjects: Cochlear implantation -- Demographics -- Hearing loss -- Implant candidacy; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000003670
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objective: To characterize the influence of expanding indications on the profile of adults undergoing cochlear implantation (CI) at a high-volume CI center. Study Design: Retrospective review. Setting: Tertiary referral center. Patients: 774 adults undergoing CI evaluation from August 2015 to August 2020. Main Outcome Measures: Demographics; audiometry; speech recognition; speech, spatial, and qualities of hearing scale (SSQ-12). Results: Of 745 (96.3%) patients qualifying for implantation, 642 (86.6%) pursued surgery. Median age at evaluation was 69 years; 56.3% were men; 88.2% were Caucasian. Median distance to our center was 95 miles. The majority (51.8%) had public insurance (Medicare, Medicaid), followed by private (47.8%) and military (0.4%). Mean PTA, CNC, and AzBio in quiet and noise for the ear to be implanted were 85.2 dB HL, 15.0%, and 19.2% and 3.5%, respectively. Hybrid/EAS criteria were met by 138 (18.5%) CI candidates, and 436 (77.0%) unilateral CI recipients had aidable contralateral hearing for bimodal hearing configurations. Younger age (odds ratio [OR], 0.96; 95% confidence interval, 0.93–0.99) and non-Caucasian race (OR, 6.95; 95% confidence interval, 3.22–14.98) predicted candidacy. Likelihood of surgery increased for Caucasian (OR, 8.08; 95% confidence interval, 4.85–13.47) and married (OR, 2.28; 95% confidence interval, 1.50–3.47) patients and decreased for those with public insurance (OR, 0.45; 95% confidence interval, 0.29–0.69). A lower SSQ-12 score predicted both candidacy and surgery. Conclusion: Despite expansions in criteria, speech understanding remained extremely low at CI evaluation. Younger age and non-Caucasian race predicted candidacy, and Caucasian, married patients with private insurance and lower SSQ scores were more likely to pursue surgery.