Results of pediatric bone-anchored hearing aid implantation

INTRODUCTION: The bone-anchored hearing aid (BAHA) system uses an osseointegrated titanium implant to propagate sound directly to the inner ear through the bones of the skull, bypassing the impedance of the skin and subcutaneous tissues. Children as young as 18 months have had hearing rehabilitated with this device. OBJECTIVES: The goals were to evaluate the efficacy of patient selection criteria, the safety and effectiveness of the implantation procedure, and the level of patient satisfaction after BAHA implantation in children. METHODS: The records of all pediatric patients implanted in Edmonton were retrospectively reviewed. Twenty patients, who received 25 implants, with postimplantation follow-up of 6 months or greater, were included. The average follow-up was 3 years, 7 months. RESULTS: Of 20 original implants, 3 were lost owing to trauma, whereas 2 failed to osseointegrate. All were successfully reimplanted. Complications related to the implants included three instances of skin necrosis around the abutment. All patients and caregivers reported greater than 95% improvement in patient-identified listening situations. Pure-tone averages improved from a mean of 49 dB for the better hearing ear preoperatively to 16 dB with the BAHA set at normal listening levels. CONCLUSIONS: The BAHA provides a safe and effective means of rehabilitation of conductive or mixed hearing loss in the pediatric population. Our patients report a high level of satisfaction and continued use of their devices.