Objectives: The current study provides an update of the incidence of cochlear implantation among traditional cochlear implant (CI) candidates in the US.

Study Design: Deidentified CI data were acquired from prospectively collected patient registries from two CI manufacturers (Cochlear Americas and Advanced Bionics), which supply an estimated 85% of CIs in the US.

Setting: US CI centers.

Patients: Adults ≥20 years old who underwent CI surgery between 2020 and 2023.

Interventions: cochlear implantation

Main Outcome Measures: Annual incidence of cochlear implantation among traditional CI candidates, changes in incidence over time.

Results: The study cohort included 36,857 adults ≥20 years old who underwent CI surgery between 2020 and 2023, with a median age of 68 (IQR 55-77). The estimated traditional CI candidate population (bilateral severe-to-profound hearing loss) in 2023 was 2.4 million adults. When including an estimated 15% market share for Med-EL, the annual number of CIs increased from 8,158 in 2020 to 13,347 in 2023. Overall, the incidence of CI among adult traditional (bilateral severe-to-profound hearing loss) CI candidates increased from 344 CIs per 100,000 person-years in 2020 to 540 in 2023. While the 30-39 year age cohort demonstrated the highest overall incidence among candidates, the oldest age group (80+ years) demonstrated the largest growth of incidence during the study period.

Conclusions: Though still exhibiting severe under-penetration, the incidence of cochlear implantation among the adult candidate continues to increase significantly and grew at a faster rate in recent years.