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Background: Cochlear implantation is a highly successful intervention that, despite remarkable improvements in hardware and software, continues to show a high degree of variability in outcomes. Performance in adult patients can potentially be affected by the integrity of spiral ganglion neurons or by the performance of the central auditory system. Prolonged deafness and dementia are conditions that affect the central auditory system and can negatively impact cochlear implant outcomes. Central auditory test batteries can evaluate the central component of hearing in patients that have significant residual hearing, but cannot be effectively used in most cochlear implant patients. A wide variety of recent studies have shown that decline in olfaction predates and often predicts a variety of central nervous system degenerative disorders. We set out to evaluate if olfaction testing could predict hearing results after cochlear implantation. Material and methods: Adult cochlear implant candidates were recruited and olfaction measured with the University of Pennsylvania smell identification test (UPSIT). Testing variables in the analysis include patient age, UPSIT score, AzBio +10 dB score at 6 months post activation, and change in AzBio +10 dB score from preoperative to post-activation testing times. Results: Lower olfaction (UPSIT) scores correlated with poorer hearing outcomes (AzBio +10 dB) at 6 months post activation. Patients with lower UPSIT scores also showed less change in AzBio +10 dB scores over a 6-month period. Conclusions: Olfactory testing may be useful in preoperative evaluation of cochlear implant patients. Identification of patients at risk for central auditory system dysfunction may be possible by evaluation of patients’ olfactory function.

journal of hearing science

THE CENTRAL AUDITORY SYSTEM AND COCHLEAR IMPLANTATION: USING OLFACTORY TESTING TO EVALUATE A POTENTIAL CENTRAL COMPONENT IN COCHLEAR IMPLANT PERFORMANCE