Complications of bone-conduction hearing implants (BCHI) implantation surgery

Bone-conduction Hearing Implants (BCHIs) are surgically implanted hearing devices. As the implantation surgery involves soft tissue dissection through periosteum and drilling of skull, complications related to the skin and soft tissue remain common despite several modifications of surgical techniques over the years. This study aims to evaluate a single centre's BCHI implantation complication rates over time, identify the effects of surgical modifications, and compare these to data from the literature. A retrospective case review was performed on all patients who received BCHI implantation from 2013 to 2018. 11 complication rates over time were recorded. Changes to practice occurring during the study period were also recorded and their effects on complication rates were identified. A literature search was performed to identify the complication rates reported in the literature and compared with that of our cohort. 162 BCHI implantations were performed over the 5 years. 23 articles were included in the study after the literature review process. In our cohort, complications related to skin and soft tissue were most common, which was in line with that reported in the literature. Complication rates have overall decreased following the introduction of innovative practices, including adoption of minimally-invasive single-stage procedures and the training of specialist nurses. In this study we have highlighted the changes in complication rates of BCHI implantation over time at a single centre with reference to changes in clinical practice. Continued review of practice and on-going technological developments will facilitate continued reductions in complications of BCHI surgery. •Soft tissue complications following BCHI implantation remain common despite several surgical modifications•Complication rates were generally higher in children due to reasons relating to hygiene and maintenance•Innovative practices such as minimally-invasive techniques and training of specialist nurses decreased complication rates