title: Hearing rehabilitation using the BAHA bone-anchored hearing aid: results in 40 patients.
abstract: OBJECTIVE
  This study evaluates the U.S. experience with the first 40 patients who have undergone audiologic rehabilitation using the BAHA bone-anchored hearing aid.
  
  
  METHODS
  This study is a multicenter, nonblinded, retrospective case series.
  
  
  METHODS
  Twelve tertiary referral medical centers in the United States.
  
  
  METHODS
  Eligibility for BAHA implantation included patients with a hearing loss and an inability to tolerate a conventional hearing aid, with bone-conduction pure tone average levels at 60 dB or less at 0.5, 1, 2, and 4 kHz.
  
  
  METHODS
  Patients who met audiologic and clinical criteria were implanted with the Bone-Anchored Hearing Aid (BAHA, Entific Corp., Gothenburg, Sweden).
  
  
  METHODS
  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 satisfaction.
  
  
  RESULTS
  The most common indications for implantation included chronic otitis media or draining ears (18 patients) and external auditory canal stenosis or aural atresia (7 patients). Overall, each patient had an average improvement of 32+/-19 dB with the use of the BAHA. Closure of the air-bone gap to within 10 dB of the preoperative bone-conduction thresholds (postoperative BAHA-aided threshold vs. preoperative bone-conduction threshold) occurred in 32 patients (80%), whereas closure to within 5 dB occurred in 24 patients (60%). Twelve patients (30%) demonstrated 'overclosure' of the preoperative bone-conduction threshold of the better hearing ear. Complications were limited to local infection and inflammation at the implant site in three patients, and failure to osseointegrate in one patient. Patient response to the implant was uniformly satisfactory. Only one patient reported dissatisfaction with the device.
  
  
  CONCLUSIONS
  The BAHA bone-anchored hearing aid provides a reliable and predictable adjunct for auditory rehabilitation in appropriately selected patients, offering a means of dramatically improving hearing thresholds in patients with conductive or mixed hearing loss who are otherwise unable to benefit from traditional hearing aids.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland 21287, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Lustig
authors.forename: H A
authors.initials: HA
authors.lastname: Arts
authors.forename: D E
authors.initials: DE
authors.lastname: Brackmann
authors.forename: H F
authors.initials: HF
authors.lastname: Francis
authors.forename: T
authors.initials: T
authors.lastname: Molony
authors.forename: C A
authors.initials: CA
authors.lastname: Megerian
authors.forename: G F
authors.initials: GF
authors.lastname: Moore
authors.forename: K M
authors.initials: KM
authors.lastname: Moore
authors.forename: T
authors.initials: T
authors.lastname: Morrow
authors.forename: W
authors.initials: W
authors.lastname: Potsic
authors.forename: J T
authors.initials: JT
authors.lastname: Rubenstein
authors.forename: S
authors.initials: S
authors.lastname: Srireddy
authors.forename: C A
authors.initials: CA
authors.lastname: Syms
authors.forename: G
authors.initials: G
authors.lastname: Takahashi
authors.forename: D
authors.initials: D
authors.lastname: Vernick
authors.forename: P A
authors.initials: PA
authors.lastname: Wackym
authors.forename: J K
authors.initials: JK
authors.lastname: Niparko
mesh_terms: D000161:Acoustic Stimulation / Q000295:instrumentation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001844:Bone Conduction / Q000502:physiology; D004867:Equipment Design; D005260:Female; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies