title: Office versus operating room insertion of the bone-anchored hearing aid: a comparative analysis.
abstract: BACKGROUND
  The Bone-anchored Hearing Aid is indicated for patients with unilateral deafness and/or an irreversible conductive hearing loss. The insertion of this device is usually performed in the operating room under intravenous sedation or general anesthesia. We suggest that the placement of the abutment can occur easily and safely in the clinic setting, reducing time and costs for both the patient and the physician.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Ten patients requiring 11 devices (1 bilateral) were implanted with the Bone-anchored Hearing Aid device in the outpatient clinic and another 8 patients were implanted in the operating room. All office procedures were done under local anesthesia; operating room procedures used either general anesthesia or intravenous sedation. Follow-up occurred over 12 months. Time required, cost of the procedure, and other logistical concerns between operating room and office-based insertion were evaluated and compared.
  
  
  RESULTS
  When performed in the office, patient fees were reduced by 31%, and patient time investment was reduced 73%. Physician time was reduced by 50%. After office-based insertion, patients were able to return to their normal routine immediately after the procedure, and no chaperone or designated driver was required. No infection or complications occurred in either group.
  
  
  CONCLUSIONS
  Bone-anchored Hearing Aid insertion in the clinic setting is safe and cost-effective, saving the patient and physician significant time and resources.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Lahey Clinic, Burlington, Massachusetts 01805, USA. peter.catalano@lahey.org
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Catalano
authors.forename: Ellen
authors.initials: E
authors.lastname: Choi
authors.forename: Nancy
authors.initials: N
authors.lastname: Cohen
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics; D000768:Anesthesia, General; D000772:Anesthesia, Local; D016292:Procedural Sedation; D003362:Cost-Benefit Analysis; D003638:Deafness / Q000601:surgery*; D005251:Fees, Medical / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006310:Hearing Aids / Q000191:economics; D006314:Hearing Loss, Conductive / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000191:economics; D019919:Prosthesis Implantation / Q000191:economics / Q000379:methods*