Audiology and Otology Unit, ENT Department, Bambino Gesù Children Hospital, Vatican City, Rome.
Eur Arch Otorhinolaryngol. 2012 Feb;269(2):467-74. doi: 10.1007/s00405-011-1689-5. Epub 2011 Jul 8.
The "Bambino Gesù" Children's Hospital offers the largest Italian cohort of children using a BAHA. This paper retrospectively reviews the center's experience with pediatric BAHA from its start in 1995 to December 2009, especially focusing on most debated issues, all the way from candidate selection to functional outcome and complications. A total of 47 children (21 females and 26 males) were implanted. From 1995 to 2000, a two-stage procedure was adopted in 100% (n = 22) cases. From 2001 onwards, one-stage surgery was chosen for 10 patients. Implant loss occurred in two patients (4.2%) after a two-stage surgery. Overall, the local complication rate was not different in the one-stage and in the two-stage group. The functional gain was significantly better with BAHA than conventional bone-conduction hearing aids and there was no significant difference in terms of functional outcome between the seven patients receiving a BAHA at an age younger than 5 years and the rest. The study results suggest that children presenting an indication to auditory rehabilitation with BAHA should be referred to specialized tertiary care centers. Only in such settings, a complete, multidisciplinary approach to associated comorbidities and syndromes is possible, and implantation of children at an age younger than five and one-stage surgery can be conducted safely and effectively.
“Bambino Gesù”儿童医院为使用 BAHA 的意大利最大儿科患儿群体提供服务。本文回顾了该中心自 1995 年至 2009 年 12 月期间使用 BAHA 的经验，重点关注从候选者选择到功能结果和并发症的所有最具争议性问题。共有 47 名儿童（21 名女性和 26 名男性）接受了植入手术。1995 年至 2000 年期间，100%（n = 22）的病例采用了两阶段手术。从 2001 年起，有 10 名患者选择了单阶段手术。两阶段手术后，有 2 名患者（4.2%）出现植入物丢失。总体而言，单阶段和两阶段组的局部并发症发生率没有差异。BAHA 的功能增益明显优于传统骨导助听设备，且在年龄小于 5 岁接受 BAHA 的 7 名患者和其余患者之间，功能结果没有显著差异。研究结果表明，有 BAHA 听觉康复适应证的儿童应转介至专门的三级护理中心。只有在这种环境下，才能对相关合并症和综合征进行全面的多学科处理，并且可以安全有效地对年龄小于 5 岁的儿童进行单阶段手术和植入。
