Barriers to Pediatric Osseointegrated Bone-Conduction Hearing Devices

Area of Science:

• Audiology
• Pediatric Otolaryngology
• Biomedical Engineering

Background:

• Osseointegrated Bone Conduction Devices (OBCD) offer significant benefits for children with hearing loss.
• Understanding barriers to OBCD implantation is crucial for improving access and outcomes in pediatric populations.

Purpose of the Study:

• To identify social, demographic, and clinical factors influencing OBCD implantation in pediatric candidates.
• To compare barriers to OBCD implantation with those for cochlear implantation.

Main Methods:

• Retrospective cohort study of 94 pediatric candidates for OBCD.
• Chart review of demographic and clinical factors, followed by qualitative interviews with a subset of patients.

Main Results:

• 50% of pediatric candidates (47/94) received OBCD. State of residence impacted implantation rates; children from DC and Virginia were less likely to receive implants.
• Children with anotia/microtia and those younger than 10 years were less likely to undergo implantation.
• Reasons for declining surgery included young age, planned reconstruction, and device functionality concerns.

Conclusions:

• Pediatric OBCD implantation rates remain low, with only half of eligible candidates proceeding to surgery.
• Unlike cochlear implantation, OBCD implantation barriers are multifactorial, encompassing medical, demographic, and social elements.
• Addressing these diverse barriers is essential to optimize access to OBCD for children with hearing loss.