Complications Of Cochlear Implantation Research Articles

Cochlear Implantation or Stapes Surgery in Far Advanced Otosclerosis

Abstract Background Otosclerosis is a process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone. It usually occurs during the postlingual period between the second and fifth decade of life. The most commonly affected location is around the oval window (fenestral otosclerosis), which results in conductive hearing loss due to stapes footplate fixation. As it undergoes a maturation process, the sclerotic bone increases in size and depth. Objective To compare the hearing outcomes and complications of stapes surgery vs cochlear implantation in patients with far advanced otosclerosis. Data Sources Medline databases (PubMed, Medscape, Scopus, Google Scholar, Cochrane, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Patients and Methods The current review followed the guidelines of preferred reporting items for systematic reviews and meta-analysis statement 2009 (PRISMA). The detailed steps of methods were described elsewhere as well as PRISMA checklist. Results The results of this meta-analysis show that comparing the outcomes and complications of cochlear implantation and stapes surgery in far advanced otosclerosis patients have different results, in some of them there was a highly favorable and recommended procedure than the other, other results declared no significant difference in postoperative outcomes. Conclusion Both Stapes surgery and CI are reliable treatment options for FAO with very close success rates. Statistics of CI are greater than Stapes surgery and CI has a consistent improvement in speech discrimination scores in comparison to Stapes surgery. Patients must receive adequate counseling regarding all the factors mentioned above and the decision must be made by surgeons and the informed patients.

Complications of cochlear implantation surgery in Zagazig University Hospitals

BackgroundCochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe to profound hearing loss. Complications due to surgery are minimal and are often encountered in cases with congenital anomalies of the temporal bone and inner ear. Complications in CI are related to malfunctioning of the device or the process of wound healing. In most cochlear implant centers, as the surgeon’s skill and clinical expertise in managing various cochlear implant cases improve with years of experience, the complication rates ideally come down over time.This article is intended to describe the most common surgical complications of cochlear implantation in Zagazig University Hospitals. This retrospective study included 130 patients who underwent cochlear implantation in Zagazig University Hospitals from 2016 to 2018. The patients were 61 males and 69 females; their ages ranged between 2 and 6 years old with a mean age of 4.3. This study aims to provide feedback on the common complications of CI surgery at our institution to help the reduction of its incidence in the future.ResultsOne hundred thirty cases of cochlear implants were performed in our department between 2016 and 2018. Sixty complications were recorded, including 27 cases of minor and 21 cases of major complications. Minor complications were flap wound infection in 4 cases (3.1%), chorda tympani nerve injury in 7 cases (5.4%), postoperative vertigo and vomiting in 3 cases (2.3%), injury of EAC in 7 cases (5.4%), wound seroma/hematoma in 4 cases (3.1%), and facial nerve twitching in 2 cases (1.5%). Major complications were electrode extrusion in 2 cases (1.5%), CSOM in 1 case (0.8%), CSF leak in 8 cases (6.1%), magnet migration in 3 cases (2.3%), total facial nerve paralysis in 5 cases (3.8%), and device failure in 2 cases (1.5%).ConclusionThe overall incidence of major complications is low. The majority of minor complications can be effectively managed with conservative measures. Cochlear implantation remains a safe and effective surgical procedure.

Hearing Outcomes and Complications of Cochlear Implantation in Elderly Patients over 75 Years of Age.

Objective: Populations are aging in many countries, and the proportion of elderly people with severe to profound hearing loss is increasing in parallel with the increasing average life span. The objective of this study was to investigate the outcomes of cochlear implant (CI) surgery in elderly patients compared to those in younger patients. Methods: The outcomes of CI surgery were retrospectively investigated for 81 adults (32 men and 49 women) who underwent CI surgery at our hospital. They were divided according to age at the time of implantation into the younger group (<75 years of age; n = 49) or elderly group (≥75 years of age; n = 32). Results: The mean sentence recognition score on the CI-2004 Japanese open-set test battery (±standard deviation) was 82.9% ± 24.1 in the younger group and 81.9% ± 23.2 in the elderly group, with no significant difference between the groups (Mann–Whitney U test). The incidence of major complications that required surgical treatment was not significantly different between the groups (4.1% vs. 6.2%, respectively). Thus, there were no severe complications that could affect general health status in either group. Three patients in each group died for reasons unrelated to CI surgery during follow-up. The proportion of patients who were alive and continued to use the CI five years after surgery was 92.8% and 91.5%, respectively. Conclusion: Our results show good speech recognition and a low incidence of major complications in elderly patients. This comprehensive report on the outcomes of CI surgery in elderly patients will be helpful to the elderly with severe to profound hearing loss when deciding whether to undergo CI surgery.

Incomplete Partition Type III: Computed Tomography Features and Cochlear Implantation Complications

In this case report, we review a male child who presented with severe bilateral hearing loss. Preoperative high-resolution computed tomography (HRCT) evaluation facilitated the initial diagnosis of the disease, which revealed typical findings of cochlear incomplete partition type III anomaly (IP-III), surgical planning, and cochlear implant selection to avoid possible complications. The child underwent cochlear implantation, which resulted in gushing and misplacement of the electrodes into the internal auditory canal (IAC) as postoperative complications. Postoperative imaging was used to determine the position of the implant and to assess the complications. The child’s postoperative X-ray revealed misplacement of the cochlear implant, the extent of which was further assessed by a HRCT scan for preplanning the revision surgery and electrode selection. Following the revision surgery, a further HRCT scan confirmed proper implantation and ruled out any further complications.

Alteration of Vestibular Function in Pediatric Cochlear Implant Recipients.

Background: Vestibular dysfunction is a complication of cochlear implantation (CI). Reports on the evaluation of vestibular function before and after CI are limited, especially in children. We investigated the effect of CI on vestibular function in pediatric patients.Patients and Methods: We routinely evaluated vestibular function before but not immediately after CI. Therefore, patients who underwent sequential bilateral CI were enrolled in this study. Seventy-three children who underwent sequential CI from 2003 to 2020 at our hospital were included. Since the vestibular function of the first implanted ear was evaluated before the second surgery for the contralateral ear, post-CI evaluation timing differed among the cases. The evaluation included a caloric test, a cervical vestibular-evoked myogenic potential (cVEMP) test, and a damped rotation test. The objective variables included the results of these tests, and the explanatory variables included the age at surgery, cause of hearing loss, electrode type, and surgical approach used. The associations of these tests were analyzed.Results: cVEMP was the most affected after CI (36.1%), followed by the caloric test (23.6%), and damped rotation test (7.8%). Cochleostomy was significantly more harmful than a round window (RW) approach or an extended RW approach based on the results of the caloric test (p = 0.035) and damped rotation test (p = 0.029). Perimodiolar electrodes affected the caloric test results greater than straight electrodes (p = 0.041). There were no significant associations among these tests' results.Conclusions: Minimally invasive surgery in children using a round window approach or an extended round window approach with straight electrodes is desirable to preserve vestibular function after CI.

The French Cochlear Implant Registry (EPIIC): Cochlear implantation complications

ObjectivesThe aim of this study was to evaluate peri- and post-operative complications related to cochlear implantations. We searched for risk factors predicting these complications and analyzed the complications in the youngest and most elderly. Study designRetrospective analysis of cochlear implant patients. Materials and MethodsAll patients who underwent cochlear implantation in France between January 2012 and December 2016 were anonymized and registered in the EPIIC database. This population included 3483 adults and 2245 children. Their demographic and surgical data and their incidence of peri- or post-operative complications, including their severity, whether major or minor, were all indicated. ResultsThe global complication rate was 6.84%. The risk of complication was higher in initial implantation versus reimplantation (P<0.0001). The risk was also higher for bilateral implantation versus unilateral (P<0.0001). Complications were more frequent for patients with cochlear malformation (P=0.002). There was no difference in complication rates across age groups; babies under 1 year old, and the elderly over 80 and even over 90, did not have more complications than the rest of the population. Patients treated in the daily care unit had no more complications than those who were hospitalized for one night or more (P=0.64). ConclusionCochlear implantation is a safe technique with a low incidence of complications. The absence of increased risk in patients at the extremes of the age spectrum justifies offering this solution to all, without age limitation.

When Opposites Attract: Pediatric Cochlear Implantation in the Setting of Cerebrospinal Fluid Shunts.

The Food and Drug Administration (FDA) has recently raised concern regarding the safety of cochlear implantation in the setting of programmable cerebrospinal fluid shunts. The purpose of this study was to evaluate the outcomes and complications of cochlear implantation in children who have a cerebrospinal fluid shunt. Retrospective chart review. Tertiary academic referral center. Twenty pediatric subjects with a cerebrospinal fluid shunt and cochlear implant (CI). Cochlear implantation in the setting of a cerebrospinal fluid shunt. Primary outcome measures included descriptive data regarding age at implantation, etiology of hearing loss, medical management, complications, and speech perception outcomes. The average age of CI candidacy was 30 months with an average 21.5 months delay to implantation. In 45% of cases the laterality of the shunt determined the ear to be implanted. Three of the subjects required a surgical intervention on the shunt before cochlear implantation. Three subjects had a concurrently programmable shunt and activated CI. Two of the three subjects had no complications as a result of the two devices; however, the third subject had significant interactions requiring multiple revision surgeries. For those with the cognitive ability to perform open set, recoded speech perception, the average postoperative Consonant Nucleus Consonant word score in the best aided condition was 65.2% (n = 5). Children with a cerebrospinal fluid shunt are viable candidates for cochlear implantation, although they often require additional procedures and considerations before and after implantation.

Role of High-Resolution CT and MRI in Predicting the Degree of Difficulty in Patients undergoing Cochlear Implant Surgery: An Institutional Experience

Abstract Introduction Preoperative imaging is a standard practice for cochlear implant candidacy. We are discussing association between surgical feasibility and various anatomical details of middle and inner ear by both high-resolution computed tomography (HRCT) and 3T magnetic resonance imaging (MRI) in patients with bilateral sensorineural hearing loss (SNHL) and are used as a guide during surgery as well as foresee complications in cochlear implantation. Materials and Methods A total of 56 patients of aged 1 to 5 years (prelingual) and &gt; 1 years (postlingual or perilingual) having bilateral SNHL were included in the study. HRCT temporal bone and MRI head was done in all candidates. Based on the imaging findings of CT and MRI, patients were divided into two categories (normal and abnormal). Demographic and clinical values were compared between two groups. Binary logistic regression analysis was used to identify the predictors of the outcome variable (surgical difficulty). Results Out of 56 patients, 55 underwent cochlear implantation by Veria technique, one patient having Michel’s deformity was denied surgery and was advised brain stem implant. Note that 69.1% patients had no radiological abnormality, while 30.9% patients showed abnormality including acquired disease and malformation. Out of the total study patients, 18% (n = 10) showed various type of congenital inner ear malformation. Large size of the external auditory canal (EAC), high basal turn angle (BTA), and increased distance between tympanic segment of facial canal to EAC (midpoint between level of I-S joint corresponding to EAC and exit of chordae tympanic at level of EAC), all these factors showed inverse relationship with difficulty in surgery, which were found to be statistically significant. Conclusion The imaging in cochlear implant patients is an essential tool for preoperative assessment of candidacy, surgical planning, and avoid intra- and postoperative complications. BTA and distance between tympanic segment of facial nerve and EAC (midpoint between level of I-S joint corresponding to EAC and exit of chordae tympanic at level of EAC) are important predictors for evaluating intra- and postoperative complications.

Comparison of Temporal Bone Parameters before Cochlear Implantation in Patients with and without Facial Nerve Stimulation.

Background and ObjectivesFacial nerve stimulation (FNS) is a complication of cochlear implantation (CI). This study compared the thickness and density of the bone separating the upper basal turn of the cochlea (UBTC) and the labyrinthine segment of the facial nerve (LSFN) on preoperative computed tomography (CT) in patients with and without FNS after CI.Subjects and MethodsAdult patients who underwent CI from January 2011 to February 2017 with preoperative CT at a tertiary referral hospital were considered for this retrospective case–control study. Patients were divided into two groups: with FNS (n=4) and without FNS (n=53). The density and thickness of the bone between the LSFN and UBTC were measured on preoperative CT. Charts were reviewed for other parameters.ResultsA statistically significant difference was seen in the thickness (p=0.007) but not in the density (p=0.125) of the bone between the UBTC and LSFN. Four patients had FNS at the mid-range electrode arrays, and one of them additionally had FNS at the basal arrays.ConclusionsDecreased thickness of the bone between the UBTC and LSFN can explain postoperative FNS, confirming the histologic and radiologic findings in previous studies, which indicated that the thickness of the temporal bone between the LSFN and UBTC is less in patients who experience FNS. While the density in this region was also less, it was not statistically significant.

Models to predict positive and negative effects of cochlear implantation on tinnitus.

ObjectivesThe effect of cochlear implantation on tinnitus is heterogeneous: implantation does not always reduce tinnitus and may even worsen tinnitus. Therefore, it is important to know which factors influence the consequences of cochlear implantation for tinnitus. To date, no consensus has been reached regarding the factors that influence tinnitus. This study aimed to create prognostic models, using binary logistic regression analyses to predict positive or negative changes in tinnitus after cochlear implantation.MethodsFor this study we retrospectively sent two questionnaire packages to 117 cochlear implant patients.ResultsIn the binary logistic regression analyses of the responses to the questionnaires, it was not possible to create a significant model to predict a positive effect of cochlear implantation on tinnitus. However, a negative effect of cochlear implantation on tinnitus was predictable, using a backward stepwise selection method in a model including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Tinnitus Handicap Questionnaire (THQ) (P < .001, Nagelkerke R2 = 0.529).ConclusionsOur results suggest that the lower the preoperative tinnitus handicap and the preoperative hearing handicap, the higher the chance that cochlear implantation will worsen tinnitus. More research needs to be done, preferable in a big prospective study, to make this model instrumental for clinical decision making and preoperative patient counselling. However, our results might suggest that preoperative THQ and APHAB screening could be meaningful. Especially in patients who are afraid to develop tinnitus or tinnitus worsening as complication of cochlear implantation.Level of Evidence4

Complications of Cochlear Implant at Hawler Teaching Center (Rizgary Teaching Hospital)

Background and objectives: Cochlear implantation carries many morbidity, complications, and even failure which may have an economic burden to candidates and medical administration. Several surgical techniques and implants had been suggested for optimum result and implant proper functioning. Our aim was to determine various complication types and rate encountered in cochlear implantation candidates of different age groups at Rizgary Teaching Hospital. Methods: Prospective case series review conducted on 110 cochlear implantation candidates who underwent cochlear implantation in Ear, Nose and Throat – Head &amp; Neck Surgery department, at Rizgary Teaching hospital from January 2014 until January 2016. The cochlear implantation complications were identified as (minor) and (major). All complications were systematically studied and analyzed with maximum duration of follow-up of 24 months. All cochlear implantation candidates were received unilaterally multichannels cochlear implant. The same surgical team performed all surgical procedures. All patients provided written informed consent for the procedures. Results: The overall rate of complications was 13.63% (15 out of 110). The minor complications were 12 cases (10.90%), including postoperative wound infections in 3 cases (2.72%), electrode issues in 3 cases (2.72%), acute otitis media in 2 cases and transient vertigo/dizziness in 2 cases (1.81%), transient facial palsy in 2 cases. The major complications were 3 cases (2.72%), including device failure in 2 cases (1.81%), cholesteatoma in 1 case; all major complications were required revision surgery, and other minor complications were managed medically. Conclusions: Cochlear implantation is a relatively safe and effective procedure with fewer complications rate when performed by experienced and skilled surgeons.

Cochlear Implantation in Cochlear Ossification: Retrospective Review of Etiologies, Surgical Considerations, and Auditory Outcomes

1) To review the surgical and auditory outcomes and complications of cochlear implantation in cases with cochlear ossification. 2) To evaluate association between the extent and etiology of ossification to outcomes. Retrospective study. Otology and skull base surgery center. Charts of 40 patients (42 ears) with cochlear ossification undergoing cochlear implantation were reviewed. Demographic features, operative findings, auditory outcomes, and complications were analyzed. Operative findings included extent of cochlear ossification, extent of drilling required to obtain patent cochlear lumen, approach (posterior tympanotomy/subtotal petrosectomy), electrode insertion (partial/complete, scala tympani/vestibuli), and complications. Auditory outcomes were assessed over a 4-year follow-up period using vowel, word, sentence, and comprehension scores. Patients were divided into groups (otosclerotic/non-otosclerotic and round window/basal turn ossification) for comparison of auditory outcomes. Outcomes were compared with 60 randomly identified controls (adults with postlingual deafness) who underwent implantation with no cochlear ossification. The median age and duration of deafness of patients was 54.39 and 27.15 years, respectively. Etiology of cochlear ossification was otosclerosis in 23 of 42 ears and mixed in 19 of 42 ears (chronic otitis media, temporal bone fractures, idiopathic, meningitis, Cogan's syndrome) with exclusive round window involvement in 54.7% of cases and the rest having partial or complete basal turn ossification. 59.5% ears underwent subtotal petrosectomy for implantation. Three patients underwent scala vestibuli insertion and five had incomplete electrode insertion. Auditory outcomes were comparable in otosclerotic and non-otosclerotic cases and in round window and basal turn ossification cases. No significant differences were observed in auditory scores when compared with controls with no ossification. Cochlear implantation in cochlear ossification is feasible despite surgical challenges and modifications. Auditory outcomes in basal turn ossification appear to be comparable to cases with no ossification with extent of ossification having no significant association with outcomes.

Review of cochlear implantation complications

The article provides a review of literature on cochlear implantation (CI) complications. The authors describe the current state of the problem, listing all CI complications in children and adults divided into minor and major ones depending on the severity and the need for revision surgery. The results of the studies of various authors revealed a low number of surgical complications, which are in most cases effectively removed by conservative methods or minor interventions indicating the safety of CI in children and adults.

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis.

To report surgical results and complications of cochlear implantation in patients with far-advanced otosclerosis (FAO). This was a retrospective chart review of surgical results in terms of electrode insertion as well as peri- and postoperative complications. Ten cochlear implantations (CIs) were performed in eight patients with FAO. A prior stapedotomy had been performed in all cases. Full electrode insertion was achieved in nine of the 10 operations (90%) and partial insertion in one operation. An unintended opening of the vestibule during drilling was the only perioperative complication. Postoperative complications occurred as two cases of vertigo (one prolonged). No chorda tympani syndrome and no cases of facial nerve stimulation were noted. Although based on a limited number of cases, we conclude that full electrode insertion can be achieved in almost all cases and that major complications are infrequent in CI in patients with FAO. Postoperative vertigo appears to be the most commonly occurring complication.

Surgical complications of cochlear implantation in a tertiary university hospital

Introduction: Cochlear implantation remains a popular and effective therapy for patients with sensorineural hearing loss that not get benefit from conventional hearing aidsObjective: To analyze the surgical complications obtained in patients that underwent cochlear implantation in a tertiary university hospital.Materials and methods: Retrospective analysis of the medical files of cochlear implant patients who underwent surgery at our institution between October 2014 and July 2016. This population comprised 163 patients (52.7% males and 47.3% females). Complications were classified in to ‘major’ and ‘minor’ complications depending on degree of management.Results: Overall, the mean age at the time of implantation was 7.44 years. The cause of deafness was congenital in 81.6% of patients and acquired in 18.4% of patients. The overall complication rate was 10.43%, 3.68% being major and 6.75% being minor complications. The most common minor complication in our series was wound complications, and the most common major complication was device failure. Excluding device failures, the major complication rate was 1.84%.Conclusion: Cochlear implantation is a safe surgical technique for rehabilitation of patients with severe to profound hearing loss, associated with a low surgical complications rate. The majority of surgical complications can be managed with conservative measures or minimal intervention.

The influence of obesity on operating room time and perioperative complications in cochlear implantation.

ObjectiveThe rising incidence of obesity in the United States is associated with increased healthcare expenditures and resource allocation. Obesity has been associated with prolonged operating times during surgical procedures. The primary objective of this study is to compare body mass index (BMI) to length of surgery during cochlear implantation.MethodsA retrospective case control study from a tertiary academic referral center was performed. Patients included were adults who underwent primary, single-sided cochlear implantation with documented BMI and operating room (OR) times from January 2009 to July 2015. The following data were collected: BMI, total operating room time (TORT), surgical operating room time (SORT), ASA status, perioperative and postoperative complications, age, and gender.ResultsTwo hundreds and thirty-four patients were included and stratified into obese (BMI >30) and non-obese (BMI < 30) categories. Statistical analysis was performed comparing TORT against the obesity category along with other variables. Independent sample t-test demonstrated that obesity increases TORT and SORT by 16.8 min (P = 0.0002) and 9.3 min (P = 0.03), respectively, compared to the non-obese group. Multivariate linear regression analysis demonstrated no statistically significant impact of gender, or ASA status on total operating or surgical time. Obesity was associated with increased perioperative complications (odds ratio [OR], 6.21; 95% CI, 1.18–32.80; P = 0.03) and postoperative complications (OR, 3.97; 95% CI, 1.29–12.26; P = 0.02).ConclusionsObesity leads to longer TORT and SORT during primary cochlear implant surgery. Obesity is also associated with increased perioperative and postoperative complications compared to non-obese patients. These data have implications with utilization of operating room resources.

Medical and bioethical considerations in elective cochlear implant array removal

ObjectiveCochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that...

Variations in electrode impedance during and after cochlear implantation: Round window versus extended round window insertions

ObjectivesTo assess differences in intra- and postoperative electrode impedances following cochlear implantation between round window insertions (RWI) and extended round window insertions (ERWI). MethodsFifty patients with congenital hearing loss received unilateral hearing implants (Sonata Ti100, Med-El GmbH, Innsbruck, Austria) with standard electrode arrays. The patients were divided into two groups according to the surgical technique used. Thirty-five procedures were performed with RWI (group A) and 15 with ERWI (group B). Electrode impedance was measured and analysed during the operation, and one week and one month postoperatively. ResultsThere were no statistically significant differences (i.e., P > 0.05) in electrode impedance between groups A and B intraoperatively, or at one week or one month postoperatively. Electrode impedance at one month postoperatively was higher than the intraoperative and postoperative one week values in group A (P < 0.05), with similar results in group B. ConclusionThere was no significant difference between RWI and ERWI in operative duration or complications of cochlear implantation. Moreover, no significant differences in postoperative electrode impedance values were found between the two surgical routes.

Skin Flap Necrosis by Bone Marking with Methylene Blue in Cochlear Implantation.

One of surgical complications in cochlear implantation is the necrosis of the skin flap above the receiver-stimulator coil. We present a case of 55-year-old woman who underwent cochlear implantation and developed a bluish skin necrosis due to bone marking. The planned position for the receiver-stimulator was marked using methylene blue through skin to bone. She did not undergo skin flap thinning and underwent successful implantation with complete electrode insertion. Few weeks postoperatively, the patient developed bluish discoloration with progressive thick, blue eschar formation and skin flap necrosis. She subsequently underwent wound debridement and skin flap closure. Cochlear explantation was not necessary. Timely diagnosis and management about this complication is necessary to prevent further skin breakdown and subsequent device extrusion. This report identifies the marking using methylene blue as another possible source of skin flap necrosis in cochlear implantation, and surgeons should be aware of this potential complication.

Cochlear implantation outcomes in older adults

Objective: More than 40% of the population above 65 years of age suffers from hearing impairment and approximately 1% has a severe to profound loss, which cannot benefit from hearing aids. There is strong evidence that hearing loss in older adults is associated with both cognitive impairment and aging. Cochlear implantation improves auditory function and speech perception. The aim of this paper was to analyse outcomes and complications of cochlear implantation in elderly patients. Methods: We used a retrospective observational study on 30 hearing impaired patients over 65 years of age, unilaterally implanted for severe to profound bilateral sensorineural hearing loss. The results were statistically evaluated through the Student's t-test for paired data. Results: Thirty patients (16 males and 14 females) between 65 and 79 years of age (median = 70.5) underwent cochlear implantation in the last four years at our clinic. They were unilaterally implanted for profound hearing loss: the left side was implanted in 19 cases, the right side in 11 cases. Pre-operative pure tone average at 0.5, 1, 2, and 4 kHz improved from 111.8dB HL (± 17.8) without hearing aids to 42.6dB HL (± 10) with the cochlear implant during the post-operative period of follow-up; speech recognition threshold mean improved from 90dB SPL to 65dB SPL. No major complications were noticed during post-operative follow-ups. Discussion: Cochlear implantation is a safe procedure even among elderly patients who can significantly benefit from hearing threshold (p < 0.001) and speech perception (p < 0.01) improvements. Familial and professional supports are essential, as well as specific conditions, such as long time deprivation, entity and type of hearing loss, cognitive status, depression and anxiety, which can greatly influence the results of auditory rehabilitation and its perceived benefits. Conclusion: Cochlear implantation should be considered a safe and effective treatment of hearing loss even in older adults.