Paediatric percutaneous bone anchored hearing aid implant failures: Comparing the experience of a tertiary centre with a systematic review of the literature and meta-analysis

Abstract

Background

Despite the proven audiological benefits of Percutaneous Bone Anchored Hearing Aids (BAHAs) in paediatric patients with conductive or mixed hearing loss, their adoption has been limited due to concerns over implant failure and associated complications. This paper conducts a systematic review and meta-analysis to assess the prevalence of implant failure in paediatric populations, combined with a case series from our tertiary referral centre.

Methods

A comprehensive literature search identified 562 articles, from which 34 were included in the review, covering 1599 implants in 1285 patients. Our retrospective case series included consecutive patients from our tertiary referral centre who underwent percutaneous BAHA implantation from 2003–2019.

Results

Meta-analysis revealed an overall implant failure rate of 11%, predominantly attributed to traumatic extrusion. Our retrospective case series comprised 104 implantations in 76 patients, with a 4.8% failure rate.

Discussion

Factors contributing to the lower-than-expected failure rates in the case series likely included consistent use of 4 mm fixtures from a single manufacturer and older age at implantation. The study underscores the need for standardised reporting formats in bone conduction implants research, given the systematic review’s limitations in study design heterogeneity, especially with the expected rise in the adoption of novel active devices.

Keywords:

• Bone anchored hearing aid, Device failure, Otology, Hearing loss, Paediatrics

Additional information

Notes on contributors

Matthew Bradley

Dr. Matthew Bradley, Research Fellow at Royal Manchester Children's Hospital, Manchester UK.

Callum Shields

Dr. Callum Shields, Research Fellow at Royal Manchester Children's Hospital, Manchester UK/Postgraduate research student at University of Manchester UK.

Robert Sabourn

Mr. Robert Sabourn, Medical Student at the University of Manchester.

Elizabeth Whittle

Ms. Elizabeth Whittle, Clinical Scientist in Audiology at Royal Manchester Children's Hospital, Manchester UK.

Rachel Boyd

Ms. Rachel Boyd, Clinical Scientist in Audiology at Royal Manchester Children's Hospital, Manchester UK.

Iain Alexander Bruce

Professor Iain Alexander Bruce, Consultant Otolaryngologist at Royal Manchester Children's Hospital, Manchester UK, Manchester Academic Health Science Centre, University of Manchester UK.

Jaya Nichani

Mrs. Jaya Nichani, Consultant Otolaryngologist at Royal Manchester Children's Hospital, Manchester UK.