Bonebridge Surgery in Young Children

Dr Jafri Kuthubutheen1, Dr  Hayley  Herbert1, Ms Pia  Leeming1, Dr Carl Chase1

Princess Margaret Hospital For Children, Subiaco, Australia


The Bonebridge implant is approved for use in children as young as 5 years of age. There have been perceived limitations of its use due to the lower degree of mastoid pneumatisation. We present our preliminary experience with  the device, including the youngest recipient of the device in Australia to date.


Six patients were implanted with ages raging from 4.5 years to 11 years of age. The indications were single sided deafness in one patient, chronic suppurative otitis media in one patient, and microtia in 4 patients. In all patients, potential fitment of the BC-FMT was assessed by comparing the FMT size to the degree of mastoid air-cells pneumatisation on CT scan.


All patients had well pneumatised mastoid air cells. In three patients, both a 1mm and 2mm lift kit was required to achieve contact between the implant and the curvature of the temporal bone. In all patients, the sigmoid sinus and dura were identified and skeletonized. In the 10-year-old patient, the sigmoid sinus and middle cranial fossa were decompressed at the site of the BC-FMT, which was not required in our youngest patient. The follow up time since activation ranged from 2 months to 12 months. All patients had significant improvements in aided thresholds. In our oldest patient where speech testing in noise could be performed, there was a significant improvement in speech discrimination in all speech in noise testing paradigms.


The Bonebridge implant can be used successfully in children just under the recommended age.


Hayley is a NZ-trained ENT surgeon with dual Fellowships in Laryngology and Paediatric ENT and a member of the Childrens Hearing Implant Program (CHIP) at Princess Margaret Hospital in Perth.