title: Bone-anchored hearing aid: why do some patients refuse it?
abstract: OBJECTIVE
  Bone-anchored hearing aid (BAHA™) is a proven tool to improve hearing. Nevertheless, there are patients who are candidates for BAHA™ implants that end up refusing the surgery. The objective of this study is to review our BAHA™ experience with particular emphasis on reasons behind the refusal of some candidates.
  
  
  METHODS
  A prospective cohort of 100 consecutive new candidates referred to The BAHA™ program in a tertiary health care center. Candidates' demographics, hearing status, Co-morbidities and audiometeric tests were all recorded. Patients' acceptance or refusal was noted alongside the reasons to refuse BAHA™.
  
  
  RESULTS
  100 new candidates were seen for BAHA™ assessment, 10 patients were excluded due to incomplete data. There were 68 children and 22 adults. Unilateral Conductive Hearing Loss was the most common reason for consultation (40%), followed by unilateral SNHL (23.3%). Aural Atresia was the commonest clinical finding (36.6%). The commonest reason for refusal was social acceptance by the parents due to concern with cosmesis.
  
  
  CONCLUSIONS
  The main reason of BAHA™ surgery refusal, in otherwise eligible candidates, is related to cosmesis. Patients with congenital anomalies were the most likely candidates to accept BAHA™ implants.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada.
authors.forename: Faisal
authors.initials: F
authors.lastname: Zawawi
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Kabbach
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Lallemand
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada. Electronic address: sam.daniel@mcgill.ca.
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Daniel
mesh_terms: D000328:Adult; D001504:Beauty; D002648:Child; D015331:Cohort Studies; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000628:therapy*; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D011446:Prospective Studies; D019736:Prostheses and Implants; D053441:Suture Anchors; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology*
keywords: BAHA; Candidacy; Cosmetic; Hearing loss