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BAHA Skin Complications in the Pediatric Population: Systematic Review With Meta-analysis

Scott Shapiro1, Jad Ramadan, Adam Cassis

  • 1Department of Otolaryngology - Head and Neck Surgery, West Virginia University, Morgantown, West Virginia.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|June 19, 2018
PubMed

Insights

Pediatric bone conduction implant surgery outcomes differ significantly. Percutaneous bone conduction implants (pBCI) show higher rates of skin complications, implant loss, and reoperation compared to transcutaneous bone conduction implants (tBCI).

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Biomedical Engineering

Background:

  • Bone conduction implants (BCI) are used to treat hearing loss in children.
  • Two main surgical techniques exist: percutaneous bone conduction implants (pBCI) and transcutaneous bone conduction implants (tBCI).
  • Data on complication rates for pediatric BCI surgery are crucial for informed decision-making.

Purpose of the Study:

  • To compare the incidence of skin and surgical site complications between pBCI and tBCI in pediatric patients.
  • To conduct a systematic review and meta-analysis of available data on BCI complications in children.
  • To provide evidence-based information for surgical planning in pediatric BCI procedures.

Main Methods:

  • Systematic review and meta-analysis of studies published between January 2012 and April 2017.
  • Searched PubMed, Web of Science, and EBSCOhost databases.
  • Included studies involving pediatric patients (<18 years) undergoing pBCI or tBCI with BI300 implants, reporting skin complications, implant loss, or revision surgery.

Main Results:

  • Analysis of 22 studies (14 tBCI, 8 pBCI) revealed significant differences.
  • Skin complication rates were 6.3% for tBCI versus 30% for pBCI (p < 0.0001).
  • Implant loss was 0% for tBCI versus 5.3% for pBCI (p = 0.004), and reoperation rates were 3.0% for tBCI versus 6.2% for pBCI (p < 0.00002).

Conclusions:

  • Pediatric patients undergoing pBCI surgery experience significantly higher rates of skin complications, implant loss, and reoperation compared to those receiving tBCI.
  • These findings underscore the importance of considering surgical technique when discussing BCI options for children.
  • The data support a preference for tBCI in pediatric populations to minimize surgical site morbidity.
Abstract

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