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

Objective: To identify clinical variables associated with the decision to surgically discontinue bone-anchored hearing device function. Study Design: Retrospective chart review. Setting: Tertiary neurotology referral center. Subjects and Methods: 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. Results: 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 (P =.002) and those with an increased body mass index (P =.035) were more likely to surgically discontinue their devices. Multivariate analysis revealed that a contralateral normal-hearing ear (P =.001) and infection without soft tissue overgrowth of the abutment (P =.026) were the strongest predictors of device discontinuation, after adjusting for potential confounders. Conclusion: 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.