Active Hearing Implants (AHI) in children and adolescents: Options and outcome-related counceling

Objective:

Active hearing implants (AHI) are certified since few years for use in patients less than 18 years of age. The aim of this study was to evaluate indications, safety and efficacy of hearing loss rehabilitation by these class of implants in juvenile patients and define an appropriate counseling algorithm.

Study design:

Retrospective chart study, single-subject repeated-measures design, single tertiary referral center (Olgahospital, Stuttgart). All patients, younger than 18, with an AHI were evaluated.

Patients and methods:

31 patients aged 5 to 17 years received 34 implants. 26 bone-conductive implants (BCI) and 14 middle-ear-conductive (MEI) implants were used. 8 patients were implanted bilaterally. In a single patient MEI was explanted and replaced by a BCI.

Air and bone conduction threshold and improvement in word recognition scores in aided and unaided condition were measured. Tests varied according to individual abilities and age groups.

Results:

The variety of individual surgical situations could be summarized in 3 indication groups: a. malformations, b. revision surgery and c. single sided deafness.

Intraoperative complications were not observed, however in few cases a MEI plan was switched to BCI due to an anatomical variation. Significant speech discrimination improvement was found in all patients tested after 3 months.

In 4 cases revision surgery was required: 2 cases of skin dehiscence, 1 case of cholesteatoma and 1 case of adhesive process.

Conclusion:

BCI and MEI provide variable and effective options for hearing rehabilitation in patients not able to use a conventional hearing aid. In our hands complication rate was low and limited to skin problems especially in previously percutaneous BAHA users.

Publication History

Publication Date:
23 April 2019 (online)