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Invited Commentary
August 2018

Trend Toward the Use of Transcutaneous Osseointegrated Hearing Devices in Pediatric Patients

Author Affiliations
  • 1Pediatric Ear, Nose, Throat (ENT) & Facial Plastic Surgery, Children’s Hospital of Minnesota, St Paul
  • 2Department of Otolaryngology–Head and Neck Surgery, University of Minnesota, Minneapolis
JAMA Otolaryngol Head Neck Surg. 2018;144(8):710-711. doi:10.1001/jamaoto.2018.1040

Transcutaneous osseointegrated hearing implants, instead of percutaneous implants, are increasingly becoming the choice of surgeons when considering osseointegrated hearing aids in children. Transcutaneous implants use a magnet under the skin coupled with a magnet on the processor, whereas percutaneous implants have an abutment through the skin to which the processor connects. For aural atresia and maximum conductive hearing loss, surgeons and patients have multiple options for hearing rehabilitation, including canalplasty and an osseointegrated hearing aid. Pediatric otolaryngologists seem to be choosing the transcutaneous devices because they present fewer complications and less wound care, which is better tolerated by pediatric patients. Most studies into osseointegrated hearing aids have focused on adult outcomes, and data in the pediatric population are lacking, especially information related to newer transcutaneous, rather than percutaneous, devices. Previous studies have shown a complication rate of more than 50% for pediatric patients with percutaneous implants, with most of the complications related to soft-tissue infections or growth.1 These studies have shown high rates of parental satisfaction with percutaneous devices but low compliance rates, indicating that satisfaction scores may be misleading.