Hearing rehabilitation using the BAHA bone-anchored hearing aid: Results in 40 patients

Objective: This study evaluates the U.S. experience with the first 40 patie nts who have undergone audiologic rehabilitation using the BAHA bone-anchor ed hearing aid. Study Design: This study is a multicenter, nonblinded. retrospective case s eries. Setting: Twelve tertiary referral medical centers in the United States. Patients: Eligibility for BAHA implantation included patients with a hearin g loss and an inability to tolerate a conventional hearing aid, with bone-c onduction pure tone average levels at 60 dB or less at 0.5, 1, 2, and 4 kHz . Intervention: Patients who met audiologic and clinical criteria were implan ted with the Pone-Anchored Hearing Aid (BAHA, Entific Corp.. Gothenburg. Sw eden). Main Outcome Measures: Preoperative air- and bone-conduction thresholds and air-bone gap: postoperative BAHA-aided thresholds: hearing improvement as a result of implantation; implantation complications: and patient satisfact ion. Results: The most common indications for implantation included chronic otit is media or draining ears (18 patients) and external auditory canal stenosi s or aural atresia (7 patients). Overall. each patient had an average impro vement of 32 +/- 19 dB with the use of the BAHA. Closure of the air-bone ga p to within 10 dB of the preoperative bone-conduction thresholds (postopera tive BAHA-aided threshold vs. preoperative bone-conduction threshold) occur red in 32 patients (80%), whereas closure to within 5 dB occurred in 24 pat ients (60%). Twelve patients (30%) demonstrated 'overclosure' of the preope rative bone-conduction threshold of the better hearing ear. Complications w ere limited to local infection and inflammation at the implant site in thre e patients. and failure to osseointegrate in one patient. Patient response to the implant was uniformly satisfactory. Only one patient reported dissat isfaction with the device. Conclusions: The BAHA bone-anchored hearing aid provides a reliable and pre dictable adjunct for auditory rehabilitation in appropriately selected pati ents, offering a means of dramatically improving hearing thresholds in pati ents with conductive or mixed hearing loss who are otherwise unable to bene fit from traditional hearing aids.