Time-Adjusted Risk of Bone-Anchored Hearing Device Explantation Following Early and Recurrent Wound Complications
- Journal
- Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Q1)
- Published
- 3 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Tyler J Gathman, Julio Roque, Lulia Kana, Anagha Srivatsa, Izza Ali, Masanari Kato, et al.
- PMID
- 42691957
- DOI
- 10.1097/MAO.0000000000005046
Why clinicians should know about it
- Picked for Otorhinolaryngology (paper of the day, 8 September 2026): Risk of explantation after wound complications in bone‑anchored devices
Abstract
OBJECTIVE: The objective was to examine the time-adjusted risk of explantation of bone-anchored hearing devices following wound complications after primary implantation. STUDY DESIGN: Retrospective cohort study at a tertiary care neurotology center. PATIENTS: Adults 18 years or older with primary bone-anchored hearing implants from 2003 to 2025, with available audiogram and medical history. Excluded were patients with incomplete data, prior implantations, or immediate postoperative loss to follow-up. OUTCOMES: The primary outcome was the incidence of device explantation following early (<60 days) or recurrent (>3 episodes) wound complications. The Cox proportional hazards framework with time-dependent modeling was applied for analysis. RESULTS: A total of 1090 surgical ears (666 female, 61.1%; 8 bilateral) underwent primary device implantation, with 127 (11.7%) undergoing explantation; median follow-up was 4.40 years (IQR: 1.66-7.98 y). Patients who underwent explantation were more likely to experience early (HR: 2.30; 95% CI: 1.53-3.45; P<0.001) and frequent (HR: 5.29; 95% CI: 3.62-7.72; P<0.001) wound complications. The cumulative incidence of device explantation at 10 years among patients with frequent wound complications was 60.6% (95% CI: 45.5%-71.5%), compared with 15.6% (95% CI: 11.9%-19.9%) among patients without such complications. After adjustment, frequent wound complications remained significantly associated with the device removal (aHR: 4.60; 95% CI: 2.82-7.51; P<0.001). CONCLUSIONS: Recurrent wound complications are associated with nearly a fivefold increase in hazard for device explantation, supporting the need for risk stratification, monitoring, and earlier intervention.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.