Cochlear implantation in pediatric and young adult oncologic population: institutional experience and case-control analysis

Introduction Cochlear implant (CI) pathways are well established in the general population, but data on pediatric and young adult cancer survivors are limited. This study evaluated the feasibility and safety of cochlear implantation in this population, described demographic and clinical characteristics, examined timelines to hearing rehabilitation, and reported short-term outcomes and complications.Materials and Methods Retrospective case–control study on patients aged 0–22 years with cancer-related hearing loss and matched peers who underwent CI between December 2010 and January 2023.Results Eight oncologic patients and 20 controls (37 implantations) were analyzed. All had bilateral progressive hearing loss. Except for three oncologic patients, all used bilateral hearing aids before implantation. The time from meeting candidacy criteria to CI was significantly longer in cases than controls (2.8 vs. 0.5 years; p = 0.004). Although most cases qualified for bilateral implants, only two received them. Five of eight oncologic patients demonstrated excellent CI use with good speech recognition.Conclusion Pediatric and young adult oncology patients with limited benefit from hearing aids may be good candidates for cochlear implantation. Multidisciplinary care is essential to guide timely, evidence-based implantation in this population.HighlightsCochlear implantation is safe and feasible in pediatric and young adult cancer survivors.This study presents the largest known case series of cochlear implantation in this population, demonstrating that the procedure is both technically safe and clinically beneficial for children and young adults with cancer-related hearing loss. Delayed rehabilitation and inconsistent hearing aid use are common in this populationMany patients experienced long delays, from the onset of hearing loss to cochlear implantation, and showed inconsistent preoperative hearing aid use, which may negatively impact long-term auditory and language outcomes. A multidisciplinary, individualized approach is critical for optimizing outcomesGiven the complexity of cancer treatment effects on the auditory system and developing brain, early and coordinated multidisciplinary care is essential to identify suitable candidates and determine optimal timing for cochlear implantation.