최근 소이증인 분을 오프라인에서 만나뵙고 청각학 강의 시간에 배운 골전도 이식형보청기 (BAHA)를 소개해드렸습니다.
현재 안경형보청기를 착용하고 계시는데 과연 어느 정도의 청력일 때 이 골전도 이식형보청기의 적용이 가능한지 궁금하여 Audiology Online을 검색하여 보았습니다.
마침 어느 의사선생님이 올린 질문이 있더군요.

BAHA 적용을 위한 환자의 순음평균역치 기준을 궁금해하는 의사의 질문입니다.
답변은 Cochlear America에서 BAHA Clinical Manager로 근무하는 Teri Sinopoli라는 분이 하셨습니다.



Ask the Expert

1/2/2006

Candidacy Criteria for the Baha System
Teri Sinopoli, M.A., CCC-A, F-AAA


Question
I am a Doctor interested in referring patients for BAHAs. My question is concerns criteria on pure tone average for BAHAs. What hearing threshold level in dB for a conductive hearing loss or mixed hearing loss would you consider as strong candidacy for a BAHA, where there is no additional contra-indication (otitis externa, canal atresia, chronic otitis media, cosmetic).


BAHA는 유럽의 경우 1970년대부터, 미국은 1990년대 중후반부터 적용되기 시작하였습니다.
적용은 5세이상의 혼합성 또는 전음성 난청자로서 보통의 보청기로서 만족을 못한 경우이거나, 청력 회복을 위한 수술이 성공적인 선택이 못될 경우 권합니다.   
Answer
The Baha System has been a widely accepted treatment option for candidates in Europe with conductive and mixed hearing loss since the 1970's and in the United States since the mid to late 1990's. Baha candidates who are 5 years of age and older should have a mixed or conductive hearing loss that can not be satisfactorily treated with conventional hearing aids or where surgery is not a clear option or previously unsuccessful as far as restoring hearing. The audiometric criterion of the candidate is a 45 dBHL bone conduction pure tone average (.5K, 1K, 2K, 3K) and 60% monosyllabic word score in the indicated ear. The patient can have a bilateral or unilateral conductive hearing loss. Patients with auricular atresia, microtia, chronically draining ears, cholesteatoma, otoslcerosis, and traumatic injuries are very good candidates for the Baha system.

In addition to the mixed/conductive indication, Baha is an effective treatment for patients with single sided deafness (SSD). These patients have traditionally had few effective options for hearing treatment. The Baha System uses transcranial routing of the sound from the deaf ear to the normal hearing ear. Patients who are 5 years of age or older with a profound sensorineural hearing loss and normal hearing in the opposite ear defined as a 20 dBHL air conduction pure tone average (.5K, 1K, 2K, and 3K) is considered a Baha candidate.

For more information on Cochlear, visit
www.cochlear.com

Teri Sinopoli, M.A., CCC-A, F-AAA
Baha Clinical Manager
Cochlear Americas

As of August, 2005 Teri is now employed by Cochlear Americas when Cochlear bought Entific Medical Systems and the Baha and Vistafix product line. Teri is responsible for the management of the clinical and technical aspects of the Baha System which includes clinical studies, clinical and technical support, and training and development of training materials for surgeons and audiologists.

골전도 이식형 보청기의 적용을 위해서는 1) 나이는 적어도 5세이상이 되어야하며, 
2) 500, 1000, 2000, 3000Hz에서의 골도 순음 평균 청력(bone conduction pure tone average )45dBHL 이하이어야 하고, 3) 1음절에 의한 어음변별력이 60% 이상이어야 합니다.
대상자 : auricular atresia (외이도 폐쇄), microtia (소이증), chronically draining ears (만성중이염), cholesteatoma (진주종), otoslcerosis (이경화증), traumatic injuries (외상)

단측 농(SSD, Single Side Deafness)는 500, 1000, 2000, 3000Hz에서의 기도 순음 평균 청력(air conduction pure tone average )이 20dBHL 이하이어야 한다고 규정되어 있네요~~~
단측 농(SSD)의 경우 코클리어 코리어 홈페이지에 잘 설명되어 있습니다.
      ☞  Baha(이식형 골전도 보청기)에 대해 공부해 볼께요.

참조하시길 바랍니다. 

관심이 있으신 청각장애인분께서는 가까운 이비인후과 전문의와 상의 바랍니다.




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