title: Rehabilitation of patients with conductive hearing loss and moderate mental retardation by means of a bone-anchored hearing aid.
abstract: OBJECTIVE
  To evaluate whether the bone-anchored hearing aid (BAHA) can be applied successfully to patients with conductive hearing loss and moderate mental retardation.
  
  
  METHODS
  Retrospective clinical evaluation.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Twenty-two patients with congenital moderate mental retardation and conductive or mixed hearing loss were selected to receive a BAHA at the University Medical Centre Nijmegen, the Netherlands. Four of them were fitted despite a limited air-bone gap.
  
  
  METHODS
  Rehabilitative BAHA application.
  
  
  METHODS
  Implantation results, skin reactions, and audiological data were evaluated during a mean follow-up of 36 months.
  
  
  RESULTS
  All the patients were still using the BAHA 7 days a week and for more than 8 hours a day after a follow-up period between 5 and 96 months. Two implants (9%) were lost due to insufficient integration but were reimplanted successfully. With the BAHA, mean free-field thresholds showed a clear mean improvement of 9 dB compared with the previous hearing aid. Considerable improvements in daily activities were seen in at least five patients.
  
  
  CONCLUSIONS
  Moderate mental retardation should no longer be considered as a contraindication for BAHA application. Although implant loss was low, extra attention may be required from the personal care providers to maintain the percutaneous implant. The BAHA was well-accepted by the patients with moderate mental retardation and was being used for most of the day. Implementation of the BAHA as hearing aid treatment in patients with moderate mental retardation proved to be sufficiently effective and may have strongly positive effects on activities at school or at work.
authors.affiliation: Department of Otorhinolaryngology, Radboud University Nijmegen Medical Centre, The Netherlands. s.kunst@kno.umcn.nl
authors.forename: Sylvia J W
authors.initials: SJ
authors.lastname: Kunst
authors.forename: Myrthe K S
authors.initials: MK
authors.lastname: Hol
authors.forename: Ad F M
authors.initials: AF
authors.lastname: Snik
authors.forename: Emmanuel A M
authors.initials: EA
authors.lastname: Mylanus
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D017028:Caregivers / Q000523:psychology; D002648:Child; D004314:Down Syndrome / Q000150:complications; D005260:Female; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000150:complications* / Q000534:rehabilitation*; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome