International Journal of Speech and Audiology
2025, Vol. 6, Issue 2, Part A
Long-term outcomes of cochlear implant recipients: A multicenter clinical audiology perspective
Author(s): Nurlan Askarov, Aigul Saparbekova and Marat Beketov
Abstract: Background: Cochlear implantation (CI) has proven to be an effective intervention for severe-to-profound sensorineural hearing loss across age groups, yet long-term, multicenter outcome data integrating speech perception, quality-of-life (QoL), and device reliability remain limited. This study evaluated decade-scale functional performance, patient-reported benefit, hearing preservation in electro-acoustic stimulation (EAS) users, and device survival across diverse clinical programs. Objectives: To quantify long-term (>5 years) auditory and QoL outcomes in pediatric and adult CI recipients; assess hearing preservation in EAS users; evaluate device survival and revision rates; and identify predictors of performance, including inter-center variability. Methods: A multicenter, prospective, longitudinal study was conducted across five tertiary CI programs. Eligible recipients (n=412; 197 pediatric, 215 adult) had ≥5 years of device use and complete clinical records. Primary outcomes included CNC word and AzBio sentence scores in quiet and noise (+10 dB SNR). Secondary measures comprised Health Utilities Index Mark 3 (HUI3) and Nijmegen Cochlear Implant Questionnaire (NCIQ) scores, EAS low-frequency hearing preservation, and device survival. Statistical analyses used mixed-effects models, repeated-measures ANOVA, Kaplan-Meier survival curves, and Cox regression. Results: At a mean follow-up of 9.3 ± 2.7 years, CNC quiet scores averaged 83.4% (pediatric) and 78.9% (adult) with no significant decline from 1-year results (p=0.18). AzBio in noise scores were significantly lower than in quiet (p<0.001). Age at implantation and duration of deafness predicted in-noise performance (p<0.05). QoL improved substantially (HUI3: 0.42 to 0.81, p<0.001). EAS users (n=40) preserved functional low-frequency hearing in 82.5% of cases. Device survival was 94.8% at 10 years; pediatric age predicted higher revision risk (HR=1.47, p=0.039). Inter-center variability was minimal in quiet but significant in noise performance (p=0.048). Conclusions: Cochlear implantation delivers durable speech perception, QoL improvement, and high device reliability over a decade of follow-up. Modifiable factors—particularly post-activation rehabilitation intensity—should be standardized to optimize in-noise performance and minimize inter-center variability. Hearing preservation remains achievable in most EAS recipients with careful surgical and programming practices.
DOI: 10.22271/27103846.2025.v6.i2a.85
Pages: 49-55 | Views: 350 | Downloads: 179
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How to cite this article:
Nurlan Askarov, Aigul Saparbekova and Marat Beketov. Long-term outcomes of cochlear implant recipients: A multicenter clinical audiology perspective. International Journal of Speech and Audiology. 2025; 6(2): 49-55. DOI: 10.22271/27103846.2025.v6.i2a.85
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