(1053) Performance of the Osia System in Children Converted From Percutaneous Bone Conduction Implants

Introduction: Percutaneous bone conduction implants (BCI) are associated, especially in the pediatric population, with a higher incidence of soft-tissue complications, such as inflammation, skin necrosis or overgrowth. We decided to compare surgical and audiological outcomes, complication rates, and overall satisfaction among children who were converted from percutaneous to transcutaneous BCI (Osia system).

Methods: A retrospective cohort review was conducted between 2020 and 2023. The study focused on children ( < 18 y.o.) who transitioned from percutaneous to transcutaneous BCI. Comprehensive medical and surgical history was collected. Pure-tone average and speech discrimination were used to assess hearing pre- and postoperatively. Patients served as their own controls. The measured outcomes were postoperative hearing performance, surgical challenges, early and late postoperative complications, and overall satisfaction with the device.

Results: A total of 8 patients (9 ears) with a mean age of 14 y.o. were included. 6 patients had associated congenital syndromes and 6 patients had external ear malformations (microtia or atresia). Intraoperative challenges included implant repositioning from the previous implant site (4 cases). 2 cases required an advancement skin flap. Percutaneous BCI complications were recurrent skin infections (3), skin overgrowth (1), and implant extrusion (3). No soft-tissue complications were observed with transcutaneous BCI. However, one patient required magnet strength adjustment, and one patient presented with audiological complaints. All 9 patients were satisfied with the use of transcutaneous BCI. 8 patients were daily users, and 1 patient used the device occasionally.

Conclusions: Transcutaneous BCI is associated with a lower incidence of soft-tissue complications and should be considered as an option for percutaneous BCI users with a history of frequent implant-related complications or in patients for whom wound hygiene is difficult to maintain.