Exploring Osia System's auditory outcome and the surgical benefits of posterior placement of BI300 in children with microtia.

OBJECTIVE

This study investigated the safety of utilizing further posterior placement than recommended by the manufacturer of a bone conduction implant and compared its auditory performance to that of implants placed in the recommended location.

METHOD: This is a prospective cohort study included children (aged ≤18 years) who received the Osia System implantation between January 2022 and May 2024. We recorded demographics, comorbidities, radiological imaging findings, operative details, pre- and postoperative audiological testing (audiometric measurements, speech discrimination, and sound localization), surgical outcomes, and complications. We compared the outcomes of placing the BI300 at 5.5 cm and 7 cm from the external auditory canal.

RESULTS

This study included 23 children (29 implants) with a median implantation age of 7 years (range 3-17 years). Six patients underwent simultaneous bilateral implantation, and none of the patients experienced serious complications. Group 1 (5.5 cm) had 12 implants, and Group 2 (7 cm) had 17 implants. There was no difference in median pure-tone average postoperatively, 21.67 dB HL for group 1 and 20.83 dB HL for group 2 (p = 0.66). Speech discrimination was comparable between the groups (92 % and 95 %, respectively). Sound localization improved significantly in both groups (Group 1: from 26 % to 90 % and Group 2: from 30 % to 85 %, respectively), without any statistically significant difference between the groups.

CONCLUSION

Placing the BI300 at 7 cm posterior to the external auditory canal yielded an auditory performance similar to the manufacturer's recommendation of 5.5 cm. Postero-inferior incision approach, can be an option for children prior to auricular reconstruction.

LEVEL OF EVIDENCE: Level 2 evidence: prospective cohort study.