Cochlear Implantation in the Octogenarian and Nonagenarian
Cochlear Implantation in the Octogenarian and Nonagenarian
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DOI：
10.1097/mao.0b013e3181edb69d
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发表时间：
2010-10-01
影响因子：
2.1
通讯作者：
Olund, Amy P.
中科院分区：
文献类型：
--
作者：
Carlson, Matthew L.;Breen, Joseph T.;Olund, Amy P.
目的：先前的研究表明，与年轻人相比，老年患者的人工耳蜗植入手术发病率和言语感知结果可能较差。然而，最近的轶事报道表明，老年人工耳蜗植入者正在实现越来越高的言语感知性能和手术并发症比以前注意到的更少。我们的目的是回顾使用新一代植入物和微创耳蜗造口术技术的人工耳蜗植入术在80岁及以上患者与年轻成人接受者中的结果。研究设计：回顾性病历回顾。设置：三级转诊中心。患者：所有成年人工耳蜗植入者（232名患者，258个植入物），在一家高等学术机构接受了Nucleus Freedom、Advanced Bionics HR90k或Med El Sonata器械的植入。干预：术后言语感知评分和使用电子病历的临床数据提取。主要结果测量：麻醉和手术并发症、器械故障、手术时间、入院状态、住院时间，在50例植入超过80岁的患者和208例年轻人的人工耳蜗植入手术后，结果：80岁以上的患者更容易出现麻醉并发症，需要住院治疗（p < 0.05）。两组之间在手术并发症或器械故障方面没有统计学差异。言语感知分析显示，老年人和年轻patients.Conclusion：髋关节植入术在所有成人年龄组的耐受性良好，不良手术事件或设备故障的风险相对较低。考虑到老年患者良好的安全性和高水平的语言感知，老年人和九十岁以上的患者常规植入似乎是必要的。这些结果也强调了对老年患者进行全面术前评估的必要性，因为围手术期麻醉并发症的可能性增加。
Objective: Previous studies have shown that cochlear implant outcomes with respect to surgical morbidity and speech perception may be poorer in elderly patients as compared with younger adults. However, recent anecdotal reports suggest that elderly cochlear implant recipients are achieving increasingly higher speech perception performance and fewer surgical complications than previously noted. Our objective is to review cochlear implant outcomes using newer generation implants and minimally traumatic cochleostomy techniques in patients 80 years and older compared with younger adult recipients.Study Design: Retrospective chart review.Setting: Tertiary referral center.Patients: All adult cochlear implant recipients (232 patients, 258 implants) who underwent implantation with a Nucleus Freedom, Advanced Bionics HR90k, or Med El Sonata device at a tertiary academic institution.Intervention(s): Postoperative speech perception scores and clinical data extraction using the electronic medical record.Main Outcome Measure(s): Anesthetic and surgical complications, device malfunction, operative time, admission status, length of hospital stay, and postoperative speech perception scores were collected after 50 cochlear implant procedures in patients who were implanted beyond the eighth decade and 208 among younger adults (18-79 yr).Results: Patients 80 years or older were more likely to have anesthetic complications and require hospital admission (p < 0.05). There was no statistical difference between groups with respect to surgical complications or device malfunction. Speech perception analysis revealed similar outcomes for older and younger patients.Conclusion: Cochlear implantation is well tolerated across all adult age groups with a relatively low risk for adverse surgical events or device malfunction. Given the favorable safety profile and high levels of speech perception achieved by older patients, routine implantation of octogenarian and nonagenarians seems warranted. These results also stress the need for thorough preoperative evaluation of elderly patients, given the increased likelihood for perioperative anesthetic complications.