Early activation of cochlear implants: a systematic review and narrative synthesis

Abstract

Background

Device activation typically occurs four weeks post cochlear implant surgery. Emerging evidence suggests earlier activation is feasible and beneficial, giving patients quicker access to sound and rehabilitation.

Objectives

Assess current literature for effects of early cochlear implant activation.

Methods

Electronic searches of Medline/PubMed, AMED, EMBASE, CINAHL and the Cochrane Library following PRISMA guidelines. Studies investigating any aspect of early activation were included for review.

Results

From 15 studies, 625 patients received early activation, compared with 243 patients in the control groups. Early activation was considered as within 7 days post-operatively with 12 studies reporting within 1 day post-operatively, compared with standard activation of 9-46 days post-operatively in the control group. Some studies indicated earlier low levels of impedance in the early activation group. Magnet strength adjustment or off-ear processor wear was often recommended within the early activation cohort. Complication rates were low in both groups. Early activation improved patient satisfaction and anxiety levels without detriment to speech recognition or rehabilitation.

Conclusion

Early cochlear implant activation is feasible and allows patients with no contraindications, earlier access to auditory perception and rehabilitation and reduces anxiety linked to delay in activation. Further evidence is required to monitor long-term effects of early activation.

Keywords:

• Cochlear Implantation
• Early activation‌
• Fitting Strategy
• Switch on
• Implant
• Hearing
• Rehabilitation
• Audiology

Acknowlegdements

RP and WB conceived the idea for the study. RP, MA, and JM set up and performed the searches in consultation with an information specialist librarian and performed data extraction. WB adjudicated any disagreements and supervised the findings of this work. RP drafted the manuscript, which was revised by JM, MA, and WB. All authors provided essential contributions to shape the project, analysis, and manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer statements

Contributors: None.

Funding: No funding support was received for this study.

Conflicts of interest: The authors declare that they have no conflict of interest.

Ethics approval: None.

Additional information

Funding

The authors reported there is no funding wassociated with the work featured in this article.

Notes on contributors

Rosalyn Parker

Rosalyn Parker is an Evaluation Healthcare Scientist at NuTH and a visiting Lecturer in Audiology at Queen Margaret University, Edinburgh.

Jameel Muzaffar

Jameel Muzaffar is an ENT Consultant at UHB and NIHR ENT Speciality Lead.

Muhammed Ayas AuD

Muhammed Ayas AuD is a Specialist Audiologist at CUH.

William Brassington

William Brassington is a Consultant Clinical Scientist and Head of Service at UHB.