Perioperative considerations for children undergoing bone anchored hearing device surgery: an observational study

Area of Science:

• Pediatric Anesthesiology
• Otolaryngology
• Surgical Innovation

Background:

• Bone anchored hearing device (BAHD) surgery is increasingly performed in children.
• Understanding perioperative management is crucial for optimizing outcomes in pediatric BAHD procedures.
• Previous studies provide a baseline for evaluating changes in practice over time.

Purpose of the Study:

• To identify key factors in the perioperative management of pediatric BAHD surgery.
• To compare current practices with a previous study from 2000.
• To assess changes in patient demographics and anesthetic techniques.

Main Methods:

• Retrospective review of 134 pediatric BAHD cases (2008-2011).
• Comparison of data with a prior study conducted in the same center before 2000.
• Analysis of patient comorbidities, anesthetic techniques, and complications.

Main Results:

• 194 pediatric BAHD surgeries identified; 134 case notes reviewed.
• 45.5% of children had syndromes/dysmorphisms; 17% had congenital heart anomalies.
• Laryngeal mask airway (LMA) used in 83.3% of cases; 11.9% intraoperative and 4.8% postoperative complications.
• Compared to 2000, fewer syndromic children and increased LMA use.
• Congenital heart disease rates remained stable; reduction in head/neck syndromes.

Conclusions:

• Pediatric BAHD perioperative management has evolved, with expanded indications and increased use of LMAs.
• While LMAs are effective even in complex cases, specialized pediatric airway expertise is essential.
• The trend suggests a shift towards less invasive airway management, but vigilance for complex cases is necessary.