Trends in Bilateral Cochlear Implantation Among Children, Adults, and Older Adults in the United States

Objective: To determine trends in bilateral simultaneous compared to bilateral sequential cochlear implantation (CI) in the United States. Study design: Retrospective review. Setting: Bilateral cochlear implant device registration data from the United States was reviewed from a single manufacturer with 60% of the global market share. Patients: Bilateral cochlear implant recipients. Intervention(s): Bilateral simultaneous or sequential CI. Main outcomes measure(s): Number of patients undergoing bilateral CI, percentage by age group, likelihood of bilateral simultaneous CI by age group, and interval between implants in bilateral sequential CI. Results: A total of 25,650 patients underwent bilateral CI from 2005 to 2023; 60 (57- 64) % [mean (95% CI)] were children (≤ 18 years), 29 (28-30) % were adults (19 to 64 years), and 10 (7-13) % were older adults (≥65 years). In the pediatric population, 37 (27-48) % of bilateral cases were performed simultaneously 11 (7-14) % in adults and 6 (4-8) % in older adults. Children were more likely than adults and older adults to undergo bilateral simultaneous CI ( P <0.001). The percentage of bilateral simultaneous cases in those undergoing bilateral CI significantly increased from 2005 to 2023 ( P ≤0.012). For bilateral sequential surgery, the mean (95% CI) interval between implants was 2.3 (1.6-3.0) years in children, 3.2 (2.3-4.0) years in adults, and 3.4 (2.5-4.2) years in older adults. There was a significant decrease in time interval between implants for those undergoing bilateral sequential CI from 2005 to 2023 in all age groups ( P <0.001). Conclusions: On the basis of device registration data from a single manufacturer, most bilateral cochlear implant recipients are children. Children are more likely to undergo bilateral simultaneous CI. The percentage of bilateral simultaneous CI in those undergoing bilateral CI has significantly increased from 2005 to 2023. For those undergoing bilateral sequential CI, the time interval between implants has significantly decreased from 2005 to 2023.