title: Nijmegen results with application of a bone-anchored hearing aid in children: simplified surgical technique.
abstract: OBJECTIVE
  A retrospective analysis was performed to evaluate the clinical outcome of percutaneous bone-anchored hearing aid (BAHA) application in children with the outcome measures of fixture loss and skin reactions.
  
  
  METHODS
  An analysis was done of 93 of the 101 children 16 years of age or younger who underwent the simplified Nijmegen surgical technique between January 1994 and July 2007.
  
  
  RESULTS
  Twenty-one of 129 fixtures (16.3%) were lost or removed. In 12 cases, osseointegration failed. The majority of the fixture losses (86%) occurred within 1 year after surgery. No differences were found between 3 age groups or between fixture lengths (seven 3-mm implants versus fourteen 4-mm implants). The BAHA fixtures were less stable in children than in adults. In 8 cases, Holgers grade 4 skin reactions were noted at an average (+/-SD) of 5.5 +/- 4.7 months after surgery, ie, significantly sooner than the milder reactions (p = 0.001). In 28 cases (22%), skin reactions of Holgers grades 2 to 4 were observed. Revision surgery to reduce subcutaneous scar tissue was necessary in 22 implants (17%).
  
  
  CONCLUSIONS
  Fixture loss was more frequent in children than in adults. The age of the child and the length of the fixture did not appear to influence fixture stability. Children should undergo frequent checkups at the outpatient clinic.
authors.affiliation: Department of Otorhinolaryngology, Donders Center of Neuroscience, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Maarten J F
authors.initials: MJ
authors.lastname: de Wolf
authors.forename: Myrthe K S
authors.initials: MK
authors.lastname: Hol
authors.forename: Patrick L M
authors.initials: PL
authors.lastname: Huygen
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; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000601:surgery*; D006801:Humans; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome