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Pediatric BAHA in Italy: the "Bambino Gesù" Children's Hospital's experience
Pasquale Marsella1, Alessandro Scorpecci, Concettina Pacifico
1Audiology and Otology Unit, ENT Department, Bambino Gesù Children Hospital, Vatican City, Rome.
Insights
Pediatric Bone Anchored Hearing Aid (BAHA) implantation in children shows significant functional gain compared to conventional aids. Specialized centers ensure safe and effective one-stage surgery and management of comorbidities, even in young children.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Medical Devices
Background:
- The
- Bambino Gesù
- Children's Hospital has the largest Italian pediatric cohort using Bone Anchored Hearing Aids (BAHA).
- Previous studies have debated optimal candidate selection, surgical procedures, functional outcomes, and complication rates for pediatric BAHA.
- Bone-conduction hearing aids are crucial for children with specific types of hearing loss.
Purpose of the Study:
- To retrospectively review the
- Bambino Gesù
- Children's Hospital's experience with pediatric BAHA from 1995 to 2009.
- To analyze surgical approaches (one-stage vs. two-stage), complication rates, and functional outcomes.
- To evaluate the efficacy of BAHA in children, including those younger than five years.
Main Methods:
- Retrospective review of 47 pediatric BAHA cases implanted between 1995 and 2009.
- Comparison of outcomes between two-stage (1995-2000) and one-stage (2001 onwards) surgical procedures.
- Analysis of functional gain, implant loss, and local complication rates.
Main Results:
- A total of 47 children were implanted with BAHA.
- Implant loss occurred in 4.2% of cases following two-stage surgery.
- Functional gain with BAHA was significantly better than conventional bone-conduction hearing aids.
- No significant difference in functional outcome was observed between children implanted before and after age five.
- Local complication rates did not differ between one-stage and two-stage surgeries.
Conclusions:
- Pediatric BAHA offers significant functional hearing improvement.
- Specialized tertiary care centers are essential for managing pediatric BAHA cases.
- A multidisciplinary approach is vital for addressing comorbidities in children undergoing BAHA.
- One-stage surgery and implantation in children under five can be performed safely and effectively in specialized settings.
Abstract:
The "Bambino Gesù" Children's Hospital offers the largest Italian cohort of children using a BAHA. This paper retrospectively reviews the center's experience with pediatric BAHA from its start in 1995 to December 2009, especially focusing on most debated issues, all the way from candidate selection to functional outcome and complications. A total of 47 children (21 females and 26 males) were implanted. From 1995 to 2000, a two-stage procedure was adopted in 100% (n = 22) cases. From 2001 onwards, one-stage surgery was chosen for 10 patients. Implant loss occurred in two patients (4.2%) after a two-stage surgery. Overall, the local complication rate was not different in the one-stage and in the two-stage group. The functional gain was significantly better with BAHA than conventional bone-conduction hearing aids and there was no significant difference in terms of functional outcome between the seven patients receiving a BAHA at an age younger than 5 years and the rest. The study results suggest that children presenting an indication to auditory rehabilitation with BAHA should be referred to specialized tertiary care centers. Only in such settings, a complete, multidisciplinary approach to associated comorbidities and syndromes is possible, and implantation of children at an age younger than five and one-stage surgery can be conducted safely and effectively.
