Successes and Complications of the Baha System

Otolaryngology - Head and Neck Surgery, 2010

To evaluate the effectiveness of the Baha system in cases of single-sided deafness (SSD) and mild to moderate hearing loss in the better-hearing ear. STUDY DESIGN: Prospective trial. SETTING: Tertiary otologic referral center. SUBJECTS AND METHODS: Twenty-one patients with SSD and mild to moderate hearing loss in the contralateral ear implanted with the Baha system between June 2006 and March 2008 were evaluated following Baha implantation and fitting with the Divino and Intenso processors. Pure-tone air and bone conduction thresholds, sound-field testing (aided and unaided in quiet and noise) of consonant nucleus consonant words (Northwestern University Auditory Test No. 6 words), and Hearing in Noise Test sentences were obtained. Patient satisfaction questionnaires were administered pre-and post-intervention for either device. RESULTS: Patients with SSD and mild to moderate hearing loss in the contralateral ear showed a statistically significant improvement in all measures with the use of the Divino or Intenso processors compared with the unaided situation. Change in hearing, as measured in noise testing word recognition scores, revealed a statistically significant difference between the two aided conditions favoring the Intenso (P Ͻ 0.05). The Glasgow Benefit Inventory revealed that 91 percent of the patients reported improvement in their quality of life and would recommend the procedure to others. CONCLUSION: The Baha system is effective in the rehabilitation of patients with SSD and mild to moderate hearing loss in the only hearing ear. Results of the current study suggest that either the Divino or Intenso processor was successful in reestablishing hearing from the deafened side.

European Archives of Oto-Rhino-Laryngology, 2008

We compared the indices of satisfaction and use among patients wearing an osseo-integrated prosthesis BAHA (bone anchored hearing aid) according to the indications: conductive or mixed hearing loss (CHL) and patients with single side deafness (SSD). The study was carried out among patients wearing a BAHA Wtted in one of three French departments between November 2001 and November 2005. Each patient received a postal questionnaire relating to the ease of use and the daily utilization period of the prosthesis, as well as a satisfaction rating (from 1 to 10) evaluating improvement in quality of life, overall satisfaction, improvement in sound localization and satisfaction from the aesthetic point of view. In total, 170 out of 231 patients responded to the questionnaire (response rate of 73.5%). The average age at the time of Wtting of the BAHA was 56 years (18-79 years). The SSD group was composed of 118 patients (69.4%): 92 following surgery for vestibular schwannoma, 2 following surgery for meningioma and 24 with "other" causes (e.g. idiopathic sudden deafness, sensori neural hearing loss complicating surgery of the middle ear). The CHL group was composed of 52 patients (30.5%): 44 patients with a chronic otitis and 8 with a malformation of the middle ear. The average duration of use of the prosthesis was 22 months (3-72 months). The average utilization period was higher than 8 h per day in 48.5% of cases. There was a signiWcant diVerence between the two groups concerning the quality of life (p < 0.0001), general satisfaction (p < 0.0001) and sound localization (p < 0.01). There was no signiWcant diVerence concerning aesthetics. Among the patients of the CHL group, the levels of satisfaction and quality of life are comparable with recent data in the literature with scores of good or very good. The BAHA thus remains one of the methods of choice for hearing rehabilitation in this group of patients. Among the patients of the SSD group, the levels of satisfaction and quality of life are signiWcantly poorer than in the CHL group, but remain generally good with the exception of sound localization.The treatment of SSD patients with a BAHA is interesting. A study comparing the BAHA with the WIFI CROS system is justiWed in order to ascertain the respective advantages of these two treatment options.

2000

Bone Anchored Hearing Aid has advantages when compared to conventional bone conduction devices. Conventional bone conduction devices have some problems like skin irritation for the constant pressure, the aesthetics that is extremely bad and the difficulty of maintaining the device in children, because it is easily removable. Other indications are chronic draining ears, wall down mastoidectomyte and external otitis. The

European Archives of Oto-Rhino-Laryngology, 2012

A bone-anchored hearing aid (Baha) is used in patients with single-sided sensorineural deafness (SSD) to overcome the head shadow eVect. Of all the patients with SSD, treated at our hospital, 196 patients used a Baha on trial between November 2001 and April 2010. The objective of this study is to evaluate what factors determine the decision of a SSD patient whether or not to opt for a Baha device following a Baha trial period. 196 patients with SSD were enrolled for a trial period of 2 weeks at the Antwerp University Hospital, a tertiary referral centre. 93% of these patients suVered from an acquired hearing loss. 44% of all the patients (87/196) chose to wear a Baha device after the trail period, either on an abutment or on a headband. The collected data were analysed to determine correlations between the decision of a patient following a Baha trial period on the one hand, and Fletcher Index ipsi-and contralaterally, bone conduction hearing thresholds at the better hearing ear, aetiology, age at the start of the trial period, duration of hearing loss at the start of the trial period and the type of device used during the trial period, on the other hand. Although 66% of all the patients (109/196) declined the Baha after a trial, reasons not to choose a Baha were diverse and no crucial factors could be found that determine the success of a Baha trial period. Lack of improvement concerning speech understanding in noise was the most important reason mentioned by patients who declined the Baha. The authors advocate that all patients, suVering from SSD, should be oVered the opportunity to try a Baha device as no factors could be found that determine the decision of a patient following the trial period.

Otology & Neurotology, 2001

Otology &amp; Neurotology, 2008

To analyze the short-, medium-, and long-term benefits from and satisfaction with the Baha for patients with profound unilateral sensorineural hearing loss (SNHL). Design: Prospective clinical study. Setting: Head and Neck Institute at the Cleveland Clinic. Patients: Eight patients with acquired profound unilateral SNHL. Interventions: Patients underwent unaided baseline testing and aided Baha testing using laboratory and self-report measures at 6 postfitting intervals. Main Outcome Measures: Laboratory measures included the revised Speech Perception in Noise test, Hearing in Noise Test, and localization testing. Disease-specific self-report measures included the Abbreviated Profile of Hearing Aid Benefit, Hearing Handicap Inventory for Adults, and Single-Sided Deafness Questionnaire. The Medical Outcomes Study SF-36 Health Survey was used to assess health-related quality of life. Results: Based on 95% confidence intervals for unaided testing, significant improvements on aided revised Speech Perception in Noise, Abbreviated Profile of Hearing Aid Benefit, and Hearing Handicap Inventory for Adults scores were sustained during the 18-month test interval. Variable performance was observed for the Hearing in Noise Test over time and patients. No acclimatization effects were shown for localization testing or the generic health-related quality-of-life measure. Patients reported satisfaction in a variety of situations as quantified by the Single-Sided Deafness Questionnaire in the long-term. Conclusion: The Baha is effective in reducing psychosocial consequences of unilateral profound SNHL for the long-term. Improvement in speech understanding occurred when the primary signal was spatially separated from background noise. Localization performance did not improve with Baha use. Overall, patients were satisfied with their Baha and would still elect to have this procedure if given a second chance.

Clinical Otolaryngology and Allied Sciences, 1999

The BAHA HC200/300 in comparison with conventional bone conduction hearing aids A retrospective study was performed on 78 patients from a consecutive series who received a BAHA HC199:299 after having previously used conventional bone conduction hearing aids[ The patients| performance with the BAHA HC 199:299 was compared to their performance with conventional bone conduction hearing aids[ The patients were divided into two groups\ depending on the time of implantation "before or after May 0881#[ The patients in group 0 "long!term users# were asked to _ll in a questionnaire\ the same one as they had _lled in at the initial BAHA _tting more than 4 years previously[ The answers were compared to their original opinions and di}erence scores were calculated[ The long!term clinical results from group 0 are also presented[ Although they are encouraging\ the patients| opinion about the BAHA deteriorated somewhat over time[ The audiometric results of group 1 were highly comparable with those of group 0[ This con_rms the positive results with the BAHA found in previous studies[ Keywords bone!anchored hearin`aid bone conduction hearin`aid hearin`loss speech reco`nition sound quality

Seminars in Hearing, 2010

An implantable bone conduction hearing system such as the Baha auditory osseointegrated implant is one amplification choice for patients with single-sided deafness (SSD). Several published reports outline the benefits that Baha provides for speech recognition in noise as well as subjective preference. Recent advances in Baha sound processor technology (e.g., Cochlear Baha BP100) provide technological advantages specifically for persons with SSD. In particular, fitting software is now used to measure in situ bone conduction thresholds through the Baha sound processor and to individually prescribe amplification settings based on the patient's hearing loss and degree of transcranial attenuation. Additionally, technology such as automatic directional microphones and noise reduction systems may provide improved hearing in noise solutions for patients with SSD. This article reviews the research on Baha for SSD and presents data on the advantages for this patient population using new features available in the Baha BP100 sound processor.

Indian Journal of Otolaryngology and Head & Neck Surgery, 2013

Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.

International archives of otorhinolaryngology, 2012

The bone-anchored hearing aid (BAHA) is a bone conduction hearing device that transmits sound directly into the inner ear. It is mainly used in patients with conductive hearing loss associated with aural atresia, but it is also used in those with mixed and sensorineural hearing loss. To review the main indications for BAHA, to analyze the audiometric results and its benefits for patients and compare them with other treatment modalities, and to compare the literature data with our sample of 13 patients. The research was performed using a database covering works in English, Spanish, and Portuguese, with no limitations in the years when the procedures were performed. We compared the literature data with our results for the 13 patients who underwent BAHA implantation between the years 2000 and 2009. Most of the studies showed that BAHA has great advantages over reconstructive surgery in terms of hearing results, complications, and disease recurrence. The postoperative results for ou...