Abstract
The aim of this work is to reexamine our experience with the treatment of conductive and mixed hearing loss using the Baha system. The system was implanted in 47 patients (16 adults and 31 children under the age of 14), bilaterally in two cases. The causes of hypoacusis were bilateral congenital aural atresia (31 patients), bilateral chronic otitis media or outcomes of middle-ear surgery (Gillett et al. in J laryngol Otol 120:537–542, 2006), and otosclerosis (Pazzaglia et al. in Acta Orthop Scand 54:574–579, 1983). The following parameters were assessed: mean preoperative air- and bone-conduction thresholds for the frequencies of 500, 1,000, 2,000 and 4,000 Hz; mean postoperative threshold with the Baha; hearing improvement calculated by subtracting the postoperative threshold with the Baha from the preoperative threshold for air conduction in the better ear; speech audiometry test; improvement in the quality of life, calculated using the Glasgow Benefit Inventory for the adult patients and the Glasgow Children’s Benefit Inventory for paediatric patients; frequency and type of surgical complications. Follow-up ranged from 6 to 38 months. The audiological results were satisfactory, with air–bone gap closure in 85.1% of cases. In terms of quality of life, assessment using the Glasgow Benefit Inventory showed a clear-cut improvement in health for all the 45 patients that answered to the questionnaires in our study. Out of the 49 operations that were performed, complications were reported in 3 cases (6.1%): 2 cases of skin regrowth around the titanium screw and one in which the abutment was not osseointegrated. The data from this study show that the Baha system offers a high percentage of success, which can significantly improve the patient’s quality of life, and a low rate of complications.
Similar content being viewed by others
References
Tjellstrom A, Granstrom G (1994) Long-term follow-up with the bone-anchored hearing aid: review of the first 100 patients between 1977 and 1985. Ear Nose Throat J 73:112–114
Chang SO, Choi BY, Hur DG (2006) Analysis of the long-term hearing results after surgical repair of aural atresia. Laryngoscope 116(10):1835–1841
Lustig LR, Arts HA, Brackmann DE, Francis HF, Molony T, Megerian CA, Moore GF, Moore KM, Morrow T, Potsic W, Rubenstein JT, Srireddy S, Syms CA, Takahashi G, Vernick D, Wackym PA, Niparko JK (2001) Hearing rehabilitation using the BAHA, bone-anchored hearing aid; results in 40 patients. Otol Neurotol 22:328–334
Mylanus EAM, Van der Pouw CTM, Snik AFM, Cremers CWRJ (1998) An intra-individual comparison of the BAHA and air-conduction hearing aids. Arch Otolaryngol Head Neck Surg 124:271–276
Kadhim A, Colreavy MP, O’Donovan C, Blayney A (2004) Bone-anchored hearing aids: reality, failure and current status. Ir Med J 97(10):312–314
Branemark P, Breine U, Lindstrom J et al (1969) Intra-osseous anchorage of dental prostheses: I. Experimental studies. Scand J Plast Reconstr Surg 3:81–100
Pazzaglia U, Minoia C, Cecillani L et al (1983) Metal determination in organic fluids of patients with stainless steel hip arthroplasty. Acta Orthop Scand 54:574–579
Hol MK, Bosman AJ, Snik AF, Mylanus EA, Cremers CW (2005) Bone-anchored hearing aids in unilateral inner ear deafness: patient year evaluation of audiometric and outcome measurements. Otol Neurotol 26:999–1006
Gillett D, Fairley JW, Chandrashaker TS, Bean A, Gonzalez J (2006) Bone anchored hearing aids: results of the first eight years of a programme in a district general hospital, assessed by the Glasgow benefit inventory. J Laryngol Otol 120:537–542
Badran K, Bunstone D, Arya AK, Suryanarayanan R, Mackinnon N (2006) Patient satisfaction with the bone-anchored hearing aid: a 14-year experience. Otol Neurotol 27(5):659–666
Lloyd S, Almeyda J, Sirimanna KS, Albert DM, Bailey CM (2007) Update surgical experience with bone-anchored hearing aids in children. J Laryngol Otol 121(9):826–831
Kunst SJ, Hol MK, Cremers CW, Mylanus EAM (2007) Bone anchored hearing aid in patients with moderate mental retardation: impact and benefit assessment. Otol Neurotol 28(6):793–797
Sheehan PZ, Hans PS (2006) UK and Ireland experience of bone anchored hearing aids (BAHA) in individuals with Down syndrome. Int J Pediatr Otorhinolaryngol 70:981–986
McDermott AL, Williams J, Kuo M, Reid A, Proops D (2009) The Birmingham Pediatric Bone-Anchored Hearing Aid Program: a 15-year experience. Otol Neurotol 30(2):178–183
Hamann C, Manach Y, Roulleau P (1991) La prothèse auditive à ancrage osseux BAHA. Résultats applications bilatérales. Rev Laryngol Otol Rhinol (Bord) 112:297–300
Bosman AJ, Snik AFM, Van der Pouw CTM, Mylanus EAM, Cremers CWRJ (2001) Audiometric evaluation of bilaterally fitted bone-anchored hearing aids. Audiology 40:158–167
Priwin C, Stenfelt S, Granstrom G, Tjellstrom A, Hakansson B (2004) Bilateral bone-anchored hearing aids (BAHA): an audiometric evaluation. Laryngoscope 114:77–84
Seeman R, Liu R, Di Toppa J (2004) Results of pediatric bone-anchored hearing aid implantation. J Otolaryngol 33(2):71–74
Carlsson P, Håkansson B (1997) The bone anchored aid. Reference quantities and functional gain. Ear Hear 18:34–41
Beltrame AM, Martini A, Prosser S, Giarbini N, Streitberger C (2009) Coupling the vibrant soundbridge to cochlea round window: auditory results in patients with mixed hearing loss. Otol Neurotol 30(2):194–201
Dumon T, Gratacap B, Firmin F, Vincent R, Pialoux R, Casse B, Firmin B (2009) Vibrant soundbridge middle ear implant in mixed hearing loss. Indications, techniques, results. Rev Laryngol Otol Rhinol (Bord) 130(2):75–81
Martin C, Deveze A, Richard C, Lefebvre PP, Decat M, Ibañez LG, Truy E, Mom T, Lavieille JP, Magnan J, Dubreuil C, Tringali S (2009) European results with totally implantable carina placed on the round window: 2-year follow-up. Otol Neurotol 30(8):1196–1203
Powell PH, Burell SP, Cooper HR, Proops DW (1996) The Birmingham bone anchored hearing aid programme: pediatric experience and results. J Laryngol Otol Suppl 21:21–29
Tietze L, Pepsin B (2001) Utilization of bone-anchored hearing aids in children. Int J Pediatr Otorhinolaryngol 58(1):75–80
Snik AF, Bosman AJ, Mylanus EAM, Cremers CWRJ (2004) Candidacy for the bone-anchored hearing aid. Audiol Neurootol 9:190–196
Hakansson B, Tjellström A, Rosenhall U, Carlsson P (1985) The bone anchored hearing aid: principal design and psychoacoustical evaluation. Acta Otolaryngol 100:229–239
Cremers CW, Snik FM, Beyon AJ (1992) Hearing with the bone-anchored hearing aid (BAHA, HC 200) compared to a conventional bone-conduction hearing aid. Clin Otolaryngol Allied Sci 17(3):275–279
Snik AF, Leijendeckers J, Hol MK, Mylanus EAM, Cremers CWRJ (2008) The bone-anchored hearing aid for children: recent developments. Int J Audiol 47(9):554–559
MacNamara M, Phillips D, Proops D (1996) The bone anchored hearing aid (BAHA) in chronic suppurative otitis media (CSOM). J Laryngol Otol 110:38–40
Evans AK, Kazahaya K (2007) Canal atresia: “Surgery or implantable hearing devices? The expert’s question is revisited”. Int J Pediatr Otorhinolaryngol 71(3):367–374
Digoy GP, Cueva RA (2006) Congenital aural atresia: review of short-and long-term surgical results. Otol Neurotol 28:54–60
McLarnon CM, Davison T, Johnson IJM (2004) Bone-anchored hearing aid: comparison of benefit by patient subgroups. Laryngoscope 114:942–944
Sedwick JD, Louden CL, Shelton C (1997) Stapedectomy vs. stapedotomy. Arch Otolaryngol Head Neck Surg 123:177–180
Agrawal S, Parnes L (2002) Small fenestra stapedotomy for otosclerosis in a Canadian teaching centre. J Otolaryngol 31(2):112–117
Glassock ME, Storper IS, Haynes DS, Bohrer PS (1995) Twenty-five years of experience with stapedectomy. Laryngoscope 105:899–904
Møller P (1992) Stapédectomie vs. stapédotomie, comparaison. Rev Laryngol Otol Rhinol (Bord) 113(5):397–400
Burrell SP, Cooper HC, Proops D (1996) The bone anchored hearing aid—the third option for otosclerosis. J Laryngol Otol 110:31–37
Proops DW (1996) The Birmingham bone anchored hearing aid programme: surgical methods and complications. J Laryngol Otol Suppl 21:7–12
Tringali S, Bozorg Grayeli A, Bou Cara D, Sterkers O, Chardon S, Martin C, Dubruil C (2008) A survey satisfaction and use among patients fitted with a BAHA. Eur Arch Otorhinolaryngol 265:1461–1464
Mylanus EAM, Cremers CWRJ, Snik A, Van den Berge N (1994) Clinical results of percutaneous implants in the temporal bone. Arch Otolaryngol Head Neck Surg 120:81–85
Priwin C, Jönsson R, Hultcrantz M, Granström G (2007) BAHA in children and adolescents with unilateral or bilateral conductive hearing loss: a study of outcome. Int J Pediatr Otorhinolaryngol 71(1):135–145
Priwin C, Granstrom G (2005) The bone-anchored hearing aid in children: a surgical and questionnaire follow-up study. Otorinolaryngol Head Neck Surg 132:559–565
Shirazi MA, Marzo SJ, Lonetti JP (2006) Perioperative complications with the bone-anchored hearing aid. Otolaryngol Head Neck Surg 134:236–239
House JW, Kutz JW (2007) Bone anchored hearing aids: postoperative incidence and management of complications. Otol Neurotol 28:213–217
Wazen JJ, Caruso M, Tjellstrom A (1998) Long-term results with the titanium bone-anchored hearing aid: the US experience. Am J Otol 19:737–741
Stalfors J, Tjellstrom A (2008) Skin reactions after BAHA surgery: a comparison between the U-graft technique, the BAHA dermatome. Otol Neurotol 29(8):1109–1114
Conflict of interest statement
The authors declare that they have no conflict of interest with any financial support or any commercial source that may, directly or indirectly, interfere with the results reported in the present article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ricci, G., Della Volpe, A., Faralli, M. et al. Results and complications of the Baha system (bone-anchored hearing aid). Eur Arch Otorhinolaryngol 267, 1539–1545 (2010). https://doi.org/10.1007/s00405-010-1293-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-010-1293-0