Abstract
Objective: The present study aimed to demonstrate the patient outcomes after cochlear implantation in a rural area of Germany with special respect to older patients. Study Design: Retrospective Study. Setting: ENT-Department of Bad Hersfeld as an academic teaching hospital of the Justus-Liebig-University of Giessen. This is located in a rural county in Germany. Patients: A consecutive series of 217 patients implanted between 2003 and 2017. Intervention: Patients were implanted with different cochlear implant devices by the same surgeon in a standard procedure. In cases of chronic otitis media a middle ear obliteration was performed 6 months prior to cochlear implantation. Main Outcome Measures: Patients were divided in two groups: group 1 was 18 to 65 years of age and group 2 was older than 65 years. Pre- and postoperative hearing and speech understanding evaluated by the Freiburg monosyllable word test and the HSM-sentence test in the group of patients. Results: The mean preoperative speech understanding of group 1 was 0.5% for monosyllables at 60 dB and 2.7% at 80 dB. Group 2 showed similar results with 0.2% and 1.2%. In the HSM-test, group 1 had a speech understanding of 2.6% and group 2 of 3.2%. No statistically significant difference could be found between both groups. After cochlear implantation mean speech understanding at 60 dB increased in group 1 to 53.2% and 65.1% at 80 dB respectively. Group 2 had an improvement to 51.8% at 60 dB and 68.3% and 80 dB. The results in the HSM-sentence test were 77.8% in group 1 and 83.7% in group 2 (p = 0.47). Both groups had a significant increase in speech understanding concerning both tests after cochlear implantation (p = 0.0001) whereas we could not confirm any significant difference between the younger and older CI-recipients in the monosyllable word test. During the observation period no major complications had to be observed. Conclusion: Our data suggest that cochlear implantation in a rural area of Germany is feasible without increased risk and provides good hearing results even in older patients.
Highlights
The cochlear implant (CI) is an established method of hearing rehabilitation in pre- and postlingual deafness in appropriate candidates
The present study aimed to demonstrate the patient outcomes after cochlear implantation in a rural area of Germany with special respect to older patients
The results in the HSM-sentence test were 77.8% in group 1 and 83.7% in group 2 (p = 0.47). Both groups had a significant increase in speech understanding concerning both tests after cochlear implantation (p = 0.0001) whereas we could not confirm any significant difference between the younger and older CI-recipients in the monosyllable word test
Summary
The cochlear implant (CI) is an established method of hearing rehabilitation in pre- and postlingual deafness in appropriate candidates. The increasing number of older people with a significant multimorbidity faces a health system which tends to focus on a few centers offering services like cochlear implantation. This means a serious problem in rural areas with limited infrastructure to guarantee access for this often physically and mentally handicapped group. Based on these considerations, we tried to demonstrate the feasibility of a cochlear implant program at a non-university hospital in a rural area of Germany with special respect to older patients. The first author has undergone his professional training at a large university clinic and performed more than 700 cochlear implantations so far
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More From: International Journal of Otolaryngology and Head & Neck Surgery
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