OBJECTIVE: To compare speech recognition and quality of life outcomes in elderly patients with bimodal hearing and bilateral cochlear implants (CIs). STUDY DESIGN: Retrospective cohort. SETTING: Tertiary referral center. PATIENTS: Adults older than 65 years with preoperative AzBio sentences in quiet scores <60% bilaterally who underwent cochlear implantation between 2012 and 2021. MAIN OUTCOME MEASURES: Consonant-nucleus-consonant (CNC), AzBio sentences in quiet, and Speech, Spatial and Qualities of Hearing Scale (SSQ) scores. RESULTS: Two hundred fifty-eight patients met the inclusion criteria, of whom 227 (88.0%) were bimodal hearing, and 31 (12.0%) underwent bilateral cochlear implantation. Bimodal patients were older than bilateral at the time of initial implant 76 (71 to 82) vs 74 (70 to 77), P = 0.03 and had a lower contralateral pure tone average 77 (65 to 90) vs 87 (73 to 100), P = 0.04. All other preimplant testing was similar. Twelve months after initial implant, those who ultimately pursued a second implant had greater device usage (P = 0.03 ) but similar preoperative audiometric evaluations. At 12 months post-second implant, bilateral CI users had higher bilateral AzBio scores in quiet 87 (77 to 94) vs 77 (58 to 88), P = 0.05 but were otherwise similar to bimodal users. Multivariable regression demonstrated age at first implant as the only predictor of audiometric outcomes. CONCLUSIONS: Elderly bilateral CI patients have improved sentence recognition outcomes one year postoperatively compared with elderly bimodal patients. Bilateral CI patients performed similarly after first versus second implant.
Cohen et al. (Tue,) studied this question.