This was a combined prospective and retrospective study from Belgium that looked at factors influencing speech recognition scores in quiet conditions (retrospectively) and speech reception threshold levels (SRT) in fixed noise conditions (prospectively) after cochlear implantation in postlingually deaf adults. Sixty-six patients were included over an 11-year period for the retrospective study and 21 patients were included in the prospective part of the study. The authors found that the hearing loss duration significantly affected speech recognition scores in quiet conditions (P=0.032) and SRTs in fixed noise conditions (P=0.033). The authors surmised that this may be explained by the degeneration of peripheral auditory pathways or on the central auditory pathway with increasing duration of deafness. The pure tone audiogram (PTA) of the better hearing ear significantly affected the SRT in fixed noise conditions (P=0.007). The authors explained this as being because the PTA in the better hearing ear correlates with the functionality of the central auditory pathways. This study was limited by small numbers and a heterogeneous population, but these findings can be very useful in counselling patients on their expectations with cochlear implantation.