Nicholas R Oberlies1, Johnathan E Castaño2, Monika E Freiser3, Jennifer L McCoy4, Amber D Shaffer5, Noel Jabbour6. 1. University of Pittsburgh School of Medicine, S530 Scaife Hall, 3550 Terrace St., Pittsburgh, PA, 15261, USA. Electronic address: nro6@pitt.edu. 2. Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Faculty Pavilion, 7th Floor, Pittsburgh, PA, 15224, USA. Electronic address: Jecastano@hsc.wvu.edu. 3. Department of Otolaryngology, University of Pittsburgh Medical Center, 203 Lothrop St #500, Pittsburgh, PA, 15213, USA. Electronic address: USAfreiserme@upmc.edu. 4. Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Faculty Pavilion, 7th Floor, Pittsburgh, PA, 15224, USA. Electronic address: nelsonjl2@upmc.edu. 5. Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Faculty Pavilion, 7th Floor, Pittsburgh, PA, 15224, USA. Electronic address: shafferad@upmc.edu. 6. Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, 4401 Penn Ave, Faculty Pavilion, 7th Floor, Pittsburgh, PA, 15224, USA. Electronic address: JabbourN@chp.edu.
Abstract
INTRODUCTION: Two of the most commonly employed bone-anchored hearing implant (BAHI) systems are the BAHA Connect and BAHA Attract. The BAHA Connect uses a skin-penetrating titanium abutment. The BAHA Attract uses an implanted magnet, leaving the overlying skin intact. Limited data is available on the difference in complication rates between the two systems. Our hypothesis was that there would be no difference in complications and audiologic data. METHODS: Retrospective chart review was performed of patients who had BAHA Connect vs. Attract at our tertiary care pediatric hospital from 2006 to 2018. Pre- and post-operative information, including demographics, related diagnoses, outcomes and complications were compared between the systems using Mann-Whitney U tests and Firth logistic regression for one year post-implant. Audiology data was analyzed with Wilcoxon rank-sum and Wilcoxon matched pairs signed rank tests. RESULTS: Twenty-four Attract and 18 Connect BAHA surgeries were identified from 37 patients. Eleven Connect patients had the surgery completed in two stages. Connect patients followed up an average of 6.5 years post-implant and 15 months for Attract. A total of 58.8% of patients with Connect surgeries had complications within a year and 82.4% had a complication by their last follow-up. Aside from magnet strength related issues, there were no major complications with Attract surgery at any time point. Patients with Connect surgeries had significantly more skin overgrowths, cultured infections, times on antibiotics, nursing phone calls, and ENT visits within the first year and for all records, p < .05. The pure-tone average was significantly lower for both Connect [unaided-M(SD) = 61.7(9.8); aided-M(SD) = 26.4(5.5) and Attract (unaided-M(SD) = 66.0(22.5); aided-M(SD) = 25.6(6.1)] after implant, p < .001. CONCLUSION: Implantation of both systems lead to improved hearing outcomes with profoundly different complication rates.
INTRODUCTION: Two of the most commonly employed bone-anchored hearing implant (BAHI) systems are the BAHA Connect and BAHA Attract. The BAHA Connect uses a skin-penetrating titanium abutment. The BAHA Attract uses an implanted magnet, leaving the overlying skin intact. Limited data is available on the difference in complication rates between the two systems. Our hypothesis was that there would be no difference in complications and audiologic data. METHODS: Retrospective chart review was performed of patients who had BAHA Connect vs. Attract at our tertiary care pediatric hospital from 2006 to 2018. Pre- and post-operative information, including demographics, related diagnoses, outcomes and complications were compared between the systems using Mann-Whitney U tests and Firth logistic regression for one year post-implant. Audiology data was analyzed with Wilcoxon rank-sum and Wilcoxon matched pairs signed rank tests. RESULTS: Twenty-four Attract and 18 Connect BAHA surgeries were identified from 37 patients. Eleven Connect patients had the surgery completed in two stages. Connect patients followed up an average of 6.5 years post-implant and 15 months for Attract. A total of 58.8% of patients with Connect surgeries had complications within a year and 82.4% had a complication by their last follow-up. Aside from magnet strength related issues, there were no major complications with Attract surgery at any time point. Patients with Connect surgeries had significantly more skin overgrowths, cultured infections, times on antibiotics, nursing phone calls, and ENT visits within the first year and for all records, p < .05. The pure-tone average was significantly lower for both Connect [unaided-M(SD) = 61.7(9.8); aided-M(SD) = 26.4(5.5) and Attract (unaided-M(SD) = 66.0(22.5); aided-M(SD) = 25.6(6.1)] after implant, p < .001. CONCLUSION: Implantation of both systems lead to improved hearing outcomes with profoundly different complication rates.
Authors: Robert Briggs; Catherine S Birman; Nicholas Baulderstone; Aaran T Lewis; Iris H Y Ng; Anna Östblom; Alex Rousset; Sylvia Tari; Michael C F Tong; Robert Cowan Journal: Otol Neurotol Date: 2022-08-01 Impact factor: 2.619