Surgical Explantation of Bone-Anchored Hearing Devices: A 10-year Single Institution Review.

Abstract

To identify clinical variables associated with the decision to surgically discontinue bone-anchored hearing device function. Retrospective chart review. Tertiary neurotology referral center. This study examines surgical interventions performed on existing bone-anchored hearing devices at a single institution from 2008 to 2018. Patient characteristics, indications for implantation, and complications prompting surgical intervention were assessed. Seventy-seven cases were included in this study. Among patients in the younger cohort (<37 years old), 100% (13 of 13) of those discontinuing their device had a contralateral normal-hearing ear. Conversely, 0% (0 of 14) of the younger patients with bilateral hearing loss surgically discontinued their devices. Within the older cohort (≥37 years old), female patients (<i>P</i> = .002) and those with an increased body mass index (<i>P</i> = .035) were more likely to surgically discontinue their devices. Multivariate analysis revealed that a contralateral normal-hearing ear (<i>P</i> = .001) and infection without soft tissue overgrowth of the abutment (<i>P</i> = .026) were the strongest predictors of device discontinuation, after adjusting for potential confounders. Surgical discontinuation is associated with several clinical variables. Targeted interventions that are viable alternatives to removal, such as device relocation, should be presented to younger patients with a contralateral normal-hearing ear who experience persistent complications. Patients with persistent infection in the absence of soft tissue overgrowth would especially benefit from enhanced counseling on proper hygiene.