Bone-conduction hearing devices provide good hearing outcomes for conductive/mixed hearing losses. Complications post-insertion can lead to additional procedures. Identifying factors that may increase likelihood of developing complications can mitigate risk and inform patients.

A retrospective cohort analysis of 166 adults receiving bone-anchored hearing aid connect operations from 2016–2021 was performed assessing complication rate and contributing factors causing revision procedures.

Twenty-nine per cent of patients had post-operative complications. In total, 17.5 per cent needed additional procedures. Skin overgrowth/infection, granulation and traumatic extrusion were most common reasons. No difference was found in complication rate between different surgical techniques, surgeon grade or general versus local anaesthetic. More complications were observed in decreasing age, male gender and severity of skin reaction.

Revision procedure and complication rates are similar to those reported in published literature. Patient characteristics are important in identifying those likely to develop complications. Non-patient factors did not seem to affect complication rate.