MED-EL Bonebridge implantation in pediatric patients age 11Years and younger: Is it safe and effective?

Abstract

To present our experience with off-label MED-EL Bonebridge implantation in pediatric patients younger than 12 years of age and compare outcomes to pediatric patients 12 years and older. Pediatric patients who underwent Bonebridge implantation were included in a retrospective cohort study and were categorized by off-label use (<12 years) and ≥12 years at time of bone conduction implantation (BCI). Hearing outcomes were collected after implant activation, which was typically 4-8 weeks post-implantation. Mann-Whitney U tests were performed to assess for differences between audiometric outcomes. Significance was set at p<0.05. Twenty patients (25 implants)<12 years of age and 17 patients (23 implants) ≥12 years of age underwent BCI. Pre-BCI speech recognition threshold (SRT) was better for the older patient group (median 50dB) than the younger patient group (median 60dB). Post-BCI SRT, however, was significantly lower in the younger patient group (median 22.5dB) as compared to the older patient group (median 35dB), (p<0.001, Z=3.1). The two groups performed similarly on age-appropriate wordlists presented at 50dB HL in aided conditions (p>0.05, -1<Z<1). Postoperative complication rate was low for both age groups (9% vs 8%) and operative time was similar for both groups of patients (p=0.96, Z=0.52). Pediatric patients younger than 12 years showed similar or better audiometric benefit from off-label Bonebridge implantation when compared to older patients. Pediatric patients younger than 12 years can be considered Bonebridge implant candidates if clinically indicated; Bonebridge implantation in this age group appears safe and technically feasible.