Temporal bone thickness analysis in craniofacial anomalies: key considerations for bone conduction hearing implants

This study analyzes temporal bone thickness in pediatric craniofacial anomalies patients to determine the optimal age for preoperative high-resolution computed tomography (HRCT) and enhance surgical planning of bone conduction hearing implants.

A retrospective examination of 370 temporal bone HRCT scans from 158 pediatric patients with craniofacial anomalies was conducted. Statistical analysis included descriptive statistics and correlation between age and skull thickness.

The study revealed a correlation between age and skull thickness, emphasizing the importance of preoperative HRCT at 5 years or older for a comprehensive evaluation. The bone thickness on the ipsilateral side of the disease was not significantly different from the non-disease side (p-value 0.41; 95% CI: − 0.28, 0.68). Thickness increased significantly in the first two years but displayed variability in older age groups, particularly in patients with syndromic craniosynostosis. Exclusion of untreated patients led to a more coherent correlation between thickness and age.

Bone conduction hearing implants are feasible in children under 5 years, but for those aged five or older with craniofacial anomalies, preoperative temporal bone HRCT is crucial for comprehensive evaluation. Relying solely on age for implantation timing is insufficient, emphasizing the need for individualized assessment and caution in syndromic cases.