title: Site for bone-anchored hearing system for children younger than 5 years.
abstract: OBJECTIVE
  To describe in children younger than the present US FDA-approved 5 years of age the thickest part of the temporal bone available for placement of a bone-anchored hearing system. Children with unilateral hearing loss, as with aural atresia, have deficits in at least language comprehension and oral expression. The early provision of hearing to the atretic ear may minimize the potential for auditory deprivation.
  
  
  METHODS
  Point prevalence descriptive study.
  
  
  METHODS
  Tertiary referral pediatric hospital.
  
  
  METHODS
  Thirty-eight patients less than 6 years old with congenital aural atresia had undergone temporal bone computed tomography (CT). Bone thickness lateral (ie, superficial) to the sinodural angle, in the topmost axial CT slice that included any adjacent petrous ridge, was measured.
  
  
  RESULTS
  The mean bone thicknesses lateral to the sinodural angles of the atretic ears were 5.1, 5.0, 5.9, 5.2, 5.2, and 4.8 mm for the <1, 1-, 2-, 3-, 4-, 5-year-olds, respectively; of the non-atretic ears, thicknesses were 4.1, 4.9, 5.5, 6.7, 4.3, and 4.7 mm.
  
  
  CONCLUSIONS
  Based on this small case series, bone thickness lateral (ie, superficial) to the sinodural angle is sufficient for many children suffering from aural atresia to have bone-anchored hearing devices implanted younger than age 5 years. Use of the sinodural site would require a magnetic bone-anchored hearing system, which could be repositioned posteriorly at age 5 years when pinna construction and atresiaplasty endeavors typically begin.
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Ceisha Chinwe
authors.initials: CC
authors.lastname: Ukatu
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Nilesh Kundanlal
authors.initials: NK
authors.lastname: Desai
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia ntodd@emory.edu.
authors.forename: Norman Wendell
authors.initials: NW
authors.lastname: Todd
mesh_terms: D002675:Child, Preschool; D005260:Female; D006310:Hearing Aids; D046088:Hearing Loss, Unilateral / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011474:Prosthesis Design; D053441:Suture Anchors; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: aural atresia; hearing aid; temporal bone