ADHEAR is a non-surgical bone conduction device (BCD) available from Med-El from 2017. It uses an adhesive adapter consisting of a soft rubber pad with a centre rigid plate that has a snap coupling for attachment of a sound processor. Previous trials have shown similar audiological performance to surgical BCDs. The safety and compliance profile is likewise favourable. The authors evaluated their ‘real-world’ paediatric cohort. They performed a retrospective cohort study in a tertiary centre (Birmingham Women’s and Children’s Hospital) with patients fitted between January 2017 and September 2024. A total of 111 children were included. Mean age 10.1 (range: 2–18). The most common hearing loss aetiology was congenital ear malformation (50) and chronic suppurative otitis media (36). Forty-one had bilateral hearing loss, with 13 fitted with bilateral ADHEAR. The mean air-bone gap was 46 dB HL for unilateral cases. In bilateral cases, it was 33.4 dB HL (right) and 32.5 dB HL (left). The mean functional gain observed was 22.7 dB HL (95% CI: 18.3–27.1) which is in comparable range to previous studies. Sixteen children experienced skin complaints, 9 experienced itching or redness that did not affect device use. Follow-up status in 93 patients could be achieved. Only 38 still used the device, with a 1-year compliance rate of 82% and a 5-year compliance rate of 46.3%. The main reasons for discontinuation appear to be perceived lack of benefit, appearance and social stigmatisation, discomfort and practical issues with device. In conclusion, the ADHEAR device appears to be an effective non-surgical BCD option for suitable patients. It appears to have a good safety profile, with often temporary irritation at adhesive site the only issue for a small portion of patients. It does not appear to have a long-term high compliance rate which should be discussed with patients when counselling options of treatment.
ADHEAR in the paediatric population
Reviewed by Aaron Ferguson
Audiological Performance, Complications, and Compliance of the ADHEAR Bone Conduction Device in a Paediatric Patient Cohort.
