Bone-Anchored Hearing Aid: Why Do Some Patients Refuse It?

Abstract

Objective: BAHA is a proven tool to improve hearing. Nevertheless, there are patients who are candidates for BAHA implants who end up refusing the surgery. The objective of this study is to review our BAHA experience with particular emphasis on reasons behind the refusal of some candidates.

Method: A retrospective chart review conducted in December 2011 of the most recent 100 consecutive new patients referred to the BAHA program in a tertiary health care center. Candidates’ demographics, hearing status, co-morbidities, and audiometeric tests were all recorded. Patients’ acceptance or refusal was noted alongside the reasons to refuse BAHA.

Results: One hundred new patients were seen for BAHA assessment, 10 patients were excluded because of incomplete tests. There were 68 children and 22 adults. Unilateral conductive hearing loss was the most common reason for consultation (40%), followed by unilateral SNHL (23.3%). Aural atresia was the most common clinical finding (36.6%). Seventy patients were candidates for BAHA (77.8%) as per our candidacy rules. Ten candidates refused BAHA (14.3%). The most common reason for refusal in adults was lack of sound localization in patients with unilateral SNHL.

Conclusion: The main reason for refusal of BAHA was lack of sound localization in adults, whereas the main reason for refusal in children was cultural and social acceptance by the family. Patients with congenital anomalies were the most likely candidates to accept BAHA implants.