# Clinical and surgical safety in patients transitioning from percutaneous to transcutaneous active bone conduction implants

## TL;DR

This study shows that switching from a percutaneous to a transcutaneous bone conduction implant is safe and improves quality of life for patients.

## Contribution

The study provides new clinical evidence on the safety and outcomes of transitioning to active transcutaneous bone conduction implants.

## Key findings

- Transition surgery had no major complications and only minor issues in 5.3% of follow-up points.
- Audiological performance remained stable after the transition.
- Quality of life improved notably in general health and social support.

## Abstract

The primary aim of this study was to assess clinical and surgical safety for patients who underwent transition surgery from a percutaneous to an active transcutaneous bone conduction implant. A secondary aim was to report audiological changes and outcomes for quality of life post the transition surgery.

An observational, descriptive and prospective study was performed in a tertiary referral center. Patients who underwent transition surgery as part of their treatment were included. Clinical and surgical safety were assessed through intraoperative and postoperative complications and adverse events. The audiological outcomes were assessed with the Hearing in Noise Test, both fixed noise and adaptative noise measurements. Quality of life changes were evaluated using the Glasgow Benefit Inventory, postoperatively.

The study of 23 cases (18 patients) found minor complications in 5.3% (6/113 follow-up points) and no major complications. Audiometric results showed no significant differences in speech understanding (fixed noise=-0.011%, p = 0.99; adaptive noise = 0.236dB, p = 0.617). Quality of life scores increased moderately (+ 27.0 ± 33.9), with notable gains in general health (+ 29.9) and social support (+ 31.8), and a modest improvement in physical well-being (+ 10.6).

The study showed that transitioning from a passive percutaneous to an active transcutaneous bone conduction implant is safe, with no major adverse events and only a few minor complications. The audiological outcomes with transcutaneous implants were maintained with respect to percutaneous implants, while quality of life improvements were notable in general health and social support. Clinicians should use these insights to guide patient discussions and tailor post-operative care.

The online version contains supplementary material available at 10.1007/s00405-025-09610-7.