Return of Sounds at almost 100 Years of Age: Which will be the Limit?

Abstract

Ab s t r Ac t Introduction: Cochlear implant (IC) is the standard treatment for profound deafness in children and adults. In the elderly, this indication is becoming more common every day. Aims and objectives: To describe the medical and the surgical approaches to be considered while operating a cochlear implant in an elderly patient. Materials and methods (clinical case): An approach to cochlear implants in the elderly is described, using as a common thread, the case of a 98-year and 9-month-old woman with severe bilateral gradually progressive sensorineural hearing loss who did not benefit from her hearing aids. She underwent comprehensive multispecialty medical evaluation including otolaryngology neurology, cardiology, and anesthesiology. She underwent cochlear implantation under local anesthesia and sedation. Results: No intraor postoperative complications occurred. Recovery was quick and she was discharged on the second postoperative day. The device was activated at 1 month post-surgery and all electrodes were active. Free field thresholds for pure tones were 25 dB HL PTA 4 and discrimination in silence with IC in left ear and hearing aid in right ear for sentences were 76% and for familiar words 100%. Conclusion: Cochlear implantation resulted in an adequate alternative for this elderly patient, possibly the oldest or one of the oldest implanted individuals in the world. Cochlear implantation should be considered a reasonable alternative for elderly patients with profound hearing loss. The surgical decision should focus more on the general health conditions than on the chronological age.