PP807 - Factors Impacting Cochlear Implant Usage in Recipients over the Age of 5

Abstract:
Children with severe to profound sensorineural hearing loss (SNHL) have been shown to benefit from a cochlear implant (CI) device. However, implantation at a later age increases the risk of non-usage. Consequently, there is a demonstrated need to identify the factors that impact whether a CI recipient over the age of 5 will utilize their CI regularly. Further analysis of factors impacting usage can improve recommendations for treatment of current recipients and determine appropriate future recipients.

Summary:
Purpose
Once cochlear implant candidates receive their devices, it is imperative that clinicians can identify and support those demographics that may be at an increased risk for non-use and poor outcomes. This study aims to investigate how different demographic factors and hearing loss characteristics impact CI usage after implantation in CI recipients between 5 and 18 years of age. Therefore, identifying children who are most at risk of failing to receive the benefits of cochlear implantation.

Methods
Data from an existing internal database from a tertiary pediatric hospital was analyzed from 2008 through 2024. Demographic (age, race, ethnicity, insurance type, and income), surgical, and audiological data, including datalogging was obtained. Descriptive statistics and multiple linear regression using GraphPad Prism were conducted to identify factors associated with CI usage. Additionally, a subjective parental survey with a Likert scale was performed to evaluate the behavioral and hearing improvements of the CI recipients.

Results
Of the 157 included patients, the mean age at implantation was 123.5 months (SD 49.41). 18 (11.5%) of the patients had single sided deafness (SSD) and 44 (28.0%) were pre-lingual. Of the patients with bilateral hearing loss, recipients of bilateral, simultaneous and bilateral, sequential implantation had more daily CI usage than recipients of unilateral implantation (10.62 vs. 9.96 vs. 6.14 hours, p-value < 0.0001). Patients with SSD had less CI usage than those with bilateral hearing loss (6.13 vs. 8.42 hours, p-value = 0.0281). Patients from high income households had more daily CI usage than those from low-income households (9.34 vs. 6.73 hours, p-value = 0.0006). This additionally held true upon multi-variate analysis controlling for age, race, and ethnicity (p-value = 0.0018). No relationship was found between CI usage and the perceived benefit of the CI from the parent survey.

Conclusion
This study has revealed that there are factors, both demographic and characteristic of the child’s hearing loss and implantation, that impact CI usage among children receiving cochlear implantation over five years of age. The timing and laterality of implantation, laterality of hearing loss, and income are all factors that significantly influence CI usage among children receiving late implantation. Further parent surveys to understand the factors that contribute to CI non-usage can be helpful in recommending treatment and designing interventions to mitigate this risk.

Instructional Level
The level chosen for this poster submission is that of fundamental given that minimal prior knowledge is required in order to glean knowledge from the data and results obtained.