Factors Predicting Device Usage Time Among Pediatric Cochlear Implant Recipients with Bilateral Sensorineural Hearing Loss

Introduction: The objective of this study is to investigate factors influencing device usage time among children with bilateral deafness undergoing cochlear implantation.

Methods: This is a retrospective cohort study comparing all children with bilateral deafness who underwent cochlear implantation from January 1, 2020 to December 31, 2025. Revision cases were excluded from the study. The primary outcome was data-logged device use time in hours per day recorded at 1, 3, 6, and 12 months, and most recent audiologic evaluation post-activation. Age, sex, duration of deafness, presence of comorbid conditions, etiology of hearing loss, and bilateral sequential implantation were compared at each time point.

Results: One hundred thirty-one (131) patients were included in the study, with 225 ears implanted. The median age at surgery was 2.7 years (IQR 4.69), and 61% of the patients were male. Patients were followed for an average of 20.7 months. Presence of comorbid conditions was found to be significantly related to decreased median device usage time across all time points compared to children without comorbidities (p < 0.05 by Kruskal-Wallis rank sum test). Female patients and patients undergoing bilateral sequential procedures had increased usage times at 1 and 3 months compared to males and bilateral implantation, though this difference was not present beyond 6 months post-activation. Age at implantation, duration of deafness, and etiology of hearing loss were not related to device use time.

Conclusions: The presence of comorbid conditions was significantly associated with decreased cochlear implant usage time among children with bilateral deafness up to 20 months post-activation. Additional patient factors were not found to be associated with a longstanding difference in usage time.