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The birmingham pediatric bone-anchored hearing aid program: a 15-year experience
Ann-Louise McDermott1, Jo Williams, Michael Kuo
1Department of Otolaryngology, Birmingham Children's Hospital, Birmingham, UK. annlouisemcdermott@msn.com
Insights
The Birmingham Bone-Anchored Hearing Aid (BAHA) program successfully treated children, with 97% wearing their devices daily. Despite a 14% fixture failure rate, BAHA proved effective for selected pediatric patients.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Biomedical Engineering
Background:
- Bone-anchored hearing aids (BAHA) offer a solution for hearing loss in children.
- The Birmingham BAHA program has been providing this treatment since 1992.
Purpose of the Study:
- To evaluate complication rates and outcomes in pediatric patients receiving BAHA.
- To assess the effectiveness and reliability of the BAHA program in children.
Main Methods:
- Retrospective analysis of clinical records from 182 children (<16 years) treated between 1992 and 2007.
- Evaluation of surgical procedures, healing times, implant failures, and adverse skin reactions.
Main Results:
- A 14% fixture failure rate was observed, with multiple failures in 7 patients.
- Adverse skin reactions occurred in 17% of patients, necessitating revision surgery in 8%.
- Despite complications, 97% of children actively use their BAHA with ongoing audiological benefit.
Conclusions:
- The Birmingham BAHA program serves a high proportion of syndromic children with complex medical needs.
- BAHA is a reliable and effective treatment for carefully selected pediatric patients.
- High daily usage rates indicate successful long-term outcomes and patient satisfaction.
Objective:
To evaluate the complication rates and outcomes of children who were fitted with a bone-anchored hearing aid (BAHA) on the Birmingham BAHA program.
Study Design:
Retrospective case analysis of clinical records of all children implanted at Birmingham Children's Hospital since the beginning of the program in 1992 until February 2007.
Patients:
A total of 182 children younger than 16 years old fitted with a BAHA. Of these children, 107 had a significant medical history.
Results:
Surgery was performed as a 2-stage procedure in 174 children. The healing time was between 3 and 4 months in 112 (64%) cases. Single-stage surgery was performed in 8 cases. Implant failures were 14% of 230 loaded fixtures (32 fixtures lost in total). Multiple-fixture failures (18 fixture failures) occurred in 7 patients. Adverse skin reactions appeared in 34 (17%) patients during a 15-year follow-up period. Revision surgery was undertaken in 14 (8%) cases because of skin overgrowth around the abutment. Five of these cases required multiple surgical skin reductions.
Conclusion:
The Birmingham Program has a high proportion of syndromic patients with complex medical problems. The fixture failure rate was found to be 14%. This included the multiple-fixture failures in children younger than 3 years old. There was 1 serious complication. The BAHA is a reliable and effective treatment for selected patients. Our program currently has 97% of its children wearing their BAHA on a daily basis with continuing audiologic benefit.
