Bone Conduction Hearing Aids BAHA 2014, 2018

Unlike conventional hearing aids, bone conduction hearing aids BAHA or devices bypass the apparatus of the middle ear to stimulate the inner ear directly.1 Principle involved is Osseointegration, Read it here.2 BAHA components:3,4(a) Titanium fixture (implant)(b) Titanium abutment(c) Sound processor BONE CONDUCTION HEARING AIDS BAHA Specific Indications Intolerance of conventional hearing aids– Draining ear– Mastoid cavity (feedback)– Topical sensitivityCongenital malformations– Microtia / atresia– Syndromic / sporadicConductive loss in an only hearing earSingle-sided deafness BONE CONDUCTION HEARING AIDS BAHA indications Hearing loss area for patients to benefit from Ponto processors (Oticon) & Baha 4 (Cochlear). BONE CONDUCTION HEARING AIDS BAHA Hearing loss area for patients to benefit from Ponto processors (Oticon) & Baha 4 (Cochlear). OPERATIVE TECHNIQUE1 In adult now done as single stage.In children done in 2 stages (6 months interval) give time for osseointegration.Implant must be performed meticulously and as gently as possible to minimize thermal damage to surrounding bone.The skin penetrated by the implant must be hairless to facilitate keeping the implant site clean.Subcutaneous tissue should be aggressively thinned to minimize skin mobility in relation to the implantPlace the device 50-60mm from the ear canal.Drill a whole in mastoid 3-4mm.At the end place a healing cap onto the abutment.Sound processor is loaded after 12 weeks (in pediatric post single stage place the processor 16 weeks). For complete surgical steps kindly visit-Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery BAHA IN YOUNG CHILDREN Baha recommends the osseointegration procedure in children over the age of 5 years.For children under the age of 5 years in need of bone-conduction hearing, the Baha Softband is available.Higher incidence of nonintegration (avoided by 2 stage surgery)New studies showed even better results with staged surgery in <5 years old Surgical Video - Complications1,2 Wound complications - – Infection/granulation– Overgrowth of soft tissue– Skin graft non-take, Skin site granulation, Sagging and drooping of superior skin, Thickening of subcutaneous tissues Operative complications -– Unable to find bone thick enough– Sigmoid sinus injury– Dural Injury– Facial nerve injury Bone and other complications– Non-osseointegration– Bone fracture, Whistling and feedback, Insufficient power, Skull numbness or pain, Placed too far back Alternatives to BAHA Transcutaneous Bone-Anchored Hearing Devices  Created to avoid the complications of having a percutaneous abutment Instead The implant is magnetically coupled to the external oscillator and transmits vibrations to the skull Same indications as BAHA Alpha 2 Transcutaneous Bone-Anchored Hearing Devices Bonebridge (Med-El) Transcutaneous Bone-Anchored Hearing Devices Dental Appliance–Based Bone-Conduction System  The Sound-Bite. Uses a BTE receiver and sound processor that sends signals to a custom-made, removable, in-the-mouth piezoelectric transducer coupled to the buccal surface of the maxillary molars. Sound-Bite 1. Hagr A. BAHA: Bone-Anchored Hearing Aid. Int J Health Sci (Qassim). 2007;1(2):265-276. https://www.ncbi.nlm.nih.gov/pubmed/21475438. 2. Tjellström A, Håkansson B, Lindström J, et al. Analysis of the Mechanical Impedance of Bone-Anchored Hearing Aids. Acta Oto-Laryngologica. January 1980:85-92. doi:10.3109/00016488009127113 3. Berger K. Early bone conduction hearing aid devices. Arch Otolaryngol. 1976;102(5):315-318. doi:10.1001/archotol.1976.00780100101017 4. Tjellström A, Håkansson B. The bone-anchored hearing aid. Design principles, indications, and long-term clinical results. Otolaryngol Clin North Am. 1995;28(1):53-72. https://www.ncbi.nlm.nih.gov/pubmed/7739869. For more details kindly visit - https://www.cochlear.com/us/en/home/products-and-accessories/baha-system http://www.entdev.uct.ac.za/guides/open-access-atlas-of-otolaryngology-head-neck-operative-surgery/

Bone Conduction Hearing Aids BAHA 2014, 2018

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