Impact of Cochlear Implantation on Listening-Related Fatigue in Children With Unilateral Hearing Loss

Objective: To evaluate whether cochlear implantation reduces listening-related fatigue in children with unilateral hearing loss. Study design: Prospective within-subjects crossover study. Setting: Three academic medical centers specializing in pediatric cochlear implantation. Methods: Fatigue was assessed using the Vanderbilt Fatigue Scale and PedsQL™ 3.0 Multidimensional Fatigue Scale. Parent- and child-reported versions were completed after consecutive days of baseline cochlear implant use and following a three-day discontinuation during a holiday break. Paired t-tests compared conditions ( P <0.05). Univariable regressions examined associations with age, sex, and deafness duration. Intraclass correlation coefficients assessed parent–child agreement. Results: Of 69 eligible patients, 37 responded; 18 declined due to reluctance to discontinue CI use. Nineteen children (mean age 8.6 y, 26.3% male, mean deafness duration 3.4 y) completed the study. Parent-reported fatigue significantly worsened after implant non-use in mental ( P =0.01) and physical domains ( P =0.04) on the Vanderbilt scale, and in cognitive fatigue ( P =0.03) on the PedsQL. Child-reported scores trended toward greater fatigue during non-use, though not statistically significant. Younger age and male sex were associated with higher fatigue in parent reports. Intraclass correlation coefficients indicated moderate to good parent–child agreement. Conclusion: Cochlear implantation alleviates listening-related fatigue in children with unilateral hearing loss, particularly in cognitive and physical domains as perceived by parents. Fatigue represents a clinically meaningful, non-audiological outcome in candidacy assessment and postoperative evaluation.