Simultaneous Bilateral Bone Bridge Implantation in a Two-Year-Old Child with Atresia of the External Auditory canal: A Case Report

Introduction: Active transcutaneous bone conduction implants are indicated for mild to moderate conductive or mixed hearing loss (intact inner ear and auditory nerve) for subjects 5 years or older. The aim of the here presented study was to share our results with the Bonebridge in a child aged 2 years at time of surgery. Especially the new generation of the implant being half of the size, a re-evaluation of the given indication for children 5 years or older is highly recommended. Methods: case presentation Results: At the age of one month bilateral auricle malformation as well as auditory canal atresia was diagnosed. The family history showed no further malformations and an uneventful pregnancy. The infant was provided with a Baha-Softband as well as speech therapy. Diagnostic BERA and MRI showed suitable anatomical structures allowing placement of an implant. The parents were counseled on available treatment options and the fact that the Bonebridge implantation would be off-label use due to the given indication age. Nonetheless, the parents insisted on the Bonebridge. At the age of 28 months the bilateral implantation (BCI 602) was performed within 40 minutes and without any intra- nor post-operative complications. Conclusion: Based on the safe, easy and eventless implantation, the highly satisfactory results and the beneficial audiological outcomes, the authors propose to lower the implantation age based on available bone tissue allowing device placement. Similar as for Cochlear Implant recipients, a stable and early auditory input to ensure unrestricted speech development should be the major goal.