Impact of Early Intervention on Children with Congenital Conductive Hearing Loss: Role of Active Transcutaneous Bone Conduction Implants.

Abstract

Introduction: Early pediatric conductive hearing loss intervention is crucial for ensuring optimal development outcomes. This study evaluated the impact of early access to bone conduction devices (BCDs) on children's quality of life (QoL) and academic performance, comparing results between those who received BCDs and those who did not.

Methods: We conducted a prospective cohort study involving children aged <12 years with congenital conductive hearing loss caused by external auditory canal atresia. The participants were categorized into three groups: those without BCDs, those using nonsurgical BCDs, and those implanted with active transcutaneous BCDs. QoL was assessed using the Arabic version of the Hearing Environments and Reflection on Quality of Life Measurement for Children Survey (HEAR-QL-AR) questionnaire at enrollment and during the last month of the study. School performance was evaluated based on annual academic results, grade repetition rates, and involvement in extracurricular activities. For children who were implanted with a piezoelectrive active transcutaneous bone conduction implant (OSI), data collection included age of implantation, duration of surgery, perioperative and long-term complications, and duration of device use.

Results: A total of 57 children participated in the study and were categorized into three groups: 14 in the non-BCDs group, 17 in the nonsurgical BCDs group, and 27 in the active transcutaneous BCDs group. At enrollment, the median HEAR-QL-AR scores were significantly higher in both BCD groups (80 and 81 in the nonsurgical and implanted groups, respectively) than in the non-BCD group (66, p = 0.013). After 6 months, the implanted group achieved the highest median HEAR-QL-AR score (90, IQR = 8), followed by the nonsurgical group (76, IQR = 14) and the non-BCD group (64, IQR = 16; p < 0.001). Academic performance was better in the BCD groups, with a median grade of "A" compared to "B" in the non-BCD group (p = 0.004). Participation in extracurricular activities was also higher in the implant group (median = 1.5) than in the nonsurgical (median = 1) and non-BCD groups (median = 0; p < 0.001). No surgical complications occurred, and the median surgical duration was 38 min (IQR = 7.5).

Conclusion: Early access to BCDs significantly improves QoL, academic performance, and social participation in children with conductive hearing loss. The implantation of active transcutaneous BCDs has been demonstrated to be both safe and effective, delivering superior auditory and developmental outcomes. These findings underscore the importance of advocating for timely intervention and expanding access to active transcutaneous BCDs for young children.