Bone-anchored hearing aids and chronic pain: a long-term complication and a cause for elective implant removal

Objectives: To report a case series of elective removal of bone-anchored hearing aid implants, and reasons for removal. Design: Retrospective review of a prospectively collected database. Setting: Two tertiary referral centres in the Manchester area: Manchester Royal Infirmary and Salford Royal University Hospital. Participants: A series of 499 adults and children who had undergone a total of 602 implant insertions (1984-2008). Main outcome measures: Implant removal rates, and reasons. Results: Twenty-seven of the 602 implants (4.5 per cent) required removal. Of these, 12 were due to pain (2.0 per cent), seven to persistent infection (1.2 per cent), three to failure of osseointegration (0.5 per cent), three to trauma (0.5 per cent) and two to other reasons (0.4 per cent). Conclusion: Chronic implant site pain represents the main reason why implants are removed electively, and affects 2 per cent of all implants. This complication has important medico-legal implications and should be discussed when obtaining informed consent for implantation.