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Complications of bone-anchored hearing aids in pediatric patients
Tania Kraai1, Colin Brown, Michel Neeff
1Department of Paediatric Otolaryngology, Starship Children's Hospital, Park road, Grafton, Private Bag 92 024 Auckland, New Zealand.
Insights
Complications are common following bone-anchored hearing aid (BAHA) implantation in children. Obesity and socioeconomic factors increase the risk of major complications, necessitating careful follow-up and site care.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Biomedical Engineering
Background:
- Bone-anchored hearing aids (BAHA) offer a solution for hearing loss in pediatric patients.
- Understanding complication rates is crucial for optimizing outcomes in this population.
Purpose of the Study:
- To determine the incidence and types of complications associated with BAHA implantation in children.
- To identify risk factors contributing to these complications.
Main Methods:
- Retrospective review of pediatric patients (≤16 years) who received BAHA implants between 2002 and 2009.
- Analysis of post-implantation complications including infection, soft tissue hypertrophy, osseointegration failure, and need for revision surgery.
Main Results:
- Soft tissue reactions occurred in 89% of patients, with 37% experiencing major complications requiring intervention.
- Implant removal due to infection or overgrowth occurred in 19% of cases; 11% failed to osseointegrate.
- Increased risk for major complications was observed in patients from socioeconomically deprived backgrounds and those who were obese.
Conclusions:
- Complications following pediatric BAHA implantation are frequent.
- Obesity and socioeconomic status are significant risk factors for increased complication rates.
- Meticulous site care and frequent follow-up are essential but can be challenging in this patient group.
Objective:
To describe the range and rate of complications related to bone-anchored hearing aids in pediatric patients.
Method:
We conducted a retrospective review all children 16 years of age or less who were implanted with a bone-anchored hearing aid from 2002 to 2009. The main outcome measures were post Baha(®) implantation complications including infection, soft tissue hypertrophy, loss of osseointegration, and need for further surgery.
Results:
Thirty-one patients were identified and 27 had sufficient follow up for complete analysis. Soft tissue reactions were seen in 24 patients (89%), half of which were considered minor. Ten patients (37%) had major complications defined as requiring revision surgery or removal of the implant. Soft tissue overgrowth and infection at the abutment required removal in 5 children (19%) and three implants (11%) failed to osseointegrate. Recurrent antibiotic treatment was required in eight patients (30%). Seven patients (26%) had a history of trauma and one of them lost the implant. To date, three of the children (11%) have been unable to use the device because of chronic infection and overgrowth of the abutment. There was a statistically significant increased risk for major complications in patients from socioeconomically deprived backgrounds and obesity appears to incur additional risk.
Conclusions:
Complications of bone-anchored hearing aid implants are common in our experience and obesity and socioeconomic factors appear to contribute to a higher risk for complications. Frequent follow up and meticulous care of the implant site may minimize complications but can be challenging in this population.
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