Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back
Rate ePoster

Otology/Neurotology

(060) BAHA Long-term Results: Sensorineural Hearing Loss and Quality of Life

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Sara-Ivana Calce, MD

    Resident Physician
    University of Montreal Hospital Center
    Montreal, Quebec, Canada

    • Senior Author(s)

  • Issam Saliba, MD, FRCSC

    Professor of Otology, Neurotology & skull base surgery
    University of Montreal Hospital Center (CHUM)
    Montreal, Quebec, Canada

    • Co-Author(s)

  • Joe Saliba, MD, MSc

    Assistant Professor, Neurotology and Skull Base Surgery
    University of Montreal Hospital Center
    Montreal, Quebec, Canada

Disclosure(s):
Sara-Ivana Calce, MD: No relevant relationships to disclose.
Joe Saliba, MD, MSc: No relevant relationships to disclose.


Introduction: In unilateral SNHL, sound localisation and understanding speech in noise are lost as BAHAs transmit the sound transcranially to the contralateral healthy cochlea. The objective was to determine if SNHL was associated to a negative experience with the BAHA.

Methods: Tertiary care monocentric retrospective chart review of adults operated for a BAHA implant between 2002 and 2021. Surveys on subjective hearing assessment (APHAB) and quality of life (GBI) were sent by e-mail. Cochlear reserve was assessed by calculating preoperative pure tone audiometry (PTA) for air and bone conduction (average of masked thresholds detected at 500 Hz, 1k Hz, 2k Hz and 3k Hz), as well as air bone gaps (ABG). Hypoacusis etiology, processor use, and a Kaplan Meier curve with cox regressions of surgical removal of the abutment were assessed.

Results: Patients (n = 167 ears) were followed for an average of 8.3 years (range = 0.5-20.9). For every 10dB increase in preoperative ABG in both ipsilateral (odds ratio [95% CI] = 0.78 [0.62-0.97], p = 0.023) and contralateral (0.68 [0.55-0.84], p < 0.001) ears, there was a lower association with continuous BAHA processor use. For every 10dB rise in preoperative PTA bone conduction in ipsilateral (1.19 [1.03-1.36], p = 0.015) and contralateral ear (0.75 [0.61-0.94], p = 0.011), there is respectively an increase and decrease in continuous processor use. The same augmentation in PTA air conduction shows similar results. Concomitantly, all these variables were significantly associated with a higher deliberate cessation of processor use. None were correlated to an earlier surgical removal of the abutment. APHAB scores with Pearson correlations show that increases in preoperative ABG were positively correlated to ease of communication (EC) in both ears, yet negatively correlated with background noise (p < 0.05). EC scores were lower in SNHL etiologies compared to conductive or mixed etiologies (one-way ANOVA with p-values ranging from 0.022 to < 0.001).

Conclusions: SNHL and increased ABG in mixed hearing loss are associated with a negative experience with the BAHA as well as an increased risk of ceased processor use.