Outcomes and device use in children with bone-conduction hearing devices in South Africa

Abstract

Background Bone-conduction hearing devices (BCHD) can provide hearing solutions in settings where middle ear pathology is rife. Objectives Describe functional hearing outcomes and device use of children fitted with BCHD. Method Retrospective review of 79 children fitted with BCHD between January 2017 and May 2022. Outcomes included device use and subjective reports measured with the Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) and the Teachers’ Evaluation of Aural/Oral Performance of Children (TEACH). Analysis of variance established association between mean data logging and type and degree of hearing loss. Thematic analyses were done for qualitative outcomes. Results Average usage was 7.0 h/day (5.4 SD; range 0.1–24). PEACH ratings indicated 93.3% of children wore their BCHD ‘always’ or ‘often’, with 80% displaying Typical auditory performance at 1-month follow-up. TEACH ratings indicated 84.2% of children wore their BCHD ‘always’ or ‘often’, with 78.9% showing typical auditory behaviour. Increased usage was noted for conductive, mixed, moderate and severe hearing losses. There was a mean delay of 17.2 months (23.4 SD; range 0–90) between age of diagnosis and fitting. Thematic analyses identified two main themes: advantages and barriers to BCDH use. Conclusion Average device use fell short of the internationally recommended 10 h/day. Higher BCHD use was associated with higher functional listening performance scores. Long waiting times for medical or surgical intervention for conductive hearing losses can delay BCHD fitting. Contribution Limited information is available to examine outcomes in children fitted with BCHD.