- Design
- Retrospective multicentre cohort
- Population
- 68 adults with >10 years' unilateral severe-to-profound deafness (median 17 years)
- Primary outcome
- Post-operative word recognition score and daily device use
- Effect
- Mean WRS gain 28.4 points; 54.5% gained ≥20 points; daily use 7–8 h
Five US tertiary centres reviewed 68 adults implanted after more than ten years of unilateral severe-to-profound hearing loss; the median duration was 17 years.
Word recognition improved by a mean 28 percentage points. Over half (54.5%) gained 20 points or more, and a third (32.7%) gained 50 or more. Mean daily use was 8.4 hours in the first year and 7.1 hours after. On multivariable analysis, duration of deafness did not predict word recognition after implantation.
Long duration has often been treated as a reason not to implant. This cohort suggests it should inform counselling, not exclude. Results varied widely, so candidates need realistic expectations.
- Do not decline cochlear implant assessment on duration of deafness alone.
- Assess motivation, residual cochlear anatomy and rehabilitation support.
- Counsel that benefit is variable: most improve, some little.
- Plan intensive auditory rehabilitation after activation.
Why it matters
A common exclusion rule may be denying benefit to patients who would use their implant daily.
Don't overread it
Retrospective, with no comparison group and some missing follow-up; it shows benefit is possible, not how often.
The statistics, in plain English
A mean gain of 28 points with a standard deviation of 32 means results ranged from no gain to very large gains. Patients without post-operative data were excluded from part of the analysis, which could flatter the results.
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