Patients reported a significant improvement in speech intelligibility in noise and greater benefit from BAHA compared with CROS hearing aids. Patients were satisfied with the device and its impact on their quality of life. No major complications were reported. Conclusion and significance BAHA is effective in unilateral deafness. Auditory stimuli from the deaf side can be transmitted to the good ear, avoiding the limitations inherent in CROS amplification.

After more than 25 years of clinical experience, the BAHA (bone-anchored hearing aid) system is a well-established treatment for hearing-impaired patients with conductive or mixed hearing loss. Owing to its success, the use of the BAHA system has spread and the indications for application have gradually become broader. New indications, as well as clinical applications, were discussed during scientific roundtable meetings in 2004 by experts in the field, and the outcomes of these discussions are presented in the form of statements. The issues that were discussed concerned BAHA surgery, the fitting range of the BAHA system, the BAHA system compared to conventional devices, bilateral application, the BAHA system in children, the BAHA system in patients with single-sided deafness, and, finally, the BAHA system in patients with unilateral conductive hearing loss.

No abstract

A subtotal resection through the translabyrinthine approach should be used in the treatment of large symptomatic acoustic neuromas in patients over the age of 65. This approach will consistently relieve the patient's symptoms of brain stem compression, reduce postoperative morbidity and complications, and preserve facial nerve function. In the elderly, after subtotal resection, the remaining tumor in 80% of cases appears to remain dormant during the average six year follow‐up (1‐16 year range). Eighty percent of acoustic neuromas not operated upon, appear to grow at a slow rate (0.2 cm/yr) while 20% grow at a fast rate (1 cm/yr). Patients over the age of 65 with small acoustic neuromas do not need surgical intervention. Yearly CT scanning is recommended to determine the growth rate of the acoustic neuroma. A conservative approach should be used in the treatment of all acoustic neuromas in the elderly.

Patients with UNSNHL had poor sound localization and laterality judgment abilities that did not improve with BAHA use.

The Baha system is safe and effective in the rehabilitation of patients with conductive or mixed hearing losses and with single-sided deafness. The high success rate, patient satisfaction rate, and predictable auditory outcome place the Baha among the leading choices for auditory rehabilitation.

The use of BAHA has significantly improved the hearing handicap scores in patients with unilateral conductive or mixed hearing loss. The proven safety and efficacy of the device promote its use in unilateral cases that traditionally had been left unaided.

Sequential computerized tomography (CT) allows us to determine the growth rate of acoustic neuromas. Prior to CT scanning, a variability in tumor growth rates was recognized on the basis of clinical signs. After incomplete tumor removal, some patients experienced rapid recurrence, whereas others lived many years without recurrence. We used CT scanning to study tumor growth rates in a heterogeneous group of 21 patients. Thirteen elderly patients were given annual scans after incomplete tumor removal, while eight patients who had not had surgery are likewise being followed up. Early detection and complete tumor removal with preservation of hearing and facial function remain the goal in vigorous and healthy patients. However, a large number of older, infirm patients with acoustic neuromas may not require surgery or be candidates for incomplete tumor removal. Because rapid tumor growth may necessitate total tumor removal even in older patients, a better understanding of the growth rates may permit us to take a more scientific approach in planning these patients' management.