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Published on: March 24, 2023
Impact of Early Intervention on Children with Congenital Conductive Hearing Loss: Role of Active Transcutaneous Bone
Faisal Zawawi1, Afnan F Bukhari2, Sara A Khairy2
1Department of Otolaryngology - Head & Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia, faisalzawawi@gmail.com; fzawawi@kau.edu.sa.
Insights
Early intervention with bone conduction devices (BCDs) significantly enhances quality of life and academic performance in children with conductive hearing loss. Active transcutaneous BCDs offer safe and effective auditory and developmental benefits.
Area of Science:
- Pediatric audiology
- Developmental pediatrics
- Otolaryngology
Background:
- Early intervention for pediatric conductive hearing loss is critical for optimal development.
- This study investigates the impact of early access to bone conduction devices (BCDs) on children's quality of life (QoL) and academic outcomes.
- A comparison was made between children who received BCDs and those who did not.
Purpose of the Study:
- To evaluate the impact of early bone conduction device (BCD) access on children's quality of life (QoL) and academic performance.
- To compare outcomes between children with congenital conductive hearing loss who received BCDs (nonsurgical and implanted) and those who did not.
- To assess the safety and effectiveness of active transcutaneous BCDs in this pediatric population.
Main Methods:
- Prospective cohort study of children (<12 years) with congenital conductive hearing loss due to external auditory canal atresia.
- Participants were divided into three groups: no BCDs, nonsurgical BCDs, and active transcutaneous BCDs.
- QoL assessed via HEAR-QL-AR; academic performance evaluated through grades, grade repetition, and extracurricular activity participation.
Main Results:
- Children using BCDs showed significantly higher QoL scores (HEAR-QL-AR) at enrollment and after 6 months compared to the non-BCD group.
- The implanted active transcutaneous BCD group demonstrated the highest QoL scores post-intervention.
- Academic performance (median grade 'A' vs. 'B') and extracurricular participation were significantly better in BCD groups, with no surgical complications reported.
Conclusions:
- Early BCD intervention substantially improves QoL, academic performance, and social engagement in children with conductive hearing loss.
- Active transcutaneous BCD implantation is a safe and effective method for enhancing auditory and developmental outcomes.
- Timely intervention and expanded access to active transcutaneous BCDs are crucial for young children with hearing loss.
Introduction:
Early pediatric conductive hearing loss intervention is crucial for ensuring optimal development outcomes. This study evaluated the impact of early access to bone conduction devices (BCDs) on children's quality of life (QoL) and academic performance, comparing results between those who received BCDs and those who did not.
Methods:
We conducted a prospective cohort study involving children aged <12 years with congenital conductive hearing loss caused by external auditory canal atresia. The participants were categorized into three groups: those without BCDs, those using nonsurgical BCDs, and those implanted with active transcutaneous BCDs. QoL was assessed using the Arabic version of the Hearing Environments and Reflection on Quality of Life Measurement for Children Survey (HEAR-QL-AR) questionnaire at enrollment and during the last month of the study. School performance was evaluated based on annual academic results, grade repetition rates, and involvement in extracurricular activities. For children who were implanted with a piezoelectrive active transcutaneous bone conduction implant (OSI), data collection included age of implantation, duration of surgery, perioperative and long-term complications, and duration of device use.
Results:
A total of 57 children participated in the study and were categorized into three groups: 14 in the non-BCDs group, 17 in the nonsurgical BCDs group, and 27 in the active transcutaneous BCDs group. At enrollment, the median HEAR-QL-AR scores were significantly higher in both BCD groups (80 and 81 in the nonsurgical and implanted groups, respectively) than in the non-BCD group (66, p = 0.013). After 6 months, the implanted group achieved the highest median HEAR-QL-AR score (90, IQR = 8), followed by the nonsurgical group (76, IQR = 14) and the non-BCD group (64, IQR = 16; p < 0.001). Academic performance was better in the BCD groups, with a median grade of "A" compared to "B" in the non-BCD group (p = 0.004). Participation in extracurricular activities was also higher in the implant group (median = 1.5) than in the nonsurgical (median = 1) and non-BCD groups (median = 0; p < 0.001). No surgical complications occurred, and the median surgical duration was 38 min (IQR = 7.5).
Conclusion:
Early access to BCDs significantly improves QoL, academic performance, and social participation in children with conductive hearing loss. The implantation of active transcutaneous BCDs has been demonstrated to be both safe and effective, delivering superior auditory and developmental outcomes. These findings underscore the importance of advocating for timely intervention and expanding access to active transcutaneous BCDs for young children.
