A careful look at the literature suggests a variety of clinical best practices, including the use of cochlear implantation to improve cognitive function and olfactory training to help with smell loss after infection, experts said at a Best Practice session at the 2022 Triological Society Combined Sections Meeting.
Explore This IssueJune 2022
The session was based on the popular “Best Practice” articles in The Laryngoscope, in which authors write concise reviews of the literature to try to answer clinical questions routinely faced by physicians.
Aaron Moberly, MD, an associate professor of otolaryngology– head and neck surgery at The Ohio State University in Columbus, said that the pattern in the literature shows that cochlear implantation can help improve cognition, but it isn’t a straightforward picture.
In what’s thought to be the largest series on the topic, a study out of France enrolled 93 patients who were 65 and older and assessed their cognition before cochlear implantation and at six and 12 months after implantation (JAMA Otolaryngol Head Neck Surg. 2015;141:442-450). The study’s strengths were that the patients were at a greater risk of cognitive challenges, and it used an array of tests to assess an assortment of cognitive domains, including episodic memory, processing speed, flexibility, and executive function.
As with most studies in this area, however, it didn’t include people with severe cognitive deficits. And, because the patients received rehabilitation therapy for the implants for six months, the cognitive results could have been influenced by that therapy.
Nonetheless, the results suggest that cochlear implants help with cognition, with improvement in some domains at six months, and with additional domains at 12 months, with those patients who had the poorest cognitive function seeming to receive the most benefits.
A study out of Australia that enrolled both cochlear implant recipients and controls who did not have implants but who were on the waiting list for one, found that those who had received the implant showed improvements in attention, processing speed, and working memory at six months, and, additionally, in working memory, general memory, and executive function at 12 months (Otol Neurotol. 2018;39:514-515).
Other studies have also found a tie between cognitive benefits and cochlear implants, showing that patients starting with greater cognitive deficits receive better results.