Cochlear Implants for Radiation‐Induced Hearing Loss in Nasopharyngeal Cancer: A Systematic Review

OBJECTIVES: To evaluate the safety and efficacy of cochlear implantation for auditory rehabilitation in patients with nasopharyngeal carcinoma (NPC) after radiation. DATA SOURCES: CINAHL, Cochrane Library, PubMed, and Scopus were searched from inception through February 2026. REVIEW METHODS: Studies reporting cochlear implantation for hearing loss after radiation for NPC were included. Subjective and objective measures of hearing, including thresholds, speech perception, quality-of-life outcomes, and surgical complications, were extracted. Pooled means and proportions with 95% confidence intervals (CI) were calculated for available outcomes using random-effects models. Study quality and risk of bias were assessed using Oxford Levels of Evidence and Joanna Briggs Institute critical appraisal tools. RESULTS: Twelve studies (N = 69 ears) were included. Cochlear implantation was most commonly performed via standard mastoidectomy with posterior tympanotomy, with alternative approaches used selectively. Surgical and device-related complications were uncommon, with 80.4% (95% CI: 55.1-96.7) without intraoperative complications and 96.5% (95% CI: 88.3-99.5) without postoperative complications. Audiometric improvement was observed in 91.3% of patients (95% CI: 73.1-98.8), with gains in speech perception and patient-reported outcomes. Mean duration of profound hearing loss prior to implantation was 6.5 years. CONCLUSION: Cochlear implantation after radiation in patients with NPC is generally safe and effective, providing meaningful auditory and functional benefits even in long-standing hearing loss. These findings support routine audiologic surveillance after radiation to enable timely referrals for rehabilitation. LEVEL OF EVIDENCE: NA.