Early surgical and audiologic outcomes of active, transcutaneous, osseointegrated bone-conduction hearing device (Osia 2® system) placement

Objective: To assess the outcomes of pediatric Osia 2 (R) System placements. Methods: We performed a retrospective chart review of primary and revision Osia 2 (R) System surgical cases at two tertiary academic children's hospitals. Operative details and post-operative surgical and audiologic outcomes were recorded. Results: 18 cases were performed on 14 children (mean age: 11.5 years, range 7-16) and included 9 primary surgeries and 9 revisions from BAHA Attract (R), Connect (R) and Sophono (R) implants. Surgical planning for revision surgeries was complex due to prior incisions, implants, and bony contour. Post-operative aided audiograms revealed pure tone average (0.5-4 kHz) of 26.2 +/- 2.5 dB HL (mean +/- SD), with no high frequency roll-off (8 kHz aided threshold: 23.8 +/- 7.5 dB HL). Two minor post-operative complications were identified. Conclusion: Bone-conduction hearing devices (BCHDs) are used to improve access to sound for children with conductive hearing loss, single-sided deafness, and aural atresia. Traditional passive, percutaneous abutment-based and transcutaneous magnet-based surgical BCHDs can be limited by skin complications and high-frequency acoustic attenuation. Recent availability of active, transcutaneous osseointegrated BCHD systems presents potential for improvement on both of these traditional limitations. Initial experience with the Osia 2 (R) System demonstrates overall successful, uncomplicated placement with excellent audiologic outcomes. Revision cases require careful surgical planning. Further follow-up and comparative studies with other BCHDs are necessary to fully evaluate the effectiveness of the Osia 2 (R) System.