The current practice trends in pediatric bone-anchored hearing aids in Canada: A national clinical and surgical practice survey

Abstract

BackgroundSince the introduction of bone-anchored hearing aids (BAHAs) in the 1980s, the practices of surgeons who implant these hearing aids have become varied; different indications and surgical techniques are utilized depending on the surgeon and institution. The objective of the current study is to describe the clinical and surgical practices of otolaryngologists in Canada who perform pediatric BAHA operations.MethodsA detailed practice questionnaire was devised and sent to all members of the Canadian Society of Otolaryngology-Head and Neck Surgery. Those who performed pediatric BAHA surgeries were asked to participate.ResultsTwelve responses were received (response rate of 80%). All of the respondents identified congenital aural atresia to be an indication for pediatric BAHAs. Other indications were chronic otitis externa or media with hearing loss (92%), allergic reactions to conventional hearing aids (75%), congenital fixation or anomaly of ossicular chain (67%), and unilateral deafness (25%). Minor complications, such as skin reactions, were reported in 25% of cases, while major complications were very rare. There was great variability with regards to surgical techinque and post-operative management. The extent of financial support for the BAHA hardware and device also varied between provinces, and even within the same province.ConclusionThere is a lack of general consensus regarding pediatric BAHA surgeries in Canada. With such a small community of otolaryngologists performing this procedure, we are hopeful that this survey can serve as an impetus for a national collaboration to establish a set of general management principles and inspire multi-site research ventures.

Outcomes of Bone Anchored Hearing Aid Implant at Universiti Kebangsaan Malaysia Medical Centre (UKMMC)

“…BAHA benefit for this group as their ear canal is not occluded by ear-mole [4]. Liu et al [5] in his study also showed commonest indication for BAHA is congenital atresia. The other indication of BAHA is mixed hearing loss [6].…”

Decisional Conflict in Parents Considering Bone-Anchored Hearing Devices in Children With Unilateral Aural Atresia

“…5 In a survey of Canadian otolaryngologists who perform pediatric BAHD surgeries, 100% of respondents indicated that bilateral congenital aural atresia was a suitable indication for surgery. 3 However, there was no consensus for children presenting with unilateral aural atresia. This is in keeping with the current state of evidence, which suggests that there is no definitive audiological benefit of BAHD for all patients with unilateral atresia.…”

“…1 Standard management in many pediatric centers for young children with bilateral aural atresia and conductive hearing loss include an early fitting of softband bone conduction device, followed by a bone-anchored hearing device (BAHD) implantation when the child reaches a suitable age with adequate bone thickness. 2,3 The benefits of BAHD for this indication have been clearly demonstrated. 4 Indeed, in bilateral hearing loss associated with aural atresia, studies have shown that even unilateral BAHD is associated with significant improvements in pure-tone thresholds and speech testing.…”

The effect of anatomical variables and use of the Lifts system on hearing outcomes after implantation of an active transcutaneous bone conduction device in bilateral congenital conductive hearing loss

“…Though they produced good audiological outcomes, this kind of hearing aid came with significant drawbacks. Vibrations were transmitted via a screw rigidly anchored to the skull [12]. The screw had a diameter of 4.5 mm (narrow enough to be regarded as a single point of stimulation), and it passed directly from the bone, through the skin, creating a portal for infection.…”