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Table 4 Summary of surgical practices

From: The current practice trends in pediatric bone-anchored hearing aids in Canada: a national clinical and surgical practice survey

  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
  1. EAC - external auditory canal.