title: Bone-anchored hearing aids in infants and children younger than 5 years.
abstract: OBJECTIVE
  While bone-anchored hearing aids (BAHAs) are currently indicated for rehabilitation in children older than 5 years with bilateral maximal conductive hearing loss, our objective was to capitalize on potentially important stages of auditory and speech-language development by providing BAHAs to children younger than 5 years.
  
  
  METHODS
  A retrospective review of surgical data of children receiving BAHA implants over a 10-year period.
  
  
  METHODS
  The Hospital for Sick Children, Toronto, Ontario.
  
  
  METHODS
  Twenty children 5 years or younger (mean +/- SD age, 3.21 +/- 1.65 years) served as the study group, while 20 older children (mean +/- SD age, 7.63 +/- 1.55 years) served as the comparison group.
  
  
  METHODS
  All patients received BAHA implants. Children with cortical bone thickness less than 2.5 mm underwent a 2-stage procedure; children with cortical bone thickness greater than 4 mm underwent a single-stage procedure.
  
  
  METHODS
  Traumatic and skin revision complication rates and implantation interstage intervals were compared between groups.
  
  
  RESULTS
  The mean +/- SD interstage interval was 7.72 +/- 3.81 months for the younger children, which was significantly longer than for the older children (4.41 +/- 2.51 months) (P<.003). Two traumatic fixture losses occurred in the younger children, while 4 occurred in the older children. Skin site revision was required in 3 younger children. All children are currently wearing their BAHAs.
  
  
  CONCLUSIONS
  Two-stage BAHA implantation with a prolonged interval between stages yields surgical success in younger children comparable to that routinely observed in older children.
authors.affiliation: Department of Otolaryngology and Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, USA.
authors.forename: Taryn
authors.initials: T
authors.lastname: Davids
authors.forename: Karen A
authors.initials: KA
authors.lastname: Gordon
authors.forename: Doug
authors.initials: D
authors.lastname: Clutton
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin
mesh_terms: D002675:Child, Preschool; D005260:Female; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000534:rehabilitation; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome