The bone-anchored hearing aid (BAHA) in children with auricular malformations

A retrospective study was undertaken to evaluate the outcome of the use of the bone-anchored hearing aid (BAHA) in children. All patients included in the study had bilateral auricular malformations. Previous alternatives had been conventional hearing aids or surgical middle ear reconstruction. Thirty-seven patients under 16 years of age were studied. The most common syndrome in the group was Treacher Collins. Sixteen of the patients had earlier middle ear reconstruction, the results of which did not produce social hearing. Of 40 inserted fixtures to anchor the BAHA, three were lost during the follow-up period because of failed osseointegration. Skin reactions were graded according to a clinical scoring system and were determined to be comparable in number and severity to those of an adult population. All patients in the study considered the BAHA to be superior to earlier bone-conduction devices. It is concluded that the BAHA is an excellent alternative to bone-conduction devices in children with auricular malformations. Middle ear surgery can be postponed until adulthood or abandoned, especially in syndromic patients in whom it is known to be difficult and unpredictable.