Incidence of Cochlear Implantation Among Adult Candidates in the United States

Abstract

Objectives To investigate the associations of age and year of cochlear implantation (CI) with CI incidence among adults 20 years and older residing in the US. Study Design Deidentified cochlear implant data were acquired from prospective patient registries from two cochlear implant manufacturers (Cochlear Americas and Advanced Bionics), which supply an estimated 85% of cochlear implants in the US. Population estimates for severe-to-profound sensorineural hearing loss by age group were extracted from Census and National Health and Nutrition Examination Survey data. Setting US CI centers. Patients Adults 20 years and older who underwent CI. Interventions CI. Main Outcome Measures CI incidence. Results The study cohort included 30,066 adults 20 years and older who underwent CI from 2015 to 2019. When combining actual and estimated data from all three manufacturers, the annual number of cochlear implants increased 5,406 in 2015 to 8,509 in 2019. Overall, the incidence of CI among adult traditional (bilateral severe-to-profound hearing loss) CI candidates increased from 244 per 100,000 person-years in 2015 to 350 in 2019 (p < 0.001). Although the elderly (80 years and older) population had the lowest incidence of CI, this cohort experienced the largest growth from an incidence of 105 per 100,000 person-years to 202 during the study period. Conclusions Despite growing incidence among those with qualifying hearing loss, cochlear implants remain widely underutilized. Elderly adults continue to exhibit the lowest relative cochlear implant utilization rates; however, trends over the last half-decade suggest a shift has occurred, resulting in improved access among this underserved subset.