Cochlear implantation: Listening environments among pediatric recipients.

Objectives: To examine auditory environments and challenges faced by pediatric cochlear implant (CI) users in Saudi Arabia by comparing auditory settings and device usage between preschoolers and school-age children.

Methods: A retrospective analysis was conducted on prelingually deafened children under 18 years of age using SONNET2/RONDO3 MED-EL CI. Children were categorized based on Saudi Arabia's primary school enrollment age. Datalogging metrics from 2020-2022 on device usage and auditory scene exposure were analyzed using R Software, with descriptive statistics and regression models exploring relationships between demographic factors and data logging metrics.

Results: A total of 178 ears met inclusion criteria, with a median age of 5.8 years and a median implantation age of 2.0 years. Median daily CI use was 10.1 hours, with preschoolers using their devices for 7.9 hours and school-age children for 11.6 hours. Predominant auditory exposure was to "speech-in-noise" (49%) and "noise" (37%). Significant correlations were found between age, implantation age, and various datalogging metrics.

Conclusion: Pediatric CI users in Saudi Arabia showed increased daily CI use with age, primarily in noisy environments, highlighting the need for acoustically optimized settings to support speech perception. Chronological age was a key determinant of CI usage and auditory exposure, emphasizing its role in tailoring interventions to improve outcomes for children with CI.