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

To determine the prevalence of long-term cochlear implant (CI) non-use and partial use in paediatric recipients and identify factors associated with suboptimal adherence. DATA SOURCES: A systematic search of major electronic databases including PubMed, Embase, and the Cochrane Library was performed to identify studies reporting CI usage patterns in paediatric populations. REVIEW

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

Clinicians should screen for non-use risk factors (e.g., limited family engagement, poor early outcomes) at follow-up visits and implement targeted support strategies to improve long-term device adherence in pediatric cochlear implant users.

✦ Why It Matters ✦

Even a surgically successful cochlear implant delivers no benefit if not worn, making non-use rates a critical quality metric for pediatric implant programs worldwide.

✦ Key Points ✦

01Systematic review and meta-analysis quantifies long-term cochlear implant non-use and partial use rates in children.
02Identifies demographic, audiological, and social factors associated with device non-use.
03Non-use represents a significant gap between surgical success and real-world functional outcomes.
04Findings can guide counseling and post-implantation support program design.
05Partial use is distinguished from complete non-use, capturing a broader adherence spectrum.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

A measurable proportion of pediatric cochlear implant recipients discontinue or only partially use their device over the long term.

studysupported

Specific factors (e.g., family support, degree of hearing loss, age at implantation) are associated with cochlear implant non-use in children.

studypartially supported

✦ Research metadata ✦

PMID: 42828822
DOI: 10.1016/j.ijporl.2026.113033.
Journal: International Journal of Pediatric Otorhinolaryngology
Publication type: meta_analysis
Evidence level: 1a
Population: Pediatric cochlear implant recipients
Intervention: Cochlear implantation in children

Primary outcomes

Prevalence of long-term cochlear implant non-use; Prevalence of partial device use; Factors associated with non-use

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