Impact of Cochlear Implant on Hearing-Related Quality of Life

Abstract

Background: Prelingual sensorineural hearing loss (SNHL) in children has profound implications for speech, language, and psychosocial development. Cochlear implantation (CI) is widely recognized as a viable auditory intervention for those who derive limited benefit from conventional amplification; however, caregiver-reported outcomes in resource-constrained settings remain underexplored. Understanding parental perceptions of hearing-related quality of life (HRQoL) following CI is essential for contextualizing post-operative success and informing service delivery in such environments. Objective: To evaluate parental perceptions of hearing-related quality of life in children with prelingual deafness following cochlear implantation, focusing on three functional domains: communication with others, listening to speech without lipreading, and spoken language development. Methods: This cross-sectional observational study enrolled 80 parents of children aged 2–13 years with prelingual SNHL who received CI at least six months prior. Participants were recruited from three urban centers in Lahore, Pakistan. Structured interviews were conducted using a validated 9-item questionnaire assessing pre- and post-implant expectations and outcomes. Data were analyzed using descriptive and inferential statistics (chi-square, Fisher’s exact tests), with 95% confidence intervals. Results: Post-implant, 63.8% of parents reported improvement in listening without lipreading, 51.3% in communication, and 36.3% in spoken language. Only the listening domain consistently exceeded the clinically meaningful threshold of 50%. Parental concern remained high in all domains (>96%), regardless of time since implantation. Conclusion: Cochlear implantation yields moderate caregiver-perceived gains in auditory perception and communication in children with prelingual deafness; however, spoken language outcomes remain limited. These findings highlight the critical need for integrated post-implant rehabilitation to optimize functional outcomes in low-resource settings.