Early Loading of a Percutaneous Bone-Anchored Hearing Implant System Following Single-Stage Surgery in Children: A Prospective 2-Year Study.

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.