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Trends in pediatric bone conduction hearing device selection according to demographic and socioeconomic factors
Joseph S Schertzer1, Priya Arya2, Ashley Catanzarite3
1Department of Otolaryngology-Head and Neck Surgery, Emory University, 550 Peachtree Street NE, Suite 1135, Atlanta, 30308, Georgia.
Insights
Pediatric bone conduction hearing device (BCHD) selection shows a trend towards active transcutaneous devices. Demographic and socioeconomic factors did not significantly influence BCHD choice in this study.
Area of Science:
- Otolaryngology
- Audiology
- Biomedical Engineering
Background:
- Conductive hearing loss in children can be treated with various bone conduction hearing devices (BCHD), including percutaneous, passive transcutaneous, and active transcutaneous types.
- Device selection is a critical decision influenced by multiple factors.
Purpose of the Study:
- To analyze trends in the selection of pediatric BCHD.
- To investigate the influence of demographic and socioeconomic factors on BCHD choice.
Main Methods:
- Retrospective cohort study of pediatric patients receiving BCHD from January 2019 to April 2023.
- Multivariate logistic regression analysis to assess relationships between patient factors (age, gender, language, hearing loss etiology, insurance) and device selection.
- Data included 97 patients and 129 BCHD placements.
Main Results:
- A majority of patients received active transcutaneous devices (Med-El Bonebridge, Cochlear Osia).
- No significant associations were found between demographic/socioeconomic factors and the choice of active transcutaneous BCHD.
- Comparable audiometric outcomes were observed between passive transcutaneous and percutaneous devices.
Conclusions:
- There is an institutional shift towards active transcutaneous BCHD in pediatric patients.
- Pediatric BCHD selection is a multifaceted decision involving interdisciplinary input and family preferences.
- Further research may explore long-term outcomes and cost-effectiveness of different BCHD types.
Objectives:
A variety of bone conduction hearing devices (BCHD) exist for the treatment of conductive hearing loss including percutaneous, passive transcutaneous, and active transcutaneous devices. The purpose of this study was to evaluate trends in selection of pediatric BCHD according to demographic and socioeconomic factors.
Methods:
A retrospective cohort study was performed on all patients who underwent BCHD placement at a tertiary academic pediatric healthcare system between January 2019 to April 2023. Audiology discussed all BCHD options during the consultation, with families deciding the ultimate device and manufacturer. Data collected for multivariate logistic regression analysis included age, gender, primary language spoken, etiology for hearing loss, and insurance type. Significance was set at p > 0.05.
Results:
A total of 97 patients were included in the study representing 129 devices. Twenty-eight patients received concurrent bilateral BCHD placement at initial surgery, and four underwent contralateral BCHD placement at a later date. The majority of patients received an active transcutaneous device (Med-El Bonebridge, n = 55; Cochlear Osia, n = 33), three received a passive transcutaneous device (Sophono), and ten patients received percutaneous devices (Ponto Connect, n = 3, Cochlear Connect, n = 7). Multivariate logistic regression analysis was performed on the subset of patients who received active transcutaneous devices (Med-El Bonebridge, n = 37; Cochlear Osia, n = 21) and revealed no significant relationships between demographic and socioeconomic factors and device selection (p > 0.05).
Conclusion:
There has been a shift towards the active transcutaneous devices at our institution, with comparable audiometric outcomes between the passive transcutaneous and percutaneous devices. Selection of a pediatric BCHD is a complex decision-making process which involves interdisciplinary discussion between the audiologist, surgeon, patient, and caregivers.
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