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Literature Review: A Roundup of Important Recent Studies

Speech Perception Lower in Older CI Users

Do cochlear implant (CI) users older than 65 years of age have different surgical and audiological outcomes than younger adult CI users?

Background: The number of adults older than 65 is expected to double between 2000 and 2030. Several studies have shown that although older adults benefit from CI, experiencing improved hearing ability and quality of life, current studies are not in agreement as to whether older adults have similar audiological and surgical outcomes to those experienced by younger adults.

Study design: Retrospective single-institution study of medical and audiologic records from 2006 to 2010 of 113 post-lingually deafened adults with unilateral cochlear implants.

Setting: Department of Otolaryngology and Department of Audiology, Massachusetts Eye and Ear Infirmary, Boston.

Synopsis: Records were divided into two primary groups: 1) those younger than age 65 and 2) those aged 65 or older; these groups were also subdivided according to decade of age. Total audiological follow-up time, sex, noise exposure, history of neurological disease, side of implantation and device type were the same between Groups 1 and 2. Speech perception improved in both groups, but octogenarians had poorer speech recognition compared with patients aged 60 to 69. Patients who reported a family history of hearing loss had higher word intelligibility scores compared with those who did not and tended to be younger than age 65. Also, a family history of hearing loss was associated with a trend toward improved post-implantation speech perception in all patients. Patients in both groups were equally likely to experience vertigo/disequilibrium. Group 2 patients trended toward a preference for left-sided implantation; however, this did not influence speech perception. Limitations included a risk of bias and the fact that the data represent a single institution’s experience.

Bottom line: Speech perception ability was significantly poorer in CI users older than age 65 when compared with younger adult patients, and a family history of hearing loss was associated with a trend toward better speech recognition.

Citation: Roberts DS, Lin HW, Hermann BS, Lee DJ. Differential cochlear implant outcomes in older adults. Laryngoscope. 2013;123:1952-1956.

—Reviewed by Amy Eckner

Caseload Volume Predictor of Thyroid Surgery Outcomes

How do surgeon and hospital volume affect the outcome of thyroid surgery in the United States?

Background: Surgeons with a high-volume thyroid caseload have a lower incidence of post-operative complications. However, low-volume thyroid surgeons performing three or fewer cases per year perform the majority of thyroid surgery in the United States. This study seeks to characterize national trends in thyroid surgical care and the effect of hospital and surgeon volume on practice patterns and short-term outcomes.