Trends and Incidence of Hearing Implant Utilization in Italy: A Population-Based Study.

Background/Objectives: Cochlear implants (CIs) and other implantable hearing devices are crucial to treat hearing loss. The aim of this study was to analyze the temporal trends of implantation for hearing devices in Italy between 2001 and 2023, with stratification by age. Methods: This population-based study explored Hospital Discharge Records and used codes from the International Classification of Diseases, 9th revision-Clinical Modification (ICD9-CM) to identify cochlear and non-cochlear implants. Patients were partitioned into six age classes: <1, 1-2, 3-17, 18-65, 66-80, and >80; and time series for counts and incidence rates (IRs) per 1,000,000 inhabitants with confidence intervals (CI95%) were explored overall and by age class. Trends were assessed by incidence rate ratio and Cox-Stuart test with a significance threshold for p-values at 0.05. Results: 22,850 (83.6%) records for cochlear and 4476 (16.4%) for non-cochlear implants were extracted. Cochlear implants volume shifted from 537 procedures in 2001 to 1595 in 2023 (p < 0.01), while IR increased (p < 0.01) from 9.4 (CI95%: 9.7, 10.3) in 2001 to 27 (CI95%: 25.7, 28.4) in 2023. The volumes of implanted CIs increased in children and adults. Volumes for non-cochlear implants increased between 2001 and 2010, from 62 to 254, and remained stable afterwards. IR shifted from 1.1 (CI95%: 0.8, 1.4) in 2001 to 4.1 (CI95%: 3.6, 4.7) in 2023. Conclusions: Those trends highlight the importance of monitoring efficacy and safety of hearing devices, and the establishment of the Italian Implantable Hearing Device Registry at the Italian National Institute of Health is a first step in such a direction.