title: Complications of bone-anchored hearing aids in pediatric patients.
abstract: OBJECTIVE
  To describe the range and rate of complications related to bone-anchored hearing aids in pediatric patients.
  
  
  METHODS
  We conducted a retrospective review all children 16 years of age or less who were implanted with a bone-anchored hearing aid from 2002 to 2009. The main outcome measures were post Baha(®) implantation complications including infection, soft tissue hypertrophy, loss of osseointegration, and need for further surgery.
  
  
  RESULTS
  Thirty-one patients were identified and 27 had sufficient follow up for complete analysis. Soft tissue reactions were seen in 24 patients (89%), half of which were considered minor. Ten patients (37%) had major complications defined as requiring revision surgery or removal of the implant. Soft tissue overgrowth and infection at the abutment required removal in 5 children (19%) and three implants (11%) failed to osseointegrate. Recurrent antibiotic treatment was required in eight patients (30%). Seven patients (26%) had a history of trauma and one of them lost the implant. To date, three of the children (11%) have been unable to use the device because of chronic infection and overgrowth of the abutment. There was a statistically significant increased risk for major complications in patients from socioeconomically deprived backgrounds and obesity appears to incur additional risk.
  
  
  CONCLUSIONS
  Complications of bone-anchored hearing aid implants are common in our experience and obesity and socioeconomic factors appear to contribute to a higher risk for complications. Frequent follow up and meticulous care of the implant site may minimize complications but can be challenging in this population.
authors.affiliation: Department of Paediatric Otolaryngology, Starship Children's Hospital, Park road, Grafton, Private Bag 92 024 Auckland, New Zealand.
authors.forename: Tania
authors.initials: T
authors.lastname: Kraai
authors.forename: Colin
authors.initials: C
authors.lastname: Brown
authors.forename: Michel
authors.initials: M
authors.lastname: Neeff
authors.forename: Kate
authors.initials: K
authors.lastname: Fisher
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017439:Cicatrix, Hypertrophic / Q000453:epidemiology; D005260:Female; D006310:Hearing Aids / Q000009:adverse effects*; D034381:Hearing Loss / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D016348:Osseointegration; D012086:Reoperation; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D053441:Suture Anchors / Q000009:adverse effects*