Article

Experience and Outcomes of New Developments in Bone Conduction Hearing Technologies in Children

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Abstract

Objectives (1) Recognize that percutaneous implant stability in children can be measured using radio frequency analysis (RFA) to generate Implant Stability Quotients (ISQs) and guide sound processor loading. (2) Discuss sound processor loading of the Cochlear BahaÒ (BIA300, BA400) transcutaneous implants at 4-6 weeks in selected children and potential advantages of the transcutaneous ATTRACT implant. Methods We collected data prospectively on all children undergoing implantable BC implants at surgery and follow up appointments. We aimed to assess implant stability over time in children undergoing 1-stage surgery using RFA measurements and investigate the possible implications for earlier loading following surgery. Our experience and outcomes with the ATTRACT transcutaneous device as part of the controlled market release (3+ cases) will also be reviewed. Results Nine children underwent 10 BI300 implants with a mean age of 9 years 4 months. 7 children received the BA400 percutaneous device without soft tissue reduction, with a mean age of 7 years 11 months. Using RFA the mean ISQ at surgery for BI300 implants was 60 and the corresponding unadjusted value for BA400 implants was 50. Changes in ISQs over time are discussed, showing the potential for processor loading at 4-6 weeks. Conclusions Greater implant stability has been demonstrated using the BI300 and BA400 implants, which would subsequently enable early Baha loading. The transcutaneous ATTRACT system potentially offers further improvement in cosmesis and skin inflammation and is likely to have greater acceptance in children with microtia and canal atresia and those who would have previously declined Baha.

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