Non-usage rates after paediatric cochlear implantation: A systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis examined long-term cochlear implant use among paediatric recipients, synthesising 29 studies involving 2,595 children. Random-effects models estimated pooled non-use at 4.45% (95% CI: 2.21-8.78) and partial use, defined as <8 h/day, at 8.99% (95% CI: 5.91-13.44). Rates varied across regions and clinical subgroups. Longer duration of hearing loss was associated with more partial use, while implantation at ≤12 months was associated with less partial use than implantation at 12-24 months. The authors concluded that more than one-tenth had suboptimal long-term adherence.

Key findings

• Pooled non-use prevalence was 4.45% (95% CI: 2.21-8.78); partial use (<8 h/day) was 8.99% (95% CI: 5.91-13.44).
• Non-use estimates ranged from 27.27% (95% CI = 9.05-58.57) in Oceania to 1.99% (95% CI: 1.00-3.94) in Europe.
• Longer hearing-loss duration was associated with greater partial use (coefficient 0.477, p < 0.001); partial use was 6.89% with implantation at ≤12 months versus 16.81% at 12-24 months.
• No significant associations were found between use and follow-up duration, sex, or implant laterality.

Why it matters

The pooled estimates indicate that a meaningful minority of paediatric recipients do not use their implants consistently over the long term. Variation by region and clinical characteristics, alongside associations with hearing-loss duration and implantation age, highlights the value of monitoring device use and understanding factors linked to adherence. These findings describe patterns across studies rather than proving that any particular factor causes non-use.

What to keep in mind

The estimates combine studies with differing populations and settings; regional and subgroup estimates may therefore be less precise, as reflected in their wide confidence intervals.