Quality of Life, Self-Esteem, and Social Integration in Cochlear Implant Recipients: A Cross-Sectional Study from a Tertiary Center in Romania

Background and Objectives: Outcomes after cochlear implantation are usually judged using audiological measures, although recipients’ everyday benefit also depends on psychological and social functioning. This study characterized post-implant quality of life (QoL) across six patient-reported domains in cochlear implant recipients followed at a tertiary center in Romania and explored factors associated with social integration. Methods: In this cross-sectional study, 50 consecutive cochlear implant recipients (24 children and adolescents, 26 adults) completed a validated 35-item Romanian-language questionnaire covering speech perception, psychological self-esteem, media and music, environmental sound, listening effort, and social integration, with parent-proxy completion for the youngest children. Domain scores were transformed to a 0–100 scale. Subgroup comparisons used rank-based tests, and associations with social integration were examined with Spearman correlations and an exploratory multivariable regression. Results: The median overall QoL score was 67.1 (interquartile range, 53.6–77.9). Media and music scored highest (median 85.7) and listening effort lowest (median 56.2); psychological self-esteem had a median of 66.7 (interquartile range, 50.0–79.2). QoL scores did not differ significantly by sex, age group, time since implantation, surgical approach, or SMART NAV use, although several subgroup analyses were underpowered. Psychological self-esteem showed the strongest correlation with social integration (rho = 0.56, p < 0.001) and was the only predictor with p < 0.05 in the exploratory multivariable model (B = 0.456, 95% CI, 0.117–0.795; p = 0.010; R2 = 0.428). Conclusions: In this cohort, post-implant QoL varied across functional domains, with listening effort remaining a relative challenge. Social integration was more closely associated with psychological self-esteem than with individual auditory domains. These findings are exploratory and require confirmation in larger longitudinal studies with pre-implant measurements.