A different way to look at bone anchored devices for small

childrenLori Van Riper

University of Michigan Mott Children’s Hospital

Z

• 14 months old• Ongoing otitis media and chronic MEE w/ear

drainage• Fluctuating mild to moderate conductive

hearing loss• Delayed speech-language skills

Z

• Fit Cochlear Baha on softband in clinic• Sent loaner device home with child• Returns after using it daily for 4 months• Mother reports child suddenly doesn’t want to

wear it anymore• Hearing is WNL!

J

• Newborn with Down syndrome • Diagnosed moderate conductive hearing loss

bilaterally• Miniscule ear canals• Fit with loaner Oticon Ponto on softband

J

• Age 7 months, PE tubes placed bilaterally• Ears big enough for earmolds• Fit with BTEs– Doesn’t appear to hear as well– Pulls them off repeatedly– Parents go back to Ponto

J

• Age 14 months, PE tubes replaced• Parents report J won’t wear Ponto anymore• They feel his hearing is much better• Testing reveals borderline normal hearing• 17 months old, hearing WNL

K

• 7 year old with Down syndrome• Passes NBHS• Age 7 months behavioral testing suggests

severe hearing loss• Ears too small for PE tube placement• Age 11 months ABR suggests bilateral

moderate mixed hearing loss

K

• PE tubes placed at 15 months• Moderate mixed hearing loss identified

through behavioral testing• Fit with Cochlear Baha on softband at 18

months• Worn intermittently

K

• Age 6 years, arrives for appointment to consider implanting Baha

• Testing suggests mild conductive hearing loss• Goes to OR for EUA/cerumen (impacted)

removal• Repeat testing a few weeks later reveals

hearing WNL bilaterally for speech frequencies.

E

• Newborn with stenotic EACs• Moderate conductive hearing loss bilaterally• Could not fabricate earmolds• Fit with Oticon Ponto on softband

E

• Age 16 months, EACs large enough for earmolds

• Fit with loaner BTEs• 18 months, fit with own BTEs