Outcomes of Osia 2 Implantation With and Without Concurrent Microtia Reconstruction

The Cochlear Osia 2 system is a bone-conduction device (BCD) that is effective for conductive, mixed hearing loss, and single-sided deafness. Limited data exist on Osia 2 outcomes in pediatric patients with microtia. This study aimed to compare Osia 2 implantation performed concurrently with microtia reconstruction versus Osia 2 implantation alone, and to investigate surgical techniques and variables impacting complication rates and outcomes.

Retrospective case series.

Pediatric tertiary care center.

Patients who underwent Cochlear Osia 2 device implantation between June 2020 and December 2024 were identified. Data was collected on postoperative complications, presence of prior BCD, incision type, coil placement location, and concurrent surgical procedures. Complications were classified as minor or major based upon need for operative intervention.

Of the 113 included cases and 129 operated ears, 42.5% (n = 48) underwent Osia implantation alone, 37.2% (n = 42) underwent concurrent microtia repair, and 20.3% (n = 23) underwent other concurrent otologic procedures. Minor complication rate was 10.9%, major complication rate was 14.0%, and device explant rate was 10.1%. Complication rates did not significantly differ between concurrent microtia cases versus Osia alone (19.0% vs 33.8%, RD -14.8%, 95% CI: -35.4% to 9.4%; P = .092), between cases with prior BCD versus those without (42.3% vs 24.1%, RD 18.2%, 95% CI: -8.5% to 44.7%; P = .071), nor between subperiosteal versus subcutaneous coil placement (27.5% vs 27.9%, RD 0.4%, 95% CI: -56.7% to 1.2%; P = .966).

Osia 2 implantation is safe to perform concurrently with microtia reconstruction. Factors including prior BCD, coil placement location, and implant physical characteristics may impact postoperative outcomes, however, further studies are needed to better characterize practices and patient factors that influence outcomes.