Safety and Outcome of Piezoelectric Active Transcutaneous Bone Conduction Implants for Children Younger Than 5 Years: A Prospective Cohort Study

OBJECTIVE: This study aimed to examine auditory outcomes in young children implanted with active bone conduction implants. STUDY DESIGN: Prospective cohort study. SETTING: A single tertiary referral academic center. PATIENTS: Fourteen patients younger than 5 years of age who were implant with a piezoelectric active transcutaneous bone conduction implant (OSI) with a follow-up of at least 1 year. INTERVENTIONS: Demographics, surgical techniques, duration of surgery, hospital stay, auditory outcomes, postoperative complications, and device use were collected. After OSI surgery, patients were followed up for 1 week post-surgery, with devices switched on at 3 weeks postoperatively. Surgery and audiology follow-up occurred at 1, 3, 6 months, and 1 year. MAIN OUTCOME MEASURES: Perioperative course, surgical complications, aided audiograms, and speech discrimination scores were obtained 6 months and 1 year after implantation. RESULTS: Fourteen children received 18 implants (4 patients received bilateral simultaneous implants). The median implantation age in this study was 4.07 years (IQR=0.875). The indication for implantation was congenital conductive hearing loss (cCHL) due to external auditory canal atresia in 15/18 ears, and congenital single-sided deafness (SSD) in 3/18 ears. No patients experienced serious intraoperative or postoperative complications. For patients with cCHL, there was a significant postoperative improvement in hearing, marked by a median pure-tone average gain of 45 dB. All 14 patients regularly used their sound processors, with a median utility time of 10.6 h/day. There was no decline in the auditory performance in any ear throughout the median follow-up period of 2.36 years. CONCLUSIONS: Active transcutaneous piezoelectric bone conduction implants are a safe option for young children and provided significant and stable improvements in auditory function.