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Management of repeated trauma to bone-anchored hearing aids in a paediatric patient
E Shamil1, V Topsakal2, W Grolman2
1King's College London School of Medicine, Guy's, King's and St Thomas' Hospital, UK.
Insights
Repeated falls can damage bone-anchored hearing aid (BAHA) abutments in children, potentially disrupting osseointegration. For active children, consider non-invasive options like the BAHA Softband to prevent such complications.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Neurosurgery
Background:
- Bone-anchored hearing aids (BAHA) are crucial for managing severe conductive hearing loss and congenital ear malformations.
- Pediatric patients, especially those with developmental conditions, may be at higher risk for traumatic injuries impacting implanted devices.
Observation:
- A case report details a 3-year-old boy with CHARGE syndrome who experienced two separate traumatic falls, each damaging his bone-anchored hearing aid abutment.
- The initial abutment failure necessitated a second implant on the same side, which was also subsequently damaged.
- Despite surgical repair options, the parents chose to retain the damaged abutments in situ.
Findings:
- Direct trauma to BAHA fixtures is a recognized complication in pediatric users, potentially leading to osseointegration failure and implant dysfunction.
- The study highlights the vulnerability of BAHA abutments to repeated impact injuries in young children prone to falls.
Implications:
- For children with a high risk of falls or behavioral challenges, alternative non-invasive hearing solutions like the BAHA Softband should be considered.
- Management strategies for pediatric BAHA users should address the risk of traumatic injury and its impact on device longevity and hearing rehabilitation.
Objective:
To outline the management options and neurological complications associated with repeated traumatic falls that cause intrusion of bone-anchored hearing aid abutments.
Case Report:
A three-year-old boy with coloboma, heart defects, atresia of nasal choanae, retarded growth, genital abnormalities, ear defects and deafness was fitted with a bone-anchored hearing aid for severe conductive hearing loss and congenital ear malformations. Six months later, a traumatic fall caused an intrusion injury which rendered the bone-anchored hearing aid abutment unusable. Without removing the original abutment, a second abutment was inserted on the same side to aid his hearing. Two years later, the child fell again and damaged his second bone-anchored hearing aid abutment. Having been offered a surgical option to repair the area, the parents opted to keep the abutments in situ.
Conclusion:
Direct trauma to the fixture of a bone-anchored hearing aid is a relatively common long-term complication in children which can disrupt osseointegration and disable the implant. For young children who are either prone to falling or have behavioural problems, a bone-anchored hearing aid Softband may be more appropriate to non-invasively aid hearing.
