Table 4 Summary of surgical practices
Respondents | ||
|---|---|---|
Number | Percent | |
For patients with microtia, do you consult the reconstructive ear surgeon for advice on implant location? | ||
Yes | 9 | 75 |
No | 3 | 25 |
Location of implant for non-microtia children | ||
3.5-4.5 cm posterosuperior to EAC | 2 | 17 |
5.0-5.5 cm posterosuperior to EAC | 5 | 42 |
6.5 cm posterosuperior to EAC | 1 | 8 |
Posterosuperior to EAC, measurement not specified | 2 | 17 |
No answer | 2 | 17 |
Location of implant for microtia children | ||
Same as for non-microtia children | 4 | 33 |
Further posteriorly or superiorly | 5 | 42 |
Variable | 1 | 3 |
No answer | 2 | 17 |
What are your indications for 2-staged procedures in children? | ||
Bone thickness/condition and age | 6 | 50 |
Bone thickness/condition only | 2 | 17 |
Age only | 2 | 17 |
Single stage procedures only | 1 | 8 |
No answer | 1 | 8 |
Incision type | ||
Linear | 5 | 42 |
U-shaped | 7 | 58 |
Dermatome use | ||
Yes | 6 | 50 |
No | 6 | 50 |
Do you perform pre-operative imaging to assess the thickness or quality of the bone? | ||
Yes | 3 | 25 |
No | 8 | 67 |
No answer | 1 | 3 |
Do you use Gortex® or other bony augmentation? | ||
Yes | 3 | 25 |
No | 9 | 75 |
What is the earliest age at which you would typically perform the BAHA surgery? (years) | ||
1.5 | 1 | 8 |
3 | 3 | 25 |
4 | 5 | 42 |
5-6 | 3 | 25 |
What are your indications for a 3 mm versus 4 mm fixture? | ||
Bone thickness | 9 | 75 |
4 mm preferred, 3 mm fixtures used if there is inadequate bone thickness | 5/9 | 56 |
4 mm fixtures used in 80% of cases, 3 mm in 20% of cases | 2/9 | 22 |
3 mm fixtures typically used in young children | 2/9 | 22 |
4 mm fixtures regardless of bone thickness | 1 | 8 |
Age | 1 | 8 |
No answer | 1 | 8 |
Length of time between 1st and 2nd stage? (months) | ||
3 | 1 | 8 |
4-6 | 4 | 33 |
3 for children >6yo, 6 for children <6yo | 1 | 8 |
6-12 depending on age and bone quality | 1 | 8 |
No timeline specified but depends on age and bone thickness/quality | 1 | 8 |
Only perform single-stage surgeries | 1 | 8 |
No answer | 3 | 25 |
Do you use of a mastoid dressing after the 1st stage procedure? | ||
Yes | 9 | 75 |
No | 2 | 17 |
No answer | 1 | 8 |
Do you routinely admit children after stage 1 or 2 procedures? | ||
Yes | 6 | 50 |
No | 5 | 42 |
No answer | 1 | 8 |
Do you routinely place a sleeper implant during a pediatric case? | ||
Yes | 7 | 58 |
No | 4 | 33 |
No answer | 1 | 8 |
If yes to the above question, how often have you had to use the sleeper implant? | ||
Never | 4/7 | 57 |
Once | 1/7 | 14 |
Twice | 1/7 | 14 |
4% of cases | 1/7 | 14 |
Do you perform soft-tissue reduction during the 1st or 2nd stage? | ||
1st stage | 2 | 17 |
2nd stage | 8 | 67 |
No answer | 2 | 17 |
If you perform 2-stage operations, how many days after the 2nd stage procedure do you place the sound processor on the abutment? | ||
7-14 | 2/9 | 22 |
14-30 | 4/9 | 44 |
60-90 | 3/9 | 33 |
How often do you see pediatric BAHA patients have a successful operation? | ||
Every 1 month, then every 12 months | 1 | 8 |
Every 3 months, then every 6 months | 1 | 8 |
Every 6–12 months | 9 | 75 |
Every 6 months for 24 months, then every 12 months | 1 | 8 |