Bone anchored hearing aids (BAHA)

A bone anchored hearing aid (BAHA) is similar to other hearing aids, but instead of being inserted into the ear canal or held behind the ear, it is fixed to an implant in the skull. This implant is inserted in an operation under general anaesthetic, usually in two stages around three to four months apart.

A BAHA works by conducting sound through the skull bone to the inner ear. It is usually suggested for children with significant hearing loss who cannot use conventional in the ear, or behind the ear, hearing aids. It is also suggested for children who have auditory canal atresia, which is a condition where the ear canal does not form properly in the womb.

The first stage

The first stage is the operation to insert the fixtures into the skull bone.

What happens before the operation?

You will receive information about how to prepare your child for the operation in your admission letter. The doctors will explain the operation in more detail, discuss any worries you may have and ask you to give permission for the surgery by signing a consent form. Another doctor will also visit you to explain about the anaesthetic. If your child has any medical problems, particularly allergies, please tell the doctors about these. Please also bring in any medicines your child is currently taking.

What does the operation involve?

Once your child is under general anaesthetic, the surgeon will make a small incision (cut) behind the ear and insert two titanium fixtures into the bone. The incision is closed with dissolvable stitches and covered with a head bandage. The head bandage applies pressure to the operation site and reduces the risk of bleeding.

Are there any risks?

Every anaesthetic carries a risk but this is small. There is a risk of bleeding and possible infection, but we will give your child a course of antibiotics to reduce this risk. Please complete the course even if your child is feeling better. Your child may be uncomfortable after the operation, but we will give them pain relief as needed.

What happens afterwards?

Most children usually stay overnight after the operation. The large head bandage will be removed the following morning and if they are recovering well, they will be able to go home. You should keep the operation site clean and dry until it has healed. The stitches will dissolve on their own so do not need to be removed. Your child should avoid any contact sports after the operation.

Your child will need to come back to Great Ormond Street Hospital (GOSH) two to three weeks after the operation for a check up to make sure they are recovering well. At this appointment, the surgeon will book the second stage operation.

The second stage

This operation is planned for three to four months after the first operation. The aim is to attach a fitting to the titanium fixtures (called the abutment) to which the hearing aid can be attached.

What happens before the operation?

The preparation for the second operation is the same as for the first stage, as detailed above.

What does the operation involve?

Once your child is under general anaesthetic, the surgeon will re-open the incision from the first operation and connect the abutment to the fixtures through the skin. They will close the incision with stitches, but these are a different type so will need to be removed a week or so after the operation.

Are there any risks?

As with the first operation, there is a risk of bleeding and infection. It is also likely that your child may develop a bruise around the abutment. This is normal but can be uncomfortable so we will give your child pain relief as needed.

What happens afterwards?

As with the first operation, most children usually stay overnight after the operation. The large head bandage will be removed the following morning and if they are recovering well, they will be able to go home. You should keep the operation site clean and dry until it has healed. Your child should avoid any contact sports after the operation.

Your child will need to come back to GOSH one week after the operation, to have the dressing changed and the stitches removed. They will then have another appointment two weeks afterwards to remove the dressing. After three to four weeks, they will have a general check up appointment with the surgeon, with the aim of attaching the hearing aid at another appointment in two weeks.

You should call your family doctor (GP) or the ward if:

  • Your child is in a lot of pain and pain relief does not seem to help.

  • Your child has a temperature of 38°C or higher and pain relief does not bring it down.

  • Your child is not drinking any fluids.

  • The operation site is red or inflamed, and feels hotter than the surrounding skin.

  • There is any oozing or bleeding from the operation site.

Compiled by: 
The Ear, Nose and Throat Department in collaboration with the Child and Family Information Group.
Last review date: 
November 2015
Ref: 
2015F0433

Disclaimer

Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.