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. 2020 Jun;162(6):926-932.
doi: 10.1177/0194599820911707. Epub 2020 Mar 17.

Influence of Age at Cochlear Implantation and Frequency-to-Place Mismatch on Early Speech Recognition in Adults

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Influence of Age at Cochlear Implantation and Frequency-to-Place Mismatch on Early Speech Recognition in Adults

Michael W Canfarotta et al. Otolaryngol Head Neck Surg. 2020 Jun.

Abstract

Objective: Default frequency filters of cochlear implant (CI) devices assign frequency information irrespective of intracochlear position, resulting in varying degrees of frequency-to-place mismatch. Substantial mismatch negatively influences speech recognition in postlingually deafened CI recipients, and acclimatization may be particularly challenging for older adults due to effects of aging on the auditory pathway. The present report investigated the influence of mismatch and age at implantation on speech recognition within the initial 6 months of CI use.

Study design: Retrospective review.

Setting: Tertiary referral center.

Subjects and methods: Forty-eight postlingually deafened adult CI recipients of lateral wall electrode arrays underwent postoperative computed tomography to determine angular insertion depth of each electrode contact. Frequency-to-place mismatch was determined by comparing spiral ganglion place frequencies to default frequency filters. Consonant-nucleus-consonant (CNC) scores in the CI-alone condition at 1, 3, and 6 months postactivation were compared to the degree of mismatch at 1500 Hz and age at implantation.

Results: Younger adult CI recipients experienced more rapid growth in speech recognition during the initial 6 months postactivation. Greater degrees of frequency-to-place mismatch were associated with poorer performance, yet older listeners were not particularly susceptible to this effect.

Conclusions: While older adults are not necessarily more sensitive to detrimental effects of frequency-to-place mismatch, other factors appear to limit early benefit with a CI in this population. These results suggest that minimizing mismatch could optimize outcomes in adult CI recipients across the life span, which may be particularly beneficial in the elderly considering auditory processing deficits associated with advanced age.

Keywords: age; cochlear implant; frequency-to-place mismatch; speech recognition.

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Figures

Figure 1.
Figure 1.
CNC word scores as a function of age at implantation (top row), and absolute frequency-to-place mismatch at 1500 Hz on the SG map (bottom row). Abbreviations: SG, spiral ganglion; CNC, consonant-nucleus-consonant.

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