Service ORL pédiatrique, CHU de la Timone, université de la Méditerranée, 264, rue St-Pierre, 13385 Marseille cedex 05, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Nov;128(5):253-8. doi: 10.1016/j.anorl.2011.04.005. Epub 2011 Sep 28.
After more than 20 years of clinical experience in children, bone-anchored hearing aids, essentially BAHA(®), have become the standard treatment for conductive or mixed hearing loss. Based on a general review of the literature and the authors' own experience, this article reviews the use of bone-anchored hearing aids in children. The main indications for bone-anchored hearing aids are a minimum age of 5 years at the time of implantation and/or cortical bone thickness ≥ 3 mm. Fixture loss is observed in 40% of children under the age of 5 years versus 8% for children aged 5 to 10 years and 1% for children over the age of 10 years, i.e. identical to the rate observed in adults. Skin complications are similar to those observed in adults and must be prevented by parental education and regular follow-up. Surgery is generally performed in two stages or as a one-stage procedure for fixtures ≥ 4 mm. The functional success rate, correlated with medium- and long-term use of BAHA(®) is about 96%. BAHA(®) may be indicated in children with profound unilateral hearing loss following a trial period wearing a BAHA(®) headband for several weeks with the child's active participation. Sequential bilateral implantation requires complementary investigations and appears to provide improved perception in noise. This type of hearing aid provides an improvement of the quality of life of children with bilateral conductive and/or mixed hearing loss which should be further improved as a result of recent technical developments.
经过 20 多年的儿童临床经验，骨锚式助听器（BAHA）已成为传导性或混合性听力损失的标准治疗方法。本文基于文献综述和作者的经验，回顾了骨锚式助听器在儿童中的应用。骨锚式助听器的主要适应证为植入时年龄至少为 5 岁，或皮质骨厚度≥3mm。5 岁以下儿童的固位器丢失率为 40%，而 5-10 岁儿童为 8%，10 岁以上儿童为 1%，与成人观察到的丢失率相同。皮肤并发症与成人相似，必须通过家长教育和定期随访来预防。手术通常分两期进行，或对于≥4mm 的固位器进行一期手术。BAHA（R）的功能成功率与中、长期使用相关，约为 96%。在经过数周 BAHA（R）头带主动佩戴试验后，对于单侧重度听力损失的儿童，可以考虑使用 BAHA（R）。对于双侧传导性和/或混合性听力损失的儿童，序贯双侧植入需要进行补充检查，并且似乎可以改善噪声下的感知。这种类型的助听器可以提高双侧传导性和/或混合性听力损失儿童的生活质量，并且由于最近的技术发展，这种质量还会进一步提高。
