Bone anchored hearing aids in children

Bone-anchored hearing devices have evolved over recent years. This article provides an overview of the device history, indications, evolution of surgical technique, evidence for benefit and focuses on the challenges that are faced in the pediatric population.

Bone anchored hearing aids in children: an update

OBJECTIVE

Over recent years, there have been a significant number of publications reporting evolving bone anchored hearing device (BAHD) indications and modifications in surgical techniques. We aim to present a review of recent trends in paediatric BAHD surgery and also discuss alternative treatment options available.

METHODS

All papers referring to paediatric BAHD surgery (English language) were identified from Medline, Pubmed, Cochrane library and Embase search in May 2011. Abstracts were read and relevant papers were obtained.

RESULTS

BAHDs have evolved over recent years as technology has advanced. New bone conduction hearing devices have recently been launched such as the Ponto system [Oticon™], Alpha 1 (M) hearing system [Sophono], Soundbite system [Sonitus] and the Vibrant Soundbridge system [Medel]. Modifications to existing implant systems have significantly altered BAHD practice with earlier loading of the sound processor now a positive step forward.

CONCLUSIONS

The latest generation of percutanous devices have been designed to reduce skin complications, promote better osseointegration and earlier loading of the sound processor. Alternative devices without a skin-penetrating abutment are now available and have shown promising results in the paediatric population.

Bone anchored hearing aids in children

PURPOSE OF REVIEW

Bone anchored hearing aids are an acceptable and now widely available form of aural rehabilitation for both adults and children. Their benefit from both audiological and quality of life perspectives has been very successful to date. The paediatric population presents a variety of challenges to those clinicians who undertake bone anchored hearing aid (BAHA) surgery: medical conditions, anatomical considerations and higher risk of trauma to both abutment and sound processor are just a few common problems. This review aims to highlight the important issues that surround the provision of a BAHA service for children.

RECENT FINDINGS

Over the past 18 months there has been an increase in the number of centres worldwide providing a BAHA service for children. The indications for BAHA in children have evolved. The outcomes and quality of life have proved to be very successful. The surgical techniques are now quite varied and the timing of surgery varies between surgeons. Serious complications are fortunately very rare.

SUMMARY

The bone anchored hearing aid in children is an effective means of aural rehabilitation that has been shown to improve the overall quality of life of the child. Although, it is a 'well tolerated' and relatively 'simple' procedure it is not without risk. A multidisciplinary team approach combined with careful patient selection and an understanding of the problems that present in children should result in a successful outcome for the child.