Longitudinal Cochlear Implant Use in Pediatric Patients With Unilateral Hearing Loss

To characterize longitudinal cochlear implant (CI) usage patterns in children with unilateral hearing loss (UHL) and evaluate the impact of age at implantation and duration of deafness on device use.

Retrospective cohort study.

Two academic tertiary care centers.

Pediatric CI recipients with UHL implanted between 2018 and 2024 were included. Datalogging information was obtained at 3, 6, 12, 18, and 24 months postactivation. Patients were categorized as regular users (>6 h/day) or moderate users (>4 h/day). Usage patterns were analyzed using regression.

Fifty-three patients with datalogging available at 3 months postactivation (mean age at implantation: 7.3 years; SD 3.6) were included. At 3 months, 81% were regular users and 83% were moderate users, with mean usage of 8.2 h/day (SD 3.4). Usage remained stable over time: at 24 months, among 27 patients with available data, 64% were regular users and 82% were moderate users, with mean usage of 6.8 h/day (SD 2.9). Among regular users with sustained use at 6 months, mean usage decreased from 9.10 to 8.63 h/day by 24 months (P = .033). No patients achieving 4-hour usage at 6 months subsequently dropped below this threshold. Neither age at implantation nor duration of deafness correlated with usage changes. Most patients lost to follow-up demonstrated at least moderate use at their last visit.

Children with UHL demonstrate high sustained CI usage through 24 months. Although usage declined over time, this averaged only about 30 minutes per day. Early usage patterns appear predictive of long-term device adoption.