Quality of Life in Children With Cochlear Implants: A Systematic Review and Meta-Analysis of Different Quality of Life Domains

Purpose: The primary objective of this study was to assess the quality of life (QoL) in children with cochlear implants (CIs) from the children's and parents' perspectives through utilizing the Pediatric Quality of Life Inventory (PedsQL) and KINDL questionnaires. A secondary objective was to compare the QoL of children with CIs to those using hearing aids and to children with normal hearing (NH). Method: A total of 1,830 records were obtained since the search was systematically carried out across databases, which are PubMed, Scopus, Web of Science, Google Scholar, and Ovid Embase. Following screening, 10 studies met the eligibility criteria, with 1,194 participants. This systematic review and meta-analysis were International Prospective Register of Systematic Reviews registered and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. It included research published in English that evaluated QoL using the PedsQL and KINDL questionnaires. The Appraisal Tool for Cross-Sectional Studies tool evaluated the risk of bias in the included studies. Data extraction focused on study characteristics, participant demographics, and QoL outcomes. Descriptive analysis and meta-analysis were used to synthesize the data. Results: QoL was significantly lower in children with CIs when compared to peers with NH, according to the meta-analysis, specifically in the social and school functioning domains. Descriptive analysis revealed high heterogeneity among studies, with some children with CIs showing QoL comparable to children with NH. Conclusions: Despite the advantages of CIs, challenges remain high, specifically in social integration and academic performance. These findings are indicative of the necessity for long-term follow-up and personalized intervention to maximize the global QoL in children with CIs.