Copyright @ 200 Otology & Neurotology, Inc. Unauthorized reproduction of this article is prohibited. 8 Successes and Complications of the Baha System *Jack J. Wazen, *Dayton L. Young, *Matthew C. Farrugia, †Sujana S. Chandrasekhar, ‡Soha N. Ghossaini, ‡Julia Borik, ‡Christian Soneru, and ‡Jaclyn B. Spitzer *The Silverstein Institute, Ear Research Foundation, Sarasota, Florida; and ÞDepartment of Otolaryngology, Mount Sinai School of Medicine, and þDepartment of OtolaryngologyVHead and Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York, U.S.A. Objective: To determine the incidence and type of complica- tions, as well as patient satisfaction, associated with the Baha system. Study Design: Retrospective case review. Setting: The Silverstein Institute, Sarasota, Florida, and the Columbia University Medical Center, New York, New York. Patients: Patients with conductive/mixed hearing loss and single- sided deafness implanted with the Baha system between June 1998 and December 2007. Intervention: Implantation with the Baha system. Main Outcome Measure: Incidence and type of complica- tions associated with Baha implantation and patient satisfaction as measured by a questionnaire administered on site or by telephone. Results: In our series of 218 patients (223 ears), there were no major complications. Of these patients, 4.5% required revision surgery for soft tissue complications and 1.3% needed revision for failure of osseointegration. Eight percent (8%) required local care and resolved within 2 to 3 weeks of treatment. Five percent (5%) required in office procedures. One hundred six (106) patients satisfactorily completed the survey question- naire. Ninety-two percent (92%) reported using the device reg- ularly and 77% were happy with the device. On average, patients reported using the device 10.1 h/d, 5.6 d/wk. Conclusion: The Baha system is safe and effective in the reha- bilitation of patients with conductive or mixed hearing losses and with single-sided deafness. The high success rate, patient satisfaction rate, and predictable auditory outcome place the Baha among the leading choices for auditory rehabilitation. Key Words: ComplicationVPatient satisfactionVSoft tissue. Otol Neurotol 29:1115Y1119, 2008. Since the first application of titanium implants in the temporal bone in 1977 (1), the Baha system has become a well-established and successful method of auditory rehabilitation. Initially described for the treat- ment of conductive and mixed hearing losses, the Baha system is now also used in cases of single-sided deaf- ness, such as acoustic neuroma or sudden sensorineural hearing loss (2,3). Initial concerns of a percutaneous abutment and its potential for complications have been alleviated by a reproducible success rate, high patient satisfaction, and the lack of serious complica- tions. The purpose of this paper was to review our experience with the Baha system and to report our incidence of success, failure, and complications. METHODS This is a retrospective chart review of patients implanted with the Baha system at the Columbia University Medical Cen- ter and the Silverstein Institute between June 1998 and Decem- ber 2007. After obtaining institutional review board approval from both facilities, the medical charts were obtained and reviewed. The patients’ demographics, diagnosis, procedure date, activation date, and postoperative reactions and complica- tions were recorded and tabulated. Major complications were defined as those complications requiring inpatient hospital care or with associated significant morbidity such as meningitis, brain abscess, osteitis, or acute mastoiditis. Minor complica- tions were divided into complications requiring minimal office treatment and complications requiring revision ambulatory sur- gery. Patients with complete information were next contacted by telephone or were interviewed on site, and a patient satisfac- tion questionnaire was administered (Table 1). RESULTS Two hundred eighteen (218) patients implanted be- tween June 1998 and December 2007 were identified. Address correspondence and reprint requests to Jack J. Wazen, M.D., The Silverstein Institute, Ear Research Foundation, Sarasota, Florida; E-mail: jwazen@silversteininstitute.com Otology & Neurotology 29:1115Y1119 Ó 2008, Otology & Neurotology, Inc. 1115