64 Madridge J Otorhinolaryngol. ISSN: 2640-5148 Volume 3 • Issue 1 • 1000113 Madridge Journal of Otorhinolaryngology Research Article Open Access Bone Anchored Hearing in Children with Aural Atresia: A Comparison of outcomes with Transcutaneous Magnetic Surgical and Non-surgical Options Short Running Head: Outcomes of Magnetic Bone Anchored Hearing Aids in Pediatric Aural Atresia Douglas M Worrall 1 , Sida Chen 1 , Randi Tepper 2 , George Wanna 2 and Maura K Cosetti 2 * 1 Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, USA 2 Ear Institute, New York Eye and Ear of Mount Sinai, Mount Sinai Health System, New York, USA Article Info *Corresponding author: Maura K Cosetti Department of Otolaryngology Head and Neck Surgery Ear Institute New York Eye and Ear of Mount Sinai 380 2nd Ave 9th Floor, New York 10010 USA Tel: 212-979-4542 E-mail: Maura.Cosetti@mountsinai.org Received: August 9, 2018 Accepted: September 1, 2018 Published: September 5, 2018 Citation: Worrall DM, Chen S, Tepper R, Wanna G, Cosetti MK. Bone Anchored Hearing in Children with Aural Atresia: A comparison of outcomes with Transcutaneous Magnetic Surgical and non-surgical options. Madridge J Otorhinolaryngol. 2018; 3(1): 64-69. doi: 10.18689/mjol-1000113 Copyright: © 2018 The Author(s). This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Published by Madridge Publishers Abstract Objective: To compare audiologic outcomes and skin related complications in children with aural atresia treated with non-surgical softband or transcutaneous magnet-based implantable bone anchored hearing devices (mBAHD). Methods: Retrospective cohort study at a tertiary referral center of pediatric patients with conductive hearing loss from congenital aural atresia. The Cochlear™ Baha Attract system (Cochlear Americas, Centennial, CO) mBAHD (n=11) was compared to the non- surgical softband BAHD (n=11) in terms of aided and unaided hearing thresholds, aided word recognition scores (WRS), and device related complications. Results: Age, length of follow-up (mean=28.2 months, range: 13-43 months), and bone conduction thresholds for the atretic ear were comparable between groups (p>0.05). There were no surgical complications. The mean aided gain in the speech reception threshold (SRT) was similar between groups (p=0.55). However, the mean (SD) aided unilateral WRS was higher in the soft band group: 83.9% versus 71.2% in the mBAHD group (p=0.023). Skin complication rate was 0% in the soft band cohort and 54.5% mBAHD cohort (p=0.004) with four cases of persistent pain and erythema, and two cases of pain alone limiting device use. Interventions included decreasing magnet strength, adding soft pads, topical and oral antibiotics, and reducing device usage. Conclusions: mBAHD are effective for auditory rehabilitation in pediatric congenital aural atresia with equivalent aided gain in SRT to soft band devices. Slightly improved aided WRS was seen in the soft band cohort. Despite lack of an external abutment, skin complications with mBAHD are common and may be mitigated by prompt evaluation and use of the lowest feasible magnet strength. Keywords: Aural Atresia; mBHAD; Surgical; Non Surgical Options; Bone Anchored Hearing; Age and Length. Introduction Incomplete canalization of the temporal bone during development can cause congenital aural atresia, characterized by a complete absence of the external auditory canal (EAC), with frequently associated abnormalities of the ossicular chain and a maximal conductive hearing loss. Congenital aural atresia occurs in 1 in 10,000 births, typically occurring unilaterally and has a greater incidence in males [1]. Although often sporadic, congenital aural atresia can be associated with other craniofacial abnormalities, notably those seen in Treacher-Collins and ISSN: 2640-5148