{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T15:32:05Z","timestamp":1775835125800,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"vor","delay-in-days":41,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Military veterans have high rates of noise\u2010induced hearing loss (NIHL) which is associated with more significant spiral ganglion neuronal loss. This study explores the relationship between NIHL and cochlear implant (CI) outcomes in veterans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series of veterans who underwent CI between 2019 and 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Veterans Health Administration hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AzBio Sentence Test, Consonant\u2010Nucleus\u2010Consonant (CNC) scores, and Speech, Spatial, and Qualities of Hearing Scale (SSQ) were measured pre\u2010 and postoperatively. Linear regression assessed relationships between outcomes and noise exposure history, etiology of hearing loss, duration of hearing loss, and Self\u2010Administered Gerocognitive Exam (SAGE) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two male veterans were implanted at an average (standard deviation) age of 75.0 (9.2)\u00a0years without major complications. The average duration of hearing loss was 36.0 (18.4)\u00a0years. The average time of hearing aid use was 21.2 (15.4)\u00a0years. Noise exposure was reported in 51.3% of patients. Objectively, AzBio and CNC scores 6 months postoperatively showed significant improvement of 48% and 39%, respectively. Subjectively, average 6\u2010month SSQ scores showed significant improvement by 34 points (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). Younger age, SAGE score \u226517, and shorter duration of amplification were associated with higher postoperative AzBio scores. Greater improvement in AzBio and CNC scores was associated with lower preoperative scores. Noise exposure was not associated with any difference in CI performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite high levels of noise exposure and advanced age, veterans derive substantial benefits from cochlear implantation. SAGE score \u226517 may be predictive of overall CI outcomes. Noise exposure does not impact CI outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level 4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oto2.53","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T16:48:46Z","timestamp":1683910126000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cochlear Implantation in US\u00a0Military Veterans: A Single Institution Study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0665-9653","authenticated-orcid":false,"given":"Douglas J.","family":"Totten","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Indiana University School of Medicine Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul","family":"Saltagi","sequence":"additional","affiliation":[{"name":"College of Medicine, Indiana University School of Medicine Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Libich","sequence":"additional","affiliation":[{"name":"Department of Audiology Roudebush Veterans' Administration Medical Center Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Pisoni","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Indiana University School of Medicine Indianapolis Indiana USA"},{"name":"Department of Psychological and Brain Sciences Indiana University Bloomington Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5749-6383","authenticated-orcid":false,"given":"Rick F.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Indiana University School of Medicine Indianapolis Indiana 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