Long-deaf adults still gained from cochlear implants, just more slowly

Design

Single-centre retrospective cohort

Population

41 adults with at least 5 years of unaided deafness who received cochlear implants, 2012-2023

Primary outcome

CNC word recognition at 3 and 12 months

Effect

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

A single high-volume centre reviewed adults implanted between 2012 and 2023 who had been deaf without useful aided hearing for at least five years (Laryngoscope, 25 September 2026). Forty-one patients were grouped by deafness duration: 5-9, 10-19 and 20 or more years.

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

Long duration of deafness is often treated as a reason to discourage implantation. These data suggest it predicts a slower start rather than a poor end, while complete absence of residual hearing is the more useful warning sign.

• Do not decline cochlear implant referral on long duration of deafness alone.
• Counsel long-deaf adults that early progress may be slow but can catch up by a year.
• Treat absent measurable preoperative thresholds as a marker of higher risk of limited benefit.
• Plan intensive early rehabilitation for patients deaf 20 years or more.

Why it matters

It challenges the assumption that decades of deafness make implantation futile.

Don't overread it

With 41 patients from one centre, a real 12-month difference may have been missed.

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