Ever since Tjellström first developed the procedure of BAHA implantation, the techniques have come a long way towards faster and more convenient surgical methods to offer better hearing for a wide variety of conditions. Unilateral hearing loss has now been established as one of the more recent indications for implanting BAHA. However, after successful trialling, less than 20% of this subgroup of hearing loss patients seem to accept BAHA. In this retrospective study of 90 patients, only 30.4% of suitable patients accepted BAHA. Other studies have shown even lesser acceptance. The acceptance is less than in patients with single and bilateral conductive and mixed hearing loss. In this study, the main reason for rejection amongst BAHA suitable patients was limited benefit perceived after trial (47.3%). About 33% of patients were anxious about surgery. Wireless CROS device was preferred by 23.6%, 21.8% of patients rejected BAHA for cosmetic reasons and 3.6% found headband more acceptable. The results are revealing and authors contend that clinicians should not rush to implant BAHA. It also opens up the question as to how significant is the loss of directional hearing and sound recognition due to unilateral hearing loss if it requires major surgery to overcome the problem, compared with disabling hearing due to bilateral conductive or mixed hearing loss where acceptance of BAHA seems to be better.

Bone-anchored hearing aids and unilateral sensorineural hearing loss: why do patients reject them?
Siau D, Dhillon B, Andrews R, Green KM.
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Madhup K Chaurasia

United Lincolnshire Hospitals NHS Trust; University of Leicester, UK.

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