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Updated: Jul 17, 2026
Sound Source Localization Testing in Single-sided Deafness Following Bone Conduction Intervention
Published on: December 20, 2024
Updated surgical experience with bone-anchored hearing aids in children
S Lloyd1, J Almeyda, K S Sirimanna
1Great Ormond Street Hospital for Children NHS Trust, London, UK. sklloyd@blueyonder.co.uk
Insights
Bone-anchored hearing aids (BAHAs) offer significant audiological and quality-of-life benefits for children. While complications like fixture loss can occur, careful patient selection and follow-up are key to successful outcomes.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Biomedical Engineering
Background:
- Retrospective review of pediatric bone-anchored hearing aid (BAHA) implantation outcomes.
- Focus on data from Great Ormond Street Hospital for Children.
Purpose of the Study:
- Evaluate the effectiveness and complications of BAHAs in children.
- Assess audiological outcomes, fixture survival, skin reactions, and quality of life.
Main Methods:
- Review of 71 children (85 ears) who underwent BAHA placement (1990-2002).
- Analysis of hearing thresholds, fixture loss, skin reactions, revision rates, and quality of life measures.
Main Results:
- 54% of children experienced no complications; 42% required revision surgery; 26% had fixture loss.
- Younger age at implantation correlated with adverse outcomes.
- Skin reactions occurred in 37%, persisting long-term in 9%; associated with fixture loss.
- BAHAs showed comparable hearing thresholds to bone conduction aids but superior sound quality and quality of life.
Conclusions:
- BAHAs provide substantial audiological and quality-of-life advantages for pediatric hearing loss.
- Careful patient selection and diligent follow-up are crucial for minimizing complications and optimizing results.
Background:
We present the results of a retrospective review of children undergoing implantation with bone-anchored hearing aids (BAHAs) at the Great Ormond Street Hospital for Children.
Methods:
The case notes of 71 children undergoing BAHA placement at the Great Ormond Street Hospital for Children between December 1990 and August 2002 were reviewed. Outcome measures included hearing thresholds, incidence of fixture loss, skin reaction and need for revision. Quality of life outcomes were also measured.
Results:
Eighty-five ears had been implanted. Fifty-four per cent of children had experienced no complications, 42 per cent had required revision surgery and 26 per cent had experienced fixture loss at some point. Young age at implantation was associated with an adverse outcome. Trauma and failure of osseointegration had been the commonest reasons for failure. A skin reaction around the abutment had occurred at some point in 37 per cent of children but had persisted for longer than six months in only 9 per cent; this had been associated with fixture loss. The use of fixture site split skin grafts had reduced problems with skin hypertrophy and hair overgrowth. Hearing thresholds when using BAHAs had been comparable to those when using bone conduction hearing aids. However, BAHAs had significant additional benefits in terms of sound quality, ease of use and overall quality of life.
Conclusion:
Bone-anchored hearing aids provide significant benefits over other types of hearing aid, both audiologically and in terms of quality of life. Careful selection of candidates and meticulous follow up are required in order to minimize complications.
