The Risk of Becoming a Cochlear Implant Non-user or Minimal-user in a Patient Cohort From Denmark 2010-2022

Objective: Cochlear implant (CI) non-use and minimal-use are important, but sparsely investigated parameters. This study investigates the risk of becoming a CI non-user or a minimal-user in a post-lingual deafness adult population. Study design: Retrospective cohort study. Setting: Tertiary medical institution. Materials and methods: All adult patients (18 years or above) who received CI surgery at a single center from 2010 to 2022 (n=599) were invited to participate in a questionnaire study concerning the CI usage after surgery. The questionnaire information was combined with data from medical records. Non-use was defined as never/rarely usage of the device. Minimal-users were patients who reported <4 hours of daily use, and patients considering ceasing to use their device, and not included in the non-use group. Results: In total, 472 (78.8%) patients replied to the questionnaire regarding CI usage. Hereof, 20 patients (4.2%) were non-users and 26 patients (5.5%) were minimal-users with mean follow-up times of 8.4±3.4 years. Rehabilitation was provided for 97% of the participants by a speech-language pathologist for 6 to 12 months. Abnormal cochlear anatomy was associated with CI non-use (odds ratio=5.7, 95% confidence interval [1.1-30.8], P =0.04). No additional correlations were found between non-users, minimal-users, and CI users. Conclusion: The CI non-user rate was 4.2% and these patients experienced lower QoL compared with CI users. In addition, 5.5% of the patients were minimal-users. In adults with abnormal cochlear anatomy, an increased risk of non-use was identified, reflecting the need for thorough information regarding surgical outcomes in this specific subgroup of patients.