Bone Anchored Hearing Aid Surgery

Introduction
  • Bone anchored hearing aid (BAHA) consists of a titanium screw that becomes osseointegrated in the skull bone behind the ear
  • It is the only US-FDA approved bone conduction rehabilitation device available for clinical use
  • An active bond between tissue and implant is created without capsule formation.The implant is not only accepted, but incorporated into the bone

Candidacy for BAHA
  • Patients using conventional bc hearing aid
  • Conventional ac hearing aid users with
  • ○ Chronic otorhoea
    ○ Chronic otitis media / externa
    ○ Uncontrollable discharge due to radical mastoidectomy or large meatoplasty
  • Otosclerosis, tympanosclerosis, canal atresia with a contraindication to repair for eg.
  • ○ Only hearing ear
    ○ Combination with above mentioned diseases
  • Single sided deafness with better ear BC-PTA better than 45 db and sds>60%

Pre Operative Evaluation
  • BC-PTA & SDS
  • Aided audiograms in patients previously using hearing aids
  • CT scan of temporal bone to assess bone thickness

Types of BAHA procedure
  • BAHA SOFTBAND
  • BAHA TWO-STAGE
  • BAHA FAST

Where to insert implant
  • 50-55mm posterior to the external auditory canal
  • On or just below the linea temporalis
  • Ideal location – thin , relatively immobile skin, sufficiently posterior so that processor will not touch the pinna

Post operative considerations
  • Post operative speech therapy
  • Post operative rehabilitation of the patient in society

Benefits of BAHA
  • Works independently of ear canal and middle ear
  • Direct transmission gives clear and natural sound
  • Preoperative testing possible
  • High wearing comfort
  • Safe and minor surgery
  • Predictable outcome