Device nonuse among adult cochlear implant recipients

Objective: To examine the causes and prevalence of previous and current device nonuse among adults who have received cochlear implants. Study Design: Retrospective case review. Setting: Adult tertiary referral center for cochlear implantation. Methods: Two hundred fourteen consecutively implanted adult patients. The length of implant use ranged from I month to 14 years. Main Outcome Measure: A period of 4 consecutive weeks of nonuse of cochlear implant, including both obligatory and elective nonuse. Results: Twenty-nine adults (13.6% of implantees) were identified as having at some stage not used their device for a period of more than 4 consecutive weeks. The main reason was device failure (n = 11). Ten adults are current nonusers (4.7% of implantees). Reasons include surgical complication necessitating explantation (n = 3), comorbid illness (n = 3), elective nonuse (n 2), audiologic complication (n = 1), and device failure (n = 1). Conclusion: The overall prevalence of device nonuse was noted to increase slowly with time. The role of psychologic factors in contributing to the decision of an individual to elect to opt out of device use remains unproven.