Long-term results with the titanium bone-anchored hearing aid: The US experience

Objective: The purpose of this study is to evaluate the longterm safety and efficacy of the titanium bone-anchored hearing aid (BAHA). Study Design: A retrospective review of 24 patients implanted with the BAHA between 1984 and 1987 in a multiinstitutional study designed to evaluate t he device in the United States was performed, including detailed clinical a nd audiologic evaluations of the 10 patients implanted at the Columbia-Pres byterian Medical Center in New York. The data were collected from patients' charts, questionnaires, and the Nobel Biocare patient contact and repair r ecords. Patients: Candidates for the BAHA are unable to use a conventional air cond uction hearing aid because of congenital aural atresia, draining mastoid ca vities, or recurrent otitis externa. The audiologic indications are a condu ctive or a mixed hearing loss with a bone conduction average of 45 db or be tter and a speech discrimination score of 60% or better. Intervention: A BAHA was implanted in a two-stage procedure under local ane sthesia on an outpatient basis. Main Outcome Measures: Patients' satisfaction with the device, hearing impr ovement, and complication rates were reviewed. Results: The majority of the patients analyzed (78%) are still using the de vice an average of 15.6 hours/day 10 to 13 years after implantation. The ov erall satisfaction score was 4.5 (1, worst; 5, best). In sound field testin g, the mean speech reception threshold improved from 52 db to 27 db (p < 0. 05). There were no major complications. Conclusion: The BAHA is a safe and effective bone conduction hearing aid wi th wide applications for patients with bone conduction hearing levels of 45 db and discrimination scores of 60% or better.