The Birmingham Pediatric Bone-Anchored Hearing Aid Program: A 15-Year Experience
The Birmingham Pediatric Bone-Anchored Hearing Aid Program: A 15-Year Experience
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DOI：
10.1097/mao.0b013e31818b6271
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发表时间：
2009-02-01
影响因子：
2.1
通讯作者：
Proops, David
中科院分区：
文献类型：
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作者：
McDermott, Ann-Louise;Williams, Jo;Proops, David
目标：为了评估的并发症发生率和结果的儿童谁是安装了骨锚式助听器（BAHA）的伯明翰BAHA program.Study设计：回顾性病例分析的临床记录，所有儿童植入在伯明翰儿童医院自1992年开始的程序，直到2007年2月。患者：共182名儿童年龄小于16岁，安装了BAHA。在这些儿童中，107有显着的病史。结果：手术进行了2阶段的程序在174名儿童。愈合时间3 ~ 4个月者112例（64%）。8例行一期手术。植入物失效率为230个加载固定装置的14%（共丢失32个固定装置）。7例患者发生多个固定装置失效（18个固定装置失效）。在15年的随访期内，34例（17%）患者出现皮肤不良反应。14例（8%）因基台周围皮肤过度生长而进行了翻修手术。其中5例需要多次手术皮肤reductions.Conclusion：伯明翰计划有很高比例的综合征患者复杂的医疗问题。夹具失效率为14%。这包括3岁以下儿童的多个固定装置失效。有1例严重并发症。BAHA对于选定的患者是一种可靠有效的治疗方法。我们的项目目前有97%的儿童每天佩戴BAHA，并持续获得听力益处。
Objective: To evaluate the complication rates and outcomes of children who were fitted with a bone-anchored hearing aid (BAHA) on the Birmingham BAHA program.Study Design: Retrospective case analysis of clinical records of all children implanted at Birmingham Children's Hospital since the beginning of the program in 1992 until February 2007.Patients: A total of 182 children younger than 16 years old fitted with a BAHA. Of these children, 107 had a significant medical history.Results: Surgery was performed as a 2-stage procedure in 174 children. The healing time was between 3 and 4 months in 112 (64%) cases. Single-stage surgery was performed in 8 cases. Implant failures were 14% of 230 loaded fixtures (32 fixtures lost in total). Multiple-fixture failures (18 fixture failures) occurred in 7 patients. Adverse skin reactions appeared in 34 (17%) patients during a 15-year follow-up period. Revision surgery was undertaken in 14 (8%) cases because of skin overgrowth around the abutment. Five of these cases required multiple surgical skin reductions.Conclusion: The Birmingham Program has a high proportion of syndromic patients with complex medical problems. The fixture failure rate was found to be 14%. This included the multiple-fixture failures in children younger than 3 years old. There was 1 serious complication. The BAHA is a reliable and effective treatment for selected patients. Our program currently has 97% of its children wearing their BAHA on a daily basis with continuing audiologic benefit.