[Bone-anchored hearing aids BAHA: 10 years' experience]

Bone anchored hearing aid (BAHA), based on the concept of osseointegration, offers the possibility of restoring hearing in case of conduction or mixed deafness. We report our experience with 87 in 74 patients implanted from 1989 to 1999. The patients were divided into two major groups, with bilateral agenesia (22 cases) or chronic otitis media (52 cases). Anatomical results are very good. We got 3 extrusions with no osseointegration, 10% local infections and 3 traumas. Functional outcome was excellent, with 73 patients being fitted with 81 HC200, HC300 or HC360 prostheses. One patient had a functional failure. We stress the importance of rigorous audiometric criteria and the determinant factors of osseointegration, essentially the surgical technique. In patients with chronic otitis, BAHA offers a functional solution for those with no benefit from an air conduction hearing aid and who are not operable or decline a new operation for tympano-ossicular reconstruction. For cases of ear malformation, BAHA can be a temporary solution that does not damage the inner ear. Indeed, rehabilitation with a BAHA does not exclude the possibility of functional tympano-ossicular surgery when the child is older and if the anatomic conditions are favorable.