Young age not a barrier to implanted hearing aids

NEW YORK (Reuters Health) - Age does not appear to be an impediment for implanting hearing aids in children with hearing loss, clinicians at The Hospital for Sick Children in Toronto, Ontario report.

According to Dr. Blake C. Papsin and his associates, the medical literature suggests ages 2 to 4 years as the ideal time for implantation. That way, they explain, patients benefit from earlier speech and language acquisition.

However, treatment at this early age is not common, and the US Food and Drug Administration mandates that patients be at least 5 years old before such surgery is performed.

In a report published this month, Papsin's group details their own experiences in performing these procedures in children as young as 14 months of age between 1996 and 2006. Their cohort included 20 children treated before their fifth birthday and 20 who received the implants after age 5.

All but two patients in the older group underwent 2-stage procedures to allow time for the titanium implant to integrate into the thin bone prior to attaching the external abutment.

Even though younger children required a longer interval for increasing the thickness of the bone before attachment, they still were younger (mean age 4 years) than those in the older group (mean 8 years) when they started using the active bone-anchored hearing aid.

Complications included burial of the fixture by new bone, and thickening of the skin around the graft in response to local infection; this occurred at least 30 months after the stage 2 procedures and could possibly have been prevented by appropriate hygiene and adequate care of the surgical site. Other complications were due to falls or bumps to the head, requiring surgery.

So, in addition to specific guidance regarding hygiene and skin care, Papsin and his associates maintain that parents need to be educated about the need for children to wear helmets during sporting activities, especially when developmental delay is present.

The bone-anchored hearing device is often preferred over a conventional hearing device, the authors point out, because it can be used when the ear canal is malformed, or when chronic ear infections occur. They also note that the bone-anchored device provides better sound quality and reliability.

Thus, given the same surgical success and good audiological outcomes, they contend that age should not be a barrier to early implantation of a bone-anchored hearing aid.

SOURCE: Archives of Otolaryngology Head and Neck Surgery January 2007.