Cochlear implantation (CI) is an option for severe to profound hearing loss when hearing aids are ineffective. This study aimed to evaluate its relevance in individuals over 80 by assessing long-term CI use and audiological outcomes.

We conducted a retrospective, single-center study including 29 patients over 80 years old who received their first CI between January 2012 and December 2021 with data recorded until December 2024. Annual rates of users and non-users, audiometric test results, and pre- and postoperative complications were recorded.

The mean age at implantation was 82.8, and the mean duration of CI usage was 4.9 years. The percentage of patients still using their implant was 100%, 93%, 83%%, 76% and 75% at 1, 2, 3, 4 and 5 years respectively. This number dropped to 33% 8 years after the surgery. The main reasons for discontinuation were loss of autonomy and lack of benefit. Audiometric results showed improvement in mean pure-tone audiometry thresholds and free-field speech audiometry. Minor complications occurred in 24% of cases, while severe complications occurred in 13%.

CI is a viable option for patients over 80 years old with severe to profound hearing loss. However, given the progressive decline of usage after implantation in this age group, a detailed cost–benefit analysis could provide valuable insight into its indication for this population.