The current practice trends in pediatric bone-anchored hearing aids in Canada: a national clinical and surgical practice survey

BACKGROUND: Since the introduction of bone-anchored hearing aids (BAHAs) in the 1980s, the practices of surgeons who implant these hearing aids have become varied; different indications and surgical techniques are utilized depending on the surgeon and institution. The objective of the current study is to describe the clinical and surgical practices of otolaryngologists in Canada who perform pediatric BAHA operations. METHODS: A detailed practice questionnaire was devised and sent to all members of the Canadian Society of Otolaryngology-Head and Neck Surgery. Those who performed pediatric BAHA surgeries were asked to participate. RESULTS: Twelve responses were received (response rate of 80%). All of the respondents identified congenital aural atresia to be an indication for pediatric BAHAs. Other indications were chronic otitis externa or media with hearing loss (92%), allergic reactions to conventional hearing aids (75%), congenital fixation or anomaly of ossicular chain (67%), and unilateral deafness (25%). Minor complications, such as skin reactions, were reported in 25% of cases, while major complications were very rare. There was great variability with regards to surgical techinque and post-operative management. The extent of financial support for the BAHA hardware and device also varied between provinces, and even within the same province. CONCLUSION: There is a lack of general consensus regarding pediatric BAHA surgeries in Canada. With such a small community of otolaryngologists performing this procedure, we are hopeful that this survey can serve as an impetus for a national collaboration to establish a set of general management principles and inspire multi-site research ventures

A NEW MEASURE FOR DETERMINING THE DEGREE OF ABNORMALITY OF PSYCHOPHYSICAL TUNING CURVES IN HEARING-IMPAIRED SUBJECTS

Psychophysical tuning curves were determined in hearing-impaired and normal-hearing subjects. Frequency selectivity, determined from the tuning curves of the hearing-impaired, decreased with increasing hearing impairment. As this may be attributed to the subjects' hearing impairment as well as to the inevitably higher test (probe)-tone level, we also collected psychophysical tuning curves from normal-hearing subjects as a function of test-tone level. Their frequency selectivity also decreased with test-tone level, but to a lesser degree. This indicates a real decrease in frequency selectivity in hearing-impaired subjects. Two measures were used to describe frequency selectivity, the d1oct and the newly introduced AALD. The latter is the average absolute difference in masker levels between the individual's psychophysical tuning curve and the average normal tuning curve, obtained at the same test-tone level. The AALD turned out to be a more sensitive tool for measuring pathological frequency selectivity than the d1oct

Does the bone-anchored hearing aid have a complementary effect on audiological and subjective outcomes in patients with unilateral conductive hearing loss?

Item does not contain fulltextOBJECTIVES: To study the effect of a bone-anchored hearing aid (BAHA) in patients with unilateral conductive hearing loss. STUDY DESIGN: Prospective evaluation on 18 subjects. METHODS: Aided and unaided binaural hearing was assessed in the sound field using a sound localization test and a speech recognition in noise test with spatially separated sound and noise sources. The patients also filled out a disability-specific questionnaire. PATIENTS: 13 out of the 18 subjects had normal hearing on one side and acquired conductive hearing loss in the other ear. The remaining 5 patients had a unilateral air-bone gap and mild symmetrical sensorineural hearing loss. RESULTS: Sound localization with the BAHA improved significantly. Speech recognition in noise with spatially separated speech and noise sources also improved with the BAHA. Fitting a BAHA to patients with unilateral conductive hearing loss had a complementary effect on hearing. Questionnaire results showed that the BAHA was of obvious benefit in daily life. CONCLUSIONS: The BAHA proved to be a beneficial means to optimize binaural hearing in patients with severe (40-60 dB) unilateral conductive hearing loss according to audiometric data and patient outcome measures