Cochlear implants in adults: outcomes in prolonged auditory deprivation

OBJECTIVES: To evaluate outcomes following cochlear implantation (CI) in postlinguistically deaf adults with prolonged auditory deprivation. METHODS: A retrospective analysis was conducted on 95 patients who underwent CI between 2020 and 2022. Inclusion criteria were age ≥18 years. Main outcome measures included the pure-tone average across speech frequencies (PTA4), speech perception scores (monosyllabic words and sentences), and the Categories of Auditory Performance II (CAP-II). Correlation and regression analyses examined associations between auditory deprivation and postoperative outcomes, adjusting for confounders such as age at implantation and prior hearing aid use. RESULTS: = 0.015). Linear regression revealed a modest inverse relationship between duration of deafness and tonal gain (-0.331 dB per year). Among participants under 65 years, prolonged deprivation correlated with reduced tonal gain and CAP-II scores, whereas no such effect was observed in older adults. Age at implantation influenced monosyllabic word recognition but not sentence perception. DISCUSSION: Findings indicate that the consequences of auditory deprivation are more pronounced in younger adults, likely reflecting increased vulnerability of central auditory processing when hearing loss occurs earlier in life. CONCLUSION: Cochlear implantation provides substantial benefits across age groups. Prolonged auditory deprivation exerts a greater impact in adults under 65 years, supporting early implantation and continuous auditory stimulation to preserve central auditory processing and optimize long-term outcomes.