Bone‐Anchored Hearing Aid Implantation Using the Cochlear BA400 System: Early Experience and Patient‐Reported Outcomes

Abstract

Objectives: Several contemporary bone-anchored hearing aid (BAHA) surgical techniques have been described with the common goal of minimizing soft-tissue reduction, which may benefit patients, surgeons, and audiologists alike. Recently, the hydroxyapatite coated Cochlear BA400 abutment was introduced, the first designed specifically for soft tissue preservation. We present our early experience of this system with corresponding patient-reported outcomes. Methods: Data were collected prospectively on the first 25 patients implanted with the BA400 system at our institution (February-September 2013). The Glasgow Benefit Inventory (GBI) was subsequently used to evaluate patient-perceived quality of life in all patients 4 months following sound processor fitting. Results: Mean patient age was 61 years (range, 23-91 years). BAHA was indicated for single-sided deafness in 6 cases (24%) and for conductive or mixed loss when a conventional aid was contraindicated in the remainder. Procedures were performed under local anaesthetic in all but 1 case. Mean operating time was 14 minutes (range, 9-22 minutes). Four patients (16%) suffered implant site soft tissue reactions which were all successfully managed conservatively and graded as follows: Holger’s grade 1 (n = 2), 2 (n = 1), and 3 (n = 1). No other complications were observed. Respective overall, general health, social support, and physical health GBI benefit mean scores were +33 (95% confidence interval [CI]; 27-39), +46 (95% CI; 37-55), +15 (95% CI; 5-25), and 0 (95% CI; –8 to 8). Conclusions: Our data support use of the soft tissue preserving Cochlear BA400 implant system, with shorter operating times, comparable soft-tissue outcomes, and favorable patient-reported quality-of-life when compared with conventional BAHA implantation techniques.