Bone-anchored hearing aids in conductive and mixed hearing losses: why do patients reject them?

Abstract

This study aimed to report the bone-anchored hearing aid uptake rate and the reasons for their rejection by patients with conductive and mixed hearing losses. A retrospective review was performed of 113 consecutive patients with unilateral or bilateral conductive or mixed hearing loss referred to the Greater Manchester bone-anchored hearing aid (BAHA) programme between September 2008 and August 2011. 98 (86.7 %) patients were deemed audiologically suitable for BAHA implantation. Of these, 38 (38.8 %) had BAHA implanted; 60 (61.2 %) patients declined. Of those who declined, 27 (45 %) cited anxiety over surgery, 18 (30 %) cited cosmetic reasons, 16 (26.7 %) perceived limited benefit from the device and six (10 %) preferred conventional hearing aids. Our study highlights a 38.8 % BAHA uptake rate in audiologically suitable patients. The main reasons cited for rejection of BAHA were anxiety over surgery and cosmetic concerns. It is important that clinicians address these early during consultation with prospective BAHA recipients and avoid rushing to implant these patients with a bone-anchored hearing aid.

Speech Understanding and Sound Localization with a New Nonimplantable Wearing Option for Baha

“…Regarding the first of these potential issues, we believe that a new wearing option can be of substantial importance for current and future patients, if it is perceived as attractive by the users. It is known that a significant number of patients chooses not to use or to discontinue the use of bone conduction devices because either a surgical intervention is needed or the nonsurgical wearing option is not aesthetically appealing [ 7 , 24 , 25 ]. It is therefore not surprising that at least one other manufacturer has presented a new nonsurgical alternative to implantable bone conduction devices recently [ 26 ].…”

Bonebridge transcutaneous bone conduction implant in children with congenital aural atresia: surgical and audiological outcomes

“…Siau et al . reported that 30 per cent of patients who were eligible for a BAHA rejected BAHA implantation because of cosmetic concerns, including the size of the abutment and subsequent hair loss 12 …”

Understanding the low uptake of bone-anchored hearing aids: a review

“…In a study of BAHA-eligible patients with conductive and mixed hearing loss, similar findings were reported: 38 (39 per cent) accepted implantation and 60 (61 per cent) declined. When the sample was divided into patients with unilateral or bilateral hearing problems, acceptance rates were 64.2 per cent ( n = 27) and 19.6 per cent ( n = 11) respectively 6 …”

“…In another study of a conductive and mixed hearing loss sample, Siau et al . found the most common reasons for rejection to be anxiety about the surgery (reported by 27 patients; 45 per cent), cosmetic concerns ( n = 18; 30 per cent) and insufficient benefit during a softband trial ( n = 16; 27 per cent) 6 . While Siau and colleagues provide some indication of the reasons for declining, neither study was specifically designed to explore the reasons for refusal: instead, these were gleaned from clinical notes.…”