The effect of cochlear implantation on autonomy, participation and work in postlingually deafened adults: a scoping review

Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3135-3154. doi: 10.1007/s00405-020-06490-x. Epub 2020 Nov 27.


Purpose: This scoping review examines the available evidence on the effect of unilateral cochlear implantation (CI) in adults with postlingual bilateral hearing loss on societal-related outcomes in terms of work, autonomy and participation.

Methods: Five databases were searched (Pubmed, Web of Science, Embase, PsycINFO and Cochrane Library). Publications were screened in three steps on inclusion criteria. Of the 4230 screened publications, 110 met the inclusion criteria and were assessed for data extraction regarding outcomes "work", "autonomy", "participation". Study characteristics and key findings are presented and narratively described.

Results: Twenty-seven publications were included and categorized into retrospective (n = 3), cross-sectional (n = 18) or prospective (n = 6) study designs. Measurement or identification of number of outcomes (no) were related to work (no = 20), participation (no = 9) and autonomy or independency (no = 10). Most studies indicated benefits of CI on these outcomes. However, some studies did not or indicated additional barriers for benefits. Eleven publications primarily aimed to study one or more of our primary outcomes.

Conclusion: In this literature search, scientific databases are reviewed. The results indicate that there is a relatively small body of evidence regarding the effect of CI on the outcomes "work", "autonomy" and "participation". Even though there are some limitations of the current study including some overlap in outcome definitions, most included studies indicate a beneficial effect of CI on work, autonomy and participation. The lack of consensus in definitions and the small body of evidence indicates a need for additional prospective studies investigating the societal outcomes of CI in postlingually deafened adults.

Keywords: Autonomy; Cochlear implant; Hearing loss; Participation; Work.

Publication types

  • Review

MeSH terms

  • Adult
  • Cochlear Implantation*
  • Cochlear Implants*
  • Cross-Sectional Studies
  • Humans
  • Prospective Studies
  • Retrospective Studies
  • Treatment Outcome