{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:11:37Z","timestamp":1788963097324,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To analyze the demographic and clinical factors associated with adherence to bone conduction hearing device follow\u2010up care in pediatric patients with microtia and aural atresia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Retrospective chart review of 127 patients in a tertiary care microtia database (2015\u20132025). Data collected included ethnicity, insurance type, current age, fitting age, unilateral versus bilateral hearing loss, time to first follow\u2010up, annual visit frequency, and daily datalogging hours, each analyzed as components of a composite adherence score (1\u20139) and as independent variables.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Unilateral hearing loss was the strongest predictor of decreased adherence on multivariate analysis (OR\u2009=\u20094.504,\n p<\/jats:italic>\n \u2009=\u20090.034). Older age was independently associated with reduced adherence; patients aged \u2265\u200911\u2009years had significantly higher odds of poor adherence versus those under 6\u2009years (OR\u2009=\u20095.795,\n p<\/jats:italic>\n \u2009=\u20090.001). While patients aged 7\u201310 had 4 times the odds of reduced adherence (OR\u2009=\u20094.391,\n p<\/jats:italic>\n \u2009=\u20090.003). Public or no insurance was associated with decreased adherence versus private insurance (\n p<\/jats:italic>\n \u2009=\u20090.009). Fitting age was not significant (\n p<\/jats:italic>\n \u2009=\u20090.098). Independent analysis of daily datalogging hours confirmed a significant association with adherence tier (\n p<\/jats:italic>\n \u2009<\u20090.001); patients logging fewer than 4\u2009h per day had markedly higher odds of decreased adherence on multivariate analysis (OR\u2009=\u200933.39,\n p<\/jats:italic>\n \u2009=\u20090.003).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Unilateral hearing loss, public or no insurance, and older age are risk factors for poor long\u2010term BCHD adherence in pediatric patients. Reduced daily device wear, as measured by datalogging, is a strong independent predictor and should be routinely monitored.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70848","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:30:32Z","timestamp":1788960632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When They Stop Coming: Key Factors in Pediatric\n BCHD<\/scp>\n Adherence in Microtia Patients"],"prefix":"10.1002","author":[{"given":"Sih\u2010Yu","family":"Chan","sequence":"first","affiliation":[{"name":"University of Texas at Austin Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristan","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Texas Children's Hospital\/Baylor College of Medicine Houston Texas 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Logging and Hearing Aid Use: Focus on the Forest, Not the Trees","volume":"66","author":"McCreery R.","year":"2013","journal-title":"Hearing Journal"}],"container-title":["The 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