# Quality of life in children with unilateral hearing loss undergoing cochlear implantation: A systematic review and meta-analysis

## TL;DR

Cochlear implants improve quality of life for children with unilateral hearing loss, with similar benefits for both congenital and post-lingual groups.

## Contribution

This is the first systematic review and meta-analysis to evaluate QoL outcomes of cochlear implantation in children with unilateral hearing loss.

## Key findings

- Children and parents reported significant QoL improvements after cochlear implantation.
- Congenital and post-lingual groups showed similar QoL improvements and device usage times.
- Daily cochlear implant usage averaged around 8.8 hours with high adherence.

## Abstract

•Children with SSD experience many developmental challenges and poor quality of life.•CI has previously been shown to improve hearing, although QoL outcomes remain underreported.•This review shows improvement in QoL for parents and children and good adherence to CI.•Similar QoL improvement and duration of use for congenital and post-lingual groups.•Factors associated with discontinuation need further investigation.

Children with SSD experience many developmental challenges and poor quality of life.

CI has previously been shown to improve hearing, although QoL outcomes remain underreported.

This review shows improvement in QoL for parents and children and good adherence to CI.

Similar QoL improvement and duration of use for congenital and post-lingual groups.

Factors associated with discontinuation need further investigation.

Children with Single-Sided Deafness (SSD) may experience a range of developmental challenges. While cochlear implantation has demonstrated significant improvements in hearing, its impact on Quality of Life (QoL) remains underreported. This review evaluates how cochlear implantation for SSD influences the quality of life in children.

A systematic review was conducted following the PRISMA guidelines across nine different databases, without language restrictions, including articles indexed up to December 15, 2023. Eligible studies included patients up to 18-years-old; severe to profound unilateral hearing loss, and normal contralateral hearing; cochlear implantation with more than 3 months of follow-up; QoL assessed by structured questionnaires. Meta-analysis compared QoL scores obtained between pre- and post-operative periods for time of onset or hearing loss (congenital vs. post-lingual), evaluated by parents and children, and the effective cochlear implant usage time.

A total of 296 articles were identified, with 6 eligible for qualitative analysis and 3 for meta-analysis, involving 187 patients. The mean age at implantation was 5.8 years, with an average auditory deprivation time of 3.8 years. Both the congenital and post-lingual groups demonstrated improvement in QoL, with a mean increase of 1.51 points in children's evaluations (p-value < 0.001) and 2.70 points in parental perspectives (p-value < 0.001), assessed on a 10-point scale. The estimated effective device use time was 8.8 h per day, with 8.55 h per day for the congenital group and 10.37 h per day for the post-lingual group. There was no statistically significant difference in usage time between the two groups (p-value = 0.140).

The results indicated a significant improvement in QoL, as reported by both parents and through self-assessment. The treatment also demonstrated high levels of adherence. Both congenital and post-lingual groups yielded similar outcomes in terms of QoL and device usage time.