Time-dependent predictors of bone-anchored hearing implant extrusion after primary implantation: a longitudinal study

OBJECTIVE: To identify clinical risk factors for spontaneous and traumatic extrusion of bone-anchored hearing implants in adults. METHODS: A retrospective cohort study was carried out from 2003 to 2025 at a tertiary-care neurotology centre in adults with primary bone-anchored implantation. RESULTS: Of 1090 total implanted ears, 73 cases (6.7 per cent) experienced device extrusion. The estimated 10-year incidence of extrusion was 10.2 per cent. Temporal bone radiation and obesity were independently associated with a 5- and 2-fold increased risk of extrusion, respectively, whereas early (<60 days) or frequent (>3 instances) wound complications were not. CONCLUSION: Temporal bone radiation and obesity were independent predictors, whereas post-operative wound complications were not. Patients with these risk factors may benefit from close post-operative surveillance.