Impact of congenital cytomegalovirus on cochlear implant usage in children: A matched cohort study using datalogging metrics.

OBJECTIVE: To evaluate whether congenital cytomegalovirus (cCMV) infection is associated with differences in cochlear implant (CI) usage in children, as measured by hearing hour percentage (HHP), compared to matched non-CMV controls. STUDY DESIGN: Retrospective matched cohort study. SETTING: Tertiary pediatric hospital. METHODS: Children undergoing first-time CI between 2018 and 2023 with at least 1 year of follow-up were included. Patients with cCMV-associated hearing loss (n = 19) were matched 1:2 to non-CMV controls (n = 30) based on age at implantation, hearing loss type, insurance, and implantation period. HHP was calculated using datalogging data. Univariate and multivariate linear regression analyses were performed to evaluate predictors of HHP. RESULTS: Mean HHP was lower in the cCMV group compared to controls (37.2% vs 45.3%), though this difference was not statistically significant. In multivariate analysis, cCMV was not independently associated with HHP (β = -8.63, p = 0.132). Factors significantly associated with higher HHP included older age and private insurance, while single-sided deafness and implantation during the late COVID pandemic period were associated with reduced HHP. CONCLUSION: cCMV was not an independent predictor of CI usage. Instead, demographic and socioeconomic factors played a larger role in determining device use. These findings highlight the importance of targeted interventions to support consistent CI use, particularly among vulnerable populations.