Bilateral Simultaneous Cochlear Implants: How Early Activation Influences Wearing Hours

<b>Background/Objectives</b>: Cochlear implantation (CI) is a transformative intervention for individuals with sensorineural hearing loss, providing auditory and speech perception improvements. Traditional CI activation occurs 4-6 weeks post-surgery; however, recent advancements allow for early activation within 1-2 days. The integration of data logging in modern CI systems offers objective insights into processor usage and auditory exposure, which are crucial for optimizing rehabilitation outcomes. <b>Methods</b>: A retrospective study was conducted on 63 patients with bilateral simultaneous CIs using MED-EL SONNET2/RONDO3 devices. Patients were classified into early activation (<i>n</i> = 30, activation within 1-2 days) and classical activation groups (<i>n</i> = 33, activation after day 2). Data logging metrics, patient demographics, and implant details were analyzed using the Wilcoxon rank-sum test and Poisson regression. <b>Results</b>: Daily processor usage did not significantly differ between groups (9.5 ± 3.0 h/day for classical vs. 9.4 ± 3.7 h/day for early activation, <i>p</i> = 0.927). Subgroup analysis showed a significant 18% increase in processor usage with each additional year of patient age (IRR = 1.18, <i>p</i> < 0.001) and a 15% decrease in usage with each year delay in implantation age (IRR = 0.85, <i>p</i> < 0.001) among early activation users. Switch-on frequencies were comparable between groups, with no significant differences observed (<i>p</i> = 1.0). <b>Conclusions</b>: Early activation is feasible and associated with consistent CI usage, providing potential benefits in auditory rehabilitation. Future research should explore its impact on long-term speech and language outcomes to inform evidence-based practices.