Miniseminar: Bone-anchored hearing AIDS (BAHA) in children

Abstract

BAHA is today a well-accepted treatment modality in adults and it has received FDA approval for use in children above the age of 5 years. The educational objectives of this miniseminar are to present the current status of the use of BAHA in children. The panel will discuss:(1) indications and contraindications; (2) selection of patients; (3) surgical procedure; (4) handling of complications; and (5) postop treatment. In the panel there are surgeons with extensive experience in the treatment of children with external ear canal atresia. Topic to be discussed include when an ear canal reconstruction should be recommended and when a BAHA may be a better alternative. The recommendation of timing between BAHA vs external ear reconstruction/implant retained auricular prosthesis will be covered. The use of BAHA in single-sided conductive loss and experience with bilateral BAHA in children will also be discussed together with the special surgical considerations in children. The panelists will present their view on how to handle the soft and thin bone in the mastoid of the child and how to proceed if the dura of the middle cranial fossa is exposed; the wall of the sigmoid sinus is damaged; or if the air-cells of the mastoid process are entered. Additionally, how to increase bone volume with the use of membrane technique will be described. The importance of soft tissue handling during surgery and pointers and pitfalls will be discussed. The seminar will also cover postop and follow-up routines.