Aging and hearing loss, Anesthesia for the elderly, Cochlear implants in the elderly, Oldest person with cochlear implant
Citation Information :
Goycoolea MV, Cagnacci B, Rufs J, Levy R, Catenacci C, Andrade M, Scherpenisse J. Return of Sounds at almost 100 Years of Age: Which will be the Limit?. Int J Head Neck Surg 2021; 12 (2):79-82.
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 intra- or 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.
Goycoolea M. Introduction and general perspective of sensorineural hearing loss. Rev Med Clin Condes 2016;27(6):721–730.
Goycoolea M. Inner ear and understanding the message. In: Goycoolea MV, ed. The music of the spheres and the magic of hearing. Ciudad de Panamá: Jay Pee Highlights Medical Publishers; 2017. pp. 55–89.
Lin FR, Yaffe K, Xia J, et al. Hearing loss and cognitive decline in older adults. JAMA Intern Med 2013;173(4):293–299. DOI: 10.1001/jamainternmed.2013.1868.
Hipoacusia DP. Un nuevo factor de riesgo para demencia. Rev Otorrinolaringol Cir Cabeza Cuello 2017;77(3):237–238. DOI: 10.4067/s0718-48162017000300237.
Mosnier I, Bebear JP, Marx M, et al. Improvement of cognitive function after cochlear implantation in elderly patients. JAMA Otolaryngol Head Neck Surg 2015;141(5):442–450. DOI: 10.1001/jamaoto.2015.129.
Yang Z, Cosetti M. Safety and outcomes of cochlear implantation in the elderly: a review of recent literature. J Otol 2016;11(1):1–6. DOI: 10.1016/j.joto.2016.03.004.
Dietz A, Wüstefeld M, Niskanen M, et al. Cochlear implant surgery in the elderly. Otol Neurotol 2016;37(5):487–491. DOI: 10.1097/MAO.0000000000001025.
Vargas J, Galvez M, Rojas M, et al. Fragilidad: en busca de herramientas de evaluación preoperatoria. Rev Med Chile 2020;148(3):311–319. DOI: 10.4067/S0034-98872020000300311.
Goycoolea MV, Ribalta GL. Exploratory tympanotomy: an integral part of cochlear implantation. Acta Otolaryngol 2003;123(2):223–226. DOI: 10.1080/0036554021000028110.
Brown E, Purdon P. The aging brain and anesthesia. Curr Opin Anaesthesiol 2013;26(4):414–419. DOI: 10.1097/ACO.0b013e328362d183.
Fu H, Fan L, Wang T. Perioperative neurocognition in elderly patients. Curr Opin Anaesthesiol 2018;31(1):24–29. DOI: 10.1097/ACO.0000000000000536.
Claes AJ, Van de Heyning P, Gilles A, et al. Cognitive outcomes after cochlear implantation in older adults: a systematic review. Cochlear Implants Int 2018;19(5):239–254. DOI: 10.1080/14670100.2018. 1484328.
Strøm C. Challenges in anaesthesia for elderly. Singapore Dent J 2014;35:23–29. DOI: 10.1016/j.sdj.2014.11.003.
Lin H, Watts J, Peel N, et al. Fraility and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr 2016;16(1):157–168. DOI: 10.1186/s12877-016-0329-8.
Morley J, Vellas B, Abellan van Kan G, et al. Fraility concensus: a call to action. J Am Med Dir Assoc 2013;14(6):392–397. DOI: 10.1016/j.jamda.2013.03.022.
Fried L, Tangen C, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56(3):46–56. DOI: 10.1093/gerona/56.3.M146.
Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011;27(1):17–26. DOI: 10.1016/j.cger.2010.08.008.
Scheede-Bergdahl C, Minnella E, Carli F. Multi-modal prehabilitation: addressing the why, when, what, how and where next? Anaesthesia 2019;74(Suppl. 1):20–26. DOI: 10.1111/anae.14505.
Mrdutt M, Papaconstantinou H, Robinson B, et al. Preoperative frailty and surgical outcomes across diverse surgical subspecialties in a large health care system. J Am Coll Surg 2019;228(4):482–490. DOI: 10.1016/j.jamcollsurg.2018.12.036.
Guenther U. Patients prone for postoperative delirium: preoperative assessment, perioperative prophylaxis, postoperative treatment. Curr Opin Anaesthesiol 2016;29(3):384–390. DOI: 10.1097/ACO.0000000000000327.
Kotekar N, Shenkar A, Nagaraj R. Postoperative cognitive dysfunction-current preventive strategies. Clin Interv Aging 2018;13:2267–2273. DOI: 10.2147/CIA.S133896.
Olze H, Knopke S, Gräbel S, et al. Rapid positive influence of cochlear implantation on the quality of life in adults 70 years and older. Audiol Neurotol 2016;21(1):43–47. DOI: 10.1159/000448354.
Ramos-Macías Á, Falcón González JC, Borkoski-Barreiro SA, et al. Health-related quality of life in adult cochlear implant users: a descriptive observational study. Audiol Neurotol 2016;21(1):36–42. DOI: 10.1159/000448353.