Improvements in Perceived Abilities and Speech Recognition in Quiet and Noise for Older Adults With Single-sided Deafness or Asymmetric Hearing Loss: A Multi-center Investigation

Objective: Cochlear implantation is an effective treatment option for individuals with single-sided deafness (SSD) and asymmetric hearing loss (AHL). Most data are from young and middle-aged adults. This study assessed the outcomes of cochlear implant (CI) use for older adults. Study design: Multi-center, prospective, repeated-measures. Setting: Five academic centers. Patients: A total of 39 older adult (60 yr or older) CI users with SSD or AHL. Intervention: Cochlear implantation. Main outcome measures: Procedures were completed preoperatively with a rerouting device and 3, 6, and 12 months postactivation with the CI. Speech recognition for the affected ear was assessed with CNC words. Speech recognition in noise was assessed with the AzBio sentences. The target was presented from the front loudspeaker and the masker was co-located with the target, 90 degrees toward the better hearing ear, or 90 degrees toward the affected ear. Perceived abilities were assessed with the Speech, Spatial, and Qualities of hearing scale. Results: Participants demonstrated significant improvements over time on all measures ( p <0.001). There was no significant effect of age on CNC scores ( p =0.493) or perceived abilities ( p =0.314). Age ( p =0.031) and contralateral hearing level ( p <0.001) significantly influenced speech recognition in noise. The majority of participants experienced similar or improved performance in noise compared with their own preoperative abilities. Conclusions: Older adults with SSD and AHL demonstrate significant benefit from cochlear implantation, supporting its effectiveness for Centers for Medicare and Medicaid Services beneficiaries. Candidates should be counseled on how age and hearing level in the better hearing ear may affect outcomes, particularly in noisy environments.