title: The birmingham pediatric bone-anchored hearing aid program: a 15-year experience.
abstract: OBJECTIVE
  To evaluate the complication rates and outcomes of children who were fitted with a bone-anchored hearing aid (BAHA) on the Birmingham BAHA program.
  
  
  METHODS
  Retrospective case analysis of clinical records of all children implanted at Birmingham Children's Hospital since the beginning of the program in 1992 until February 2007.
  
  
  METHODS
  A total of 182 children younger than 16 years old fitted with a BAHA. Of these children, 107 had a significant medical history.
  
  
  RESULTS
  Surgery was performed as a 2-stage procedure in 174 children. The healing time was between 3 and 4 months in 112 (64%) cases. Single-stage surgery was performed in 8 cases. Implant failures were 14% of 230 loaded fixtures (32 fixtures lost in total). Multiple-fixture failures (18 fixture failures) occurred in 7 patients. Adverse skin reactions appeared in 34 (17%) patients during a 15-year follow-up period. Revision surgery was undertaken in 14 (8%) cases because of skin overgrowth around the abutment. Five of these cases required multiple surgical skin reductions.
  
  
  CONCLUSIONS
  The Birmingham Program has a high proportion of syndromic patients with complex medical problems. The fixture failure rate was found to be 14%. This included the multiple-fixture failures in children younger than 3 years old. There was 1 serious complication. The BAHA is a reliable and effective treatment for selected patients. Our program currently has 97% of its children wearing their BAHA on a daily basis with continuing audiologic benefit.
authors.affiliation: Department of Otolaryngology, Birmingham Children's Hospital, Birmingham, UK. annlouisemcdermott@msn.com
authors.forename: Ann-Louise
authors.initials: AL
authors.lastname: McDermott
authors.forename: Jo
authors.initials: J
authors.lastname: Williams
authors.forename: Michael
authors.initials: M
authors.lastname: Kuo
authors.forename: Andrew
authors.initials: A
authors.lastname: Reid
authors.forename: David
authors.initials: D
authors.lastname: Proops
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004431:Ear, External / Q000293:injuries; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000628:therapy; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D012871:Skin Diseases / Q000453:epidemiology / Q000209:etiology; D016038:Skin Transplantation / Q000009:adverse effects; D017211:Treatment Failure