The Relationship Between Daily Device Use and Subjective Hearing Abilities in Pediatric Cochlear Implant Users

Increased hours of cochlear implant (CI) use have been shown to improve auditory and speech recognition outcomes in children with hearing loss. However, the impact of hours of CI use over time on patient-reported functional hearing skills is unknown. Increased duration of CI use, measured by hearing hour percentage (HHP), will coincide with improved long-term subjective hearing abilities, assessed by Speech, Spatial, and Qualities of Hearing (SSQ) questionnaire.

Retrospective chart review from 2013 to 2023.

Pediatric CI recipients with at least 18 months of CI use at a single institution.

Demographic characteristics and audiology history were collected, and HHP was calculated. Changes in SSQ scores over time and HHP were correlated utilizing Spearman's rank correlation.

Of 104 patients reviewed, 24 patients (54% female) met inclusion criteria. Median age at implantation was 6.0 years (4-7.25, Q1-Q3), and median duration of CI experience was 33 months (24.5-60.3, Q1-Q3). In patients with at least two SSQ measures postoperatively, a significant positive correlation emerged between average HHP and change in SSQ score from first to most recent test (r = 0.63, P = .01). Of patients with a preimplantation SSQ score, there was a significant positive correlation between average HHP and change in SSQ from pre-CI to most recent test (r = 0.68, P = .04).

Higher average HHP corresponded to a greater increase in SSQ scores in pediatric CI users over time, suggesting that increased hours of CI use may improve patient-reported outcomes in long-term hearing ability.