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The Birmingham Pediatric Bone-Anchored Hearing Aid Program: A 15-Year Experience

McDermott, Ann-Louise; Williams, Jo; Kuo, Michael; Reid, Andrew; Proops, David

doi: 10.1097/MAO.0b013e31818b6271
Pediatric Otology

Objective: To evaluate the complication rates and outcomes of children who were fitted with a bone-anchored hearing aid (BAHA) on the Birmingham BAHA program.

Study Design: Retrospective case analysis of clinical records of all children implanted at Birmingham Children's Hospital since the beginning of the program in 1992 until February 2007.

Patients: A total of 182 children younger than 16 years old fitted with a BAHA. Of these children, 107 had a significant medical history.

Results: Surgery was performed as a 2-stage procedure in 174 children. The healing time was between 3 and 4 months in 112 (64%) cases. Single-stage surgery was performed in 8 cases. Implant failures were 14% of 230 loaded fixtures (32 fixtures lost in total). Multiple-fixture failures (18 fixture failures) occurred in 7 patients. Adverse skin reactions appeared in 34 (17%) patients during a 15-year follow-up period. Revision surgery was undertaken in 14 (8%) cases because of skin overgrowth around the abutment. Five of these cases required multiple surgical skin reductions.

Conclusion: The Birmingham Program has a high proportion of syndromic patients with complex medical problems. The fixture failure rate was found to be 14%. This included the multiple-fixture failures in children younger than 3 years old. There was 1 serious complication. The BAHA is a reliable and effective treatment for selected patients. Our program currently has 97% of its children wearing their BAHA on a daily basis with continuing audiologic benefit.

Birmingham Children's Hospital, Birmingham, U.K.

Address correspondence and reprint requests to Ann-Louise McDermott, F.D.S., R.C.S, F.R.C.S (ORL-HNS), The Department of Otolaryngology, The Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, U.K.; E-mail:

© 2009 Otology & Neurotology, Inc.