Auditory and Speech Outcomes Following Transcutaneous Bone Conduction Hearing Implantation.

Objectives: Implantable bone conduction hearing devices offer excellent auditory rehabilitation. Transcutaneous devices, which use an implanted magnet, are gaining popularity due to higher skin complications associated with traditional percutaneous devices. The Cochlear Baha® Attract System (Cochlear Corporation, Sydney, Australia) is a transcutaneous device and is regarded as a passive transcutaneous implant. This study, encompassing children and adults, aims to evaluate audiological and speech outcomes, as well as postoperative complications after the implantation of the Cochlear Baha® Attract System.

Methods: This is a retrospective cohort analysis of patients who underwent the Cochlear Baha® Attract procedure from January 2017 to December 2020. Demographics, pre-and postoperative hearing thresholds, speech discrimination testing, hearing-aided thresholds, and complications were assessed.

Results: A total of 13 patients underwent the Cochlear Baha® Attract surgery. The most common cause of implantation was microtia and aural atresia. Seven patients had mixed hearing loss (MHL), four had conductive hearing loss (CHL), and two patients had single-sided sensorineural deafness (SSD). A statistically significant improvement in hearing and speech understanding was observed with the device compared to preoperative unaided hearing (p-value = 0.00001). The overall mean for the gain at frequencies 0.5 to 4 kilohertz (kHz) was 31 decibels (dB). On average, speech discrimination scores improved by 36% after surgery. Postoperative wound healing and skin condition remained stable, with no major soft tissue-related complications. A patient developed a skin reaction at the implant site and was treated conservatively. All patients were satisfied and maintained device usage.

Conclusions: The Cochlear Baha® Attract System, classified as a passive transcutaneous bone conduction hearing implant, provides excellent auditory outcomes in patients with conductive, mixed, or single-sided sensorineural hearing loss, with minimal soft tissue complications in both children and adults. More research is necessary to directly compare passive and active transcutaneous bone conduction devices.