Complications of bone-anchored hearing aids in pediatric patients

ObjectiveTo describe the range and rate of complications related to bone-anchored hearing aids in pediatric patients.MethodWe conducted a retrospective review all children 16 years of age or less who were implanted with a bone-anchored hearing aid from 2002 to 2009. The main outcome measures were post Baha® implantation complications including infection, soft tissue hypertrophy, loss of osseointegration, and need for further surgery.ResultsThirty-one patients were identified and 27 had sufficient follow up for complete analysis. Soft tissue reactions were seen in 24 patients (89%), half of which were considered minor. Ten patients (37%) had major complications defined as requiring revision surgery or removal of the implant. Soft tissue overgrowth and infection at the abutment required removal in 5 children (19%) and three implants (11%) failed to osseointegrate. Recurrent antibiotic treatment was required in eight patients (30%). Seven patients (26%) had a history of trauma and one of them lost the implant. To date, three of the children (11%) have been unable to use the device because of chronic infection and overgrowth of the abutment. There was a statistically significant increased risk for major complications in patients from socioeconomically deprived backgrounds and obesity appears to incur additional risk.ConclusionsComplications of bone-anchored hearing aid implants are common in our experience and obesity and socioeconomic factors appear to contribute to a higher risk for complications. Frequent follow up and meticulous care of the implant site may minimize complications but can be challenging in this population.