Knowledge, Attitudes, and Practices Regarding Cochlear Implants among Non-otolaryngologist Physicians in Saudi Arabia: A Questionnaire-based Cross-sectional Study

Background: Cochlear implants (CIs) are an effective intervention for individuals with severe-to-profound hearing loss, yet awareness and referral patterns among nonotolaryngologist physicians remain underexplored in Saudi Arabia. Objective: This study aimed to assess the knowledge, attitudes, and practices regarding CIs among nonotolaryngologist physicians in Saudi Arabia and to identify factors influencing referral behaviors. Methodology: A nationwide cross-sectional study was conducted from 2024 to 2025 using a validated, self-administered online questionnaire distributed via social media platforms. A total of 383 nonotolaryngologist physicians participated. The survey assessed demographics, knowledge of hearing loss and CI candidacy, attitudes toward cochlear implantation, and clinical practices. Data were analyzed using descriptive statistics, Chi-square tests, ANOVA, and Pearson’s correlation, with significance set at P < 0.05. Results: Half of the participants (50.9%) demonstrated high levels of knowledge, whereas 70.0% exhibited positive attitudes toward cochlear implantation. However, only 36.6% achieved high practice scores, revealing a gap between knowledge and clinical implementation. Knowledge of pediatric CI candidacy was stronger (89%–94%) than that of adult candidacy (43%–59%). Practice scores were significantly linked to clinical exposure, as all physicians with high practice scores had encountered patients with hearing loss and referred them to ENT specialists ( P < 0.001). Analysis across domains showed significant correlations between knowledge, practice, and attitudes. Conclusion: Non-otolaryngologist physicians in Saudi Arabia significantly support cochlear implantation and possess good knowledge regarding pediatric candidacy. However, there are notable deficiencies in adult candidacy awareness and referral practices, potentially delaying patient interventions. It is highlighted that clinical exposure improves practices, necessitating knowledge enhancement alongside experience. Urgent measures such as mandatory continuing medical education, early integration of CI training into medical curricula, and strengthened referral systems are recommended to improve timely referrals and CI utilization, ultimately enhancing hearing healthcare outcomes in the region.