Children then, adults now: long-term outcomes-performance at 15, 20, and 25 years of cochlear implant use.
João Elói Moura, Jorge Humberto Martins, Marisa Alves and 7 others
PMID 38170021WHAT IT FOUND
Adults implanted before age three maintained significantly better hearing performance than those implanted later, even 25 years on.
Scores improved over time for both groups, but the early-implant advantage persisted, particularly in difficult listening tasks like telephone conversations.
Key findings
01Patients implanted before 3 years of age showed significantly better auditory performance than those implanted after 3 years, with medians differing by almost 20%.
02Performance improved significantly with years of use for both groups, continuing from 15 to 20 years and stabilizing slightly between 20 and 25 years.
03The advantage of early implantation was most pronounced in telephone-based listening tests, where the gap between groups was larger than in live voice tests.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (31 participants), and the groups were not randomly assigned. All participants were from a single center and used the same stimulation strategy (SPEAK), which limits generalizability to modern processors or bilateral implants. Socio-economic factors were not controlled, which could influence both academic achievement and access to ongoing rehabilitation. The study population was exclusively Caucasian and native Portuguese speakers, limiting cultural generalizability.
Declared interests
The authors declare that no financial support was received for the research, authorship, and/or publication of this article.
The easy way to misread this
Do not assume that late-implanted adults will eventually catch up to early-implanted peers. While both groups improved over 25 years, the significant gap in performance, especially on telephone tests, persisted throughout the entire follow-up period.