title: BAHA in children and adolescents with unilateral or bilateral conductive hearing loss: a study of outcome.
abstract: OBJECTIVE
  Bilateral BAHAs in adults with bilateral hearing loss (BHL) have proven to be superior to unilateral fitting, in both audiologically measurements and in overall patient satisfaction. There have been no similar studies in children. Furthermore, a recent meta-analysis of children with unilateral hearing loss (UHL) has shown numerous negative consequences. The objectives of the study were to investigate whether fitting of bilateral BAHAs in children with conductive BHL give additional hearing benefits, to investigate the effects of unilateral hearing aids in children with conductive UHL, and to identify different aspects of auditory problems in children with conductive UHL or BHL.
  
  
  METHODS
  This was a prospective study involving 22 children with either conductive UHL (unaided or with unilateral hearing aid) or conductive BHL (with unilateral or bilateral BAHAs) and 15 controls.
  
  
  METHODS
  Baseline audiometry, tone thresholds in a sound field, speech recognition in noise and sound localization were tested without, and with unilateral and bilateral hearing aids. Two questionnaires, MAIS & MUSS and IOI-HA, were completed.
  
  
  RESULTS
  Two problem areas were identified in the children with hearing impairment: in reactions to sounds and in intelligibility of speech. An additional BAHA in the children with BHL resulted in a tendency to have improved hearing in terms of better sound localization and speech recognition in noise. Fitting of unilateral hearing aids in the children with UHL gave some supplementary benefit in terms of better speech recognition in noise but no positive effect on ability to localize sound could be detected. Even so, all children fitted with hearing aids - either unilaterally or bilaterally - reported a positive outcome with their devices in the self-assessment questionnaire.
  
  
  CONCLUSIONS
  Children with either UHL or BHL displayed several problems within the hearing domain. Fitting of bilateral BAHAs in children with BHL and of a single-sided hearing aid in children with UHL appears to have some supplementary audiological benefits and also renders high patient satisfaction. In order to investigate the possible supplementary effects of hearing aids, a 3-month trial of BAHA on Softband, either unilaterally or bilaterally, may be of value in children with conductive UHL or BHL, respectively.
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Karolinska Institute, Stockholm, Sweden. claudia.priwin@karolinska.se
authors.forename: Claudia
authors.initials: C
authors.lastname: Priwin
authors.forename: Radi
authors.initials: R
authors.lastname: Jönsson
authors.forename: Malou
authors.initials: M
authors.lastname: Hultcrantz
authors.forename: Gösta
authors.initials: G
authors.lastname: Granström
mesh_terms: D000293:Adolescent; D001299:Audiometry; D001309:Auditory Threshold; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006310:Hearing Aids; D006312:Hearing Loss, Bilateral / Q000503:physiopathology / Q000628:therapy*; D006314:Hearing Loss, Conductive / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D009622:Noise; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011446:Prospective Studies; D013065:Speech Intelligibility / Q000502:physiology; D013067:Speech Perception / Q000502:physiology; D011795:Surveys and Questionnaires