Cochlear Implants for Radiation-Induced Hearing Loss in Nasopharyngeal Cancer: A Systematic Review.

OBJECTIVES

To evaluate the safety and efficacy of cochlear implantation for auditory rehabilitation in patients with nasopharyngeal carcinoma (NPC) after radiation.

DATA SOURCES: CINAHL, Cochrane Library, PubMed, and Scopus were searched from inception through February 2026.

REVIEW

METHODS

Studies reporting cochlear implantation for hearing loss after radiation for NPC were included. Subjective and objective measures of hearing, including thresholds, speech perception, quality-of-life outcomes, and surgical complications, were extracted. Pooled means and proportions with 95% confidence intervals (CI) were calculated for available outcomes using random-effects models. Study quality and risk of bias were assessed using Oxford Levels of Evidence and Joanna Briggs Institute critical appraisal tools.

RESULTS

Twelve studies (N = 69 ears) were included. Cochlear implantation was most commonly performed via standard mastoidectomy with posterior tympanotomy, with alternative approaches used selectively. Surgical and device-related complications were uncommon, with 80.4% (95% CI: 55.1-96.7) without intraoperative complications and 96.5% (95% CI: 88.3-99.5) without postoperative complications. Audiometric improvement was observed in 91.3% of patients (95% CI: 73.1-98.8), with gains in speech perception and patient-reported outcomes. Mean duration of profound hearing loss prior to implantation was 6.5 years.

CONCLUSION

Cochlear implantation after radiation in patients with NPC is generally safe and effective, providing meaningful auditory and functional benefits even in long-standing hearing loss. These findings support routine audiologic surveillance after radiation to enable timely referrals for rehabilitation.

LEVEL OF EVIDENCE: NA.