Intraindividual Comparison of the Bone-Anchored Hearing Aid and Air-Conduction Hearing Aids

AbstractObjective:Bone-anchored hearing aid surgery in younger children is a two-stage procedure, with a titanium fixture being allowed to osseointegrate for several months before an abutment is fitted through a skin graft. In the first procedure, it has been usual to place a reserve or sleeper fixture approximately 5 mm from the primary fixture as a backup in case the primary fixture fails to osseointegrate. This ipsilateral sleeper fixture is expensive, is often not used, and is placed in thinner calvarial bone where it is less likely to osseointegrate successfully. The authors have implanted the sleeper fixture on the contralateral side, with the additional objective of reducing the number of procedures for bilateral bone-anchored hearing aid implantation, providing a cost-effective use for the sleeper.Methods:The authors implanted the bone-anchored hearing aid sleeper fixture in the contralateral temporal bone instead of on the ipsilateral side in seven successive paediatric cases with bilateral conductive hearing loss requiring two-stage bone-anchored hearing aids, treated at the Royal Manchester Children's Hospital, UK.Results:The seven patients ranged in age from five to 15 years, with a mean age of 10 years; in addition, a 20-year-old with learning disability was also treated. In each case, the contralateral sleeper fixture was not needed as a backup fixture, but was used in four patients (57 per cent) as the basis for a second-side bone-anchored hearing aid.Conclusions:In children with bilateral conductive hearing loss, in whom a bilateral bone-anchored hearing aid is being considered and the second side is to be operated upon at a later date, we recommend placing the sleeper fixture on the contralateral side at the time of primary first-side surgery. Our technique provides a sleeper fixture located in an optimal position, where it also offers the option of use for a second-side bone-anchored hearing aid and reduces the number of procedures needed.

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Cartilage Conduction Hearing Aid Fitting in Clinical Practice

Journal of the American Academy of Audiology ◽

10.1055/s-0041-1728758 ◽

2021 ◽

Author(s):

Tadashi Nishimura ◽

Hiroshi Hosoi ◽

Tomoko Sugiuchi ◽

Nozomu Matsumoto ◽

Takanori Nishiyama ◽

...

Keyword(s):

Hearing Aids ◽

Hearing Aid ◽

Severe Stenosis ◽

Aural Atresia ◽

New Device ◽

Data Collection And Analysis ◽

Purchase Rate ◽

Fitting In ◽

Air Conduction ◽

Assessment Results

Abstract Background Cartilage conduction hearing aids (CCHAs) were newly devised and spread fast in Japan since their launch in 2017. However, little knowledge is available for this new device. Purpose The aim of this study was to establish the knowledge of CCHAs and suggest their indication. Research Design Correlational study. Study Sample A total 256 patients were registered. Data Collection and Analysis The fitting of CCHAs was surveyed in nine institutions. The outcomes were assessed by audiometric tests. The patients were classified into seven groups, depending on the ear conditions. The clinical characteristics, assessment results, and purchase rates were compared among the groups. The assessment results of CCHAs were also compared with those of previously used hearing aids. Results Most patients who used CCHAs were classified into the bilateral closed (aural atresia or severe stenosis) ear (n = 65) or unilateral closed ear (n = 124) groups. The patients in these groups achieved good benefits that resulted in a high purchase rate. The bilateral continuous otorrhea group also supported a high purchase rate, although the benefits of CCHAs were not always excellent. In contrast, the purchase rate was poor in the patients who could use air conduction hearing aids (ACHAs) without absolute problems. As for using a CCHA as a contralateral routing of signals hearing aid, the benefits depended on the patients. Conclusions CCHAs are considered as a great option not only to the patients with closed ears but also to those who had difficulties in ACHAs usage.

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The Birmingham bone anchored hearing aid programme: surgical methods and complications

The Journal of Laryngology & Otology ◽

10.1017/s0022215100136217 ◽

1996 ◽

Vol 110 (21) ◽

pp. 7-12 ◽

Cited By ~ 54

Author(s):

David W. Proops

Keyword(s):

Soft Tissue ◽

Hearing Aids ◽

Hearing Aid ◽

Surgical Method ◽

Surgical Methods ◽

Bone Anchored Hearing Aid

AbstractSince 1988, 309 patients have been referred to the Birmingham bone anchored hearing aid programme for assessment. One hundred and eighty-eight have been fitted with bone anchored hearing aids (BAHA). Of these 169 have been fitted with a BAHA alone and 20 with a BAHA and auricular prosthesis(es).Only four (2.1 per cent) are not wearing their BAHAs. Three cases because the hearing had continued to deteriorate and in one case because of repeated failure to integrate. Nineteen patients (10.1 per cent) have lost fixtures but all but one of these have been successfully reimplanted. Of these 19 patients 10 (52.6 per cent) were syndromal and 10 (52.6 per cent) were under 16 years of age.A surgical method has been evolved both to cope with predictable failure of integration and soft tissue control.

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Long-term complications of bone-anchored hearing aids: a 14-year experience

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002521 ◽

2008 ◽

Vol 123 (2) ◽

pp. 170-176 ◽

Cited By ~ 51

Author(s):

K Badran ◽

A K Arya ◽

D Bunstone ◽

N Mackinnon

Keyword(s):

Hearing Aids ◽

Revision Surgery ◽

Hearing Aid ◽

Retrospective Case ◽

Tertiary Referral Centre ◽

Skin Reactions ◽

Operative Complications ◽

Adults And Children ◽

Bone Anchored Hearing Aid

AbstractObjectives:To report cases of long-term surgical complications, implant failure and revision surgery, within a large bone-anchored hearing aid programme.Study design:Retrospective, case–cohort study.Setting:Tertiary referral centre.Patients:One hundred and sixty-five adults and children who had undergone a total of 177 bone-anchored hearing aid implantations.Intervention:Diagnosis and explanation of adverse events and device failure.Main outcome measures:Operative complications and survival analysis, surgical challenges related to revisions, and causes of failure.Results:Twenty-one per cent of patients (3.4 per cent of those observed) suffered from skin reactions; this rate did not increase over time. Seventeen per cent had loss of osseointegration at a median interval of 6.3 months. Loss of osseointegration was observed more frequently in patients with a 3 mm compared with a 4 mm fixture (p < 0.001). Intra-operatively, the only complication was bleeding, occurring in 3 per cent of patients. Post-operative complications included: primary bleeding (2 per cent); severe skin reactions requiring intravenous antibiotics, cautery or grafting (8 per cent); thickening or overgrowth of skin requiring excision (8 per cent); failure of osseointegration requiring a new fixture (18 per cent); and graft necrosis requiring revision (1 per cent). In two patients, it was necessary to explore the area to remove overgrowth of bone. In 16 patients (10 per cent), the bone-anchored hearing aid had to be abandoned due to failure of osseointegration (n = 4), dissatisfaction with the aid (n = 6), intolerable pain (n = 4), hair growth around the abutment (n = 1) or recurrent infections (n = 1). In 12 of these patients, the bone-anchored hearing aid was removed surgically. Overall, 57 patients (34 per cent) underwent revision surgery.Conclusion:Awareness of complications is becoming increasingly important in bone-anchored hearing aid programme. A substantial workload of device maintenance should be anticipated, and patients should be appropriately counselled beforehand. Ninety per cent of our patients chose to persevere with this form of hearing rehabilitation.

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Soft tissue overgrowth in bone-anchored hearing aid patients: use of 8.5 mm abutment

The Journal of Laryngology & Otology ◽

10.1017/s0022215111000090 ◽

2011 ◽

Vol 125 (6) ◽

pp. 576-579 ◽

Cited By ~ 13

Author(s):

S Pelosi ◽

S S Chandrasekhar

Keyword(s):

Soft Tissue ◽

Hearing Aids ◽

Revision Surgery ◽

Wound Care ◽

Hearing Aid ◽

Tissue Growth ◽

First Line ◽

Tertiary Referral Centre ◽

Number Of Patients ◽

Bone Anchored Hearing Aid

AbstractObjective:To review outcomes following implantation of an 8.5 mm bone-anchored hearing aid abutment, as regards post-operative management of scalp soft tissue overgrowth.Study design:Retrospective chart review of paediatric and adult patients implanted with bone-anchored hearing aids between 2003 and 2008 who subsequently underwent revision surgery for excessive soft tissue growth.Setting:A tertiary referral centre and a private otology and neurotology clinic.Subjects:A total of 80 patients underwent bone-anchored hearing aid placement between 2003 and 2008. Of these patients, 14 had significant scalp soft tissue overgrowth unresponsive to first-line, nonsurgical local wound care.Results:Fourteen patients underwent an average of 2.1 surgical procedures each for soft tissue overgrowth around their bone-anchored hearing aid abutment. The mean time between initial implantation and revision surgery was 13.6 months. Of these 14 patients, 11 were eventually fitted with an 8.5 mm abutment. Following placement of the longer abutment, only one patient required additional surgical reduction of soft tissue overgrowth (mean follow-up time 11.8 months). All patients were able to use their bone-anchored hearing aid.Conclusion:The 8.5 mm bone-anchored hearing aid abutment is successful in preventing the need for additional surgical intervention in the small but significant number of patients with post-implantation soft tissue overgrowth. Early consideration should be given to this option when first-line soft tissue care is inadequate.

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Disability, handicap and benefit analysis with the bone-anchored hearing aid: the Glasgow hearing aid benefit and difference profiles

The Journal of Laryngology & Otology ◽

10.1258/0022215021911310 ◽

2002 ◽

Vol 116 (S28) ◽

pp. 29-36 ◽

Cited By ~ 12

Author(s):

Ann-Louise McDermott ◽

Sunil N. Dutt ◽

Elia Tziambazis ◽

Andrew P. Reid ◽

David W. Proops

Keyword(s):

Hearing Aids ◽

Hearing Aid ◽

Adult Patients ◽

Questionnaire Study ◽

Benefit Analysis ◽

Patient Benefit ◽

Hearing Rehabilitation ◽

Bone Anchored Hearing Aid ◽

One Year ◽

Hearing Aid Benefit

The Birmingham bone-anchored hearing aid programme began in 1988 and by autumn 2000 a total of 351 patients had been fitted with such an aid. The aim of this study was to assess the effectiveness of hearing rehabilitation with the bone-anchored hearing aid. This was a prospective interview-based questionnaire study carried out in the autumn 2000. A total of 84 adult patients were interviewed. Each patient had worn their BAHA for more than one year.The questionnaire used during these interviews was the Glasgow hearing aid benefit profile (GHABP) and the Glasgow hearing aid difference profile (GHADP). This was first derived and validated by Gatehouse in 1999. The use of bone-anchored hearing aids was found to reduce the level of disability and handicap and provided the most patient benefit and satisfaction.

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The bone anchored hearing aid—The third option for otosclerosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215100136242 ◽

1996 ◽

Vol 110 (21) ◽

pp. 31-37 ◽

Cited By ~ 8

Author(s):

S. P. Burrell ◽

H. C. Cooper ◽

D. W. Proops

Keyword(s):

Hearing Loss ◽

Treatment Option ◽

Hearing Aids ◽

Hearing Aid ◽

Queen Elizabeth Hospital ◽

Suppurative Otitis Media ◽

The Third ◽

Hearing Ability ◽

Bone Anchored Hearing Aid ◽

Experience Difficulty

AbstractThe bone anchored hearing aid (BAHA) has mainly been used for the treatment of hearing loss in patients with congenital conductive problems or chronic suppurative otitis media.In a five-year period, 32 otosclerotic patients have been referred to the Queen Elizabeth Hospital for consideration of a BAHA. Ten of these patients have been fitted and gained benefit compared to their previous hearing aid. The benefits are not necessarily those in hearing ability but in some cases relate to cosmetic or comfort improvements. This paper demonstrates that the BAHA offers a third treatment option for otosclerosis in patients who cannot or will not undergo stapedectomy and experience difficulty with conventional hearing aids.

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Bone-anchored hearing aids in children and young adults: the Freeman Hospital experience

The Journal of Laryngology & Otology ◽

10.1017/s002221511000188x ◽

2010 ◽

Vol 125 (2) ◽

pp. 153-157 ◽

Cited By ~ 12

Author(s):

Y Ramakrishnan ◽

S Marley ◽

D Leese ◽

T Davison ◽

I J M Johnson

Keyword(s):

Quality Of Life ◽

Young Adults ◽

Hearing Aids ◽

Hearing Aid ◽

Adult Population ◽

Significant Proportion ◽

Glasgow Benefit Inventory ◽

Bone Anchored Hearing Aid ◽

Children And Young Adults

AbstractObjective:To investigate the utilisation of bone-anchored hearing aids and Softband, as well as the effects on quality of life, amongst the paediatric and young adult population of Freeman Hospital, Newcastle Upon Tyne, UK.Method:Retrospective, anonymised, cross-sectional survey using the Glasgow Benefit Inventory and Listening Situation Questionnaire (parent version), administered at least three months following the start of bone-anchored hearing aid or Softband use.Results:One hundred and nine patients were included, of whom syndromic children made up a significant proportion (22 of 109). Patients using bone-anchored hearing aids obtained significant educational and social benefit from their aids. The mean Listening Situation Questionnaire difficulty score was 17 (15 patients), which is below the trigger score of 22+ at which further reassessment and rehabilitation is required. 87% (of 15 patients) did not require further intervention. The overall mean GBI score for the 22 patients (syndromic and non-syndromic) was +29.Conclusion:The use of bone-anchored hearing aids and Softband results in significant improvements in quality of life for children and young adults with hearing impairment. There is significant under-utilisation of bone-anchored hearing aids in children with skull and congenital abnormalities, and we would advocate bone-anchored hearing aid implantation for these patients.

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Hearing with Bone-anchored Hearing Aid (BAHA)

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1025 ◽

2010 ◽

Vol 2 (2) ◽

pp. 125-131 ◽

Cited By ~ 1

Author(s):

MV Kirtane ◽

Gauri Mankekar ◽

Payal Bhattacharya Chitranshi

Keyword(s):

Hearing Loss ◽

Hearing Aids ◽

Hearing Aid ◽

Bone Anchored Hearing Aid

Abstract BAHA is a surgically implantable system for treatment of hearing loss in patients wherein conventional hearing aids are unable to provide benefit. e.g. patients with microtia, chronic ear discharge or single sided hearing loss.

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