Long-deaf adults still gain from cochlear implants — early progress is slower, and unmeasurable thresholds predict poorer benefit

Design

Retrospective single-centre cohort

Population

41 adults with ≥5 years unaided deafness receiving cochlear implants

Primary outcome

CNC word recognition at 3 and 12 months

Effect

Lower at 3 months with ≥20 years deafness; no significant difference at 12 months

This single-centre review, published 25 September in The Laryngoscope, looked at 41 adult cochlear implant recipients between 2012 and 2023 who had at least five years of documented unaided deafness, grouped by duration: 5–9, 10–19 and 20 years or more.

At three months, those deaf for 20 years or more had lower CNC word recognition scores than shorter-duration groups. By 12 months, there was no significant difference between groups. Patients with no measurable pre-operative hearing thresholds were more likely to become non-users or not achieve open-set speech perception.

Long duration of deafness is often treated as a reason not to implant. This small study suggests it predicts a slower start rather than a poor outcome, while the absence of any residual hearing is the more useful warning sign for counselling.

• Do not refuse cochlear implant referral on duration of deafness alone.
• Counsel long-deaf patients that early speech gains may be slow but can catch up by a year.
• Flag patients with no measurable pre-operative thresholds as at higher risk of limited benefit.
• Plan more intensive early rehabilitation for patients deaf for 20 years or more.

Why it matters

Widens who can be considered for implantation, which matters where many adults present after decades of untreated deafness.

Don't overread it

Small retrospective single-centre series; the 12-month catch-up needs confirmation in larger cohorts.

The statistics, in plain English

With only 41 patients split into three groups, the study could miss real differences at 12 months; "no significant difference" is not proof the groups end up the same.

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