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Published on: March 24, 2023
Early Loading of a Percutaneous Bone-Anchored Hearing Implant System Following Single-Stage Surgery in Children: A
Ayla Tabaksert1, Lisa Kennedy1, Diana Lynch1
1The James Cook University Hospital, South Tees Hospital Trust, Middlesbrough, UK.
Insights
Early activation of sound processors after single-stage bone-anchored hearing implants (BAHI) is safe and effective in children. This approach demonstrates excellent implant stability and improved hearing outcomes with minimal complications.
Area of Science:
- Pediatric Otolaryngology
- Biomedical Engineering
- Audiology
Background:
- Bone-anchored hearing implants (BAHI) offer a solution for hearing loss in children.
- Percutaneous BAHI systems require careful surgical and audiological management.
- Early functional rehabilitation is crucial for pediatric hearing implant users.
Purpose of the Study:
- To evaluate the safety and efficacy of early sound processor activation after single-stage BAHI surgery in children.
- To assess implant stability, audiological outcomes, and soft tissue healing.
- To determine the feasibility of percutaneous BAHI in a pediatric population.
Main Methods:
- Prospective, single-center, observational study with 24-month follow-up.
- Included 15 pediatric patients (7-14 years) undergoing single-stage BAHI surgery.
- Assessed implant stability via implant stability quotient (ISQ) and monitored audiological performance, soft tissue tolerance (Holgers score), and patient-reported outcomes.
Main Results:
- High implant stability (ISQ) observed at surgery, with increases over time, indicating good osseointegration.
- 100% implant survival rate over 24 months.
- Minimal and non-persistent skin reactions (Holgers score ≤1) at most sites; audiological assessment showed improved hearing thresholds compared to softband use.
Conclusions:
- Single-stage BAHI surgery with early percutaneous implant loading is safe and feasible in pediatric patients.
- This approach leads to good osseointegration, high implant survival, and improved hearing.
- Early functional rehabilitation can be successfully implemented in children receiving BAHI.
Objective:
To assess implant stability, safety, and functional outcomes of early sound processor activation following single-stage bone-anchored hearing implant (BAHI) surgery with a percutaneous implant system in a pediatric population.
Study Design:
Prospective single-center, single-armed, observational study with 24-month follow-up.
Setting:
University hospital clinic.
Patients:
Fifteen pediatric patients (aged 7 to 14 y), who had used a sound processor on a softband for at least 2 weeks before surgery, including one bilaterally implanted patient, leading to a total number of 16 implants.
Intervention:
Early sound processor loading following single-stage BAHI surgery.
Main Outcome Measures:
Implant stability, assessed by the implant stability quotient (ISQ). Secondary outcomes included implant survival, audiological performance, soft tissue tolerance (Holgers score), and patient-reported outcomes.
Results:
ISQ showed a high degree of implant stability already at surgery, and numerical increases over time in combination with a 100% implant survival over 24 months showed good osseointegration. Fifty percent of the implant sites were reported to have no skin reactions throughout the 24-month follow-up period. The remaining had a maximum Holgers score of 1 (minor skin reaction), and a single implant site was reported to have an adverse skin reaction (Holgers 2). None of the skin reactions were persistent or were reported to interfere with sound processor use. Postoperative audiological assessment showed improvement in hearing thresholds when comparing the implanted solution to the softband.
Conclusion:
Single-stage BAHI surgery, followed by early loading of the percutaneous implant, is safe and feasible in children.
