A patient with bilateral severe-to-profound sensorineural hearing loss (pure-tone average >90 dB HL) undergoes cochlear implantation. Post-activation, the most important prognostic factor for speech perception outcomes in a prelingually deaf adult implanted at age 35 years is:
- A Number of electrode channels activated
- B Duration of deafness before implantation ✓
- C Brand of implant used
- D Pre-implant residual hearing at 250 Hz
Correct answer: B. Duration of deafness before implantation
Explanation
Duration of deafness is the single strongest predictor of cochlear implant outcome in prelingually deaf adults. Prolonged auditory deprivation leads to central auditory pathway reorganization (cortical plasticity changes) and progressive cochlear nerve degeneration, reducing the neural substrate available for auditory learning. Electrode count and residual hearing are secondary factors; implant brand has not been shown to independently determine outcomes.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.