Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T14:12:18.916Z Has data issue: false hasContentIssue false
  • English
  • Français

Simplified bone-anchored hearing aid insertion using a linear incision without soft tissue reduction

Published online by Cambridge University Press:  07 May 2013

J Husseman ,
J Szudek ,
P Monksfield ,
D Power ,
S O'Leary  and
R Briggs
J Husseman
Affiliation:
Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
J Szudek*
Affiliation:
Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
P Monksfield
Affiliation:
Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
D Power
Affiliation:
Department of Audiology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
S O'Leary
Affiliation:
Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia The HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
R Briggs*
Affiliation:
Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia The HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
*
Address for correspondence: Dr J Szudek and Dr Robert Briggs, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria, Australia3002 E-mails: jszudek@gmail.com; rjsb@unimelb.edu.au
Address for correspondence: Dr J Szudek and Dr Robert Briggs, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria, Australia3002 E-mails: jszudek@gmail.com; rjsb@unimelb.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Numerous techniques have been described to manage the skin and other soft tissues during bone-anchored hearing aid insertion. Previously, generally accepted techniques have sometimes led to distressing alopecia and soft tissue defects. Now, some surgeons are rejecting the originally described split skin flap in favour of a less invasive approach.

Objective:

To investigate bone-anchored hearing aid placement utilising a single, linear incision with either no or minimal underlying soft tissue reduction.

Patients and methods:

Thirty-four adults were prospectively enrolled to undergo single-stage bone-anchored hearing aid placement with this modified technique. A small, linear incision was used at the standard position and carried down through the periosteum. Standard technique was then followed with placement of an extended length abutment. Patients were reviewed regularly to assess wound healing, including evaluation with Holgers' scale.

Results:

Only 14.7 per cent of patients had a reaction score of 2 or higher. Most complications were limited to minor skin reactions that settled with silver nitrate cautery and/or antibiotics. None required revision surgery for tissue overgrowth, and there were no implant failures.

Conclusion:

Our results suggest this to be a simple and effective insertion technique with favourable cosmesis and patient satisfaction.

Keywords

OsseointegrationHearing AidsOtolaryngologySurgical Procedures, Operative
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Supplement S2 , July 2013 , pp. S33 - S38
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Snik, AFM, Mylanus, EAM, Proops, DW, Wolfaardt, JF, Hodgetts, WE, Somers, T et al. Consensus statements on the BAHA system: where do we stand at present? Ann Otol Rhinol Laryngol Suppl 2005;195:2–12CrossRefGoogle ScholarPubMed
2Hol, MKS, Snik, AFM, Mylanus, EAM, Cremers, CWRJ. Long-term results of bone-anchored hearing aid recipients who had previously used air-conduction hearing aids. Arch Otolaryngol Head Neck Surg 2005;131:321–5CrossRefGoogle ScholarPubMed
3Wazen, JJ, Spitzer, JB, Ghossaini, SN, Fayad, JN, Niparko, JK, Cox, K et al. Transcranial contralateral cochlear stimulation in unilateral deafness. Otolaryngol Head Neck Surg 2003;129:248–54CrossRefGoogle ScholarPubMed
4Granström, G, Tjellström, A. The bone-anchored hearing aid (BAHA) in children with auricular malformations. Ear Nose Throat J 1997;76:238–40, 242, 244–7CrossRefGoogle ScholarPubMed
5de Wolf, MJF, Hol, MKS, Huygen, PLM, Mylanus, EAM, Cremers, CWRJ. Clinical outcome of the simplified surgical technique for BAHA implantation. Otol Neurotol 2008;29:1100–8CrossRefGoogle ScholarPubMed
6Lloyd, S, Almeyda, J, Sirimanna, KS, Albert, DM, Bailey, CM. Updated surgical experience with bone-anchored hearing aids in children. J Laryngol Otol 2007;121:826–31CrossRefGoogle ScholarPubMed
7Tamarit Conejeros, JM, Dalmau Galofre, J, Murcia Puchades, V, Pons Rocher, F, Fernández Martínez, S, Estrems Navas, P. Comparison of skin complications between dermatome and U-graft technique in BAHA surgery [in Spanish]. Acta Otorrinolaringol Esp 2009;60:422–7CrossRefGoogle ScholarPubMed
8van de Berg, R, Stokroos, RJ, Hof, JR, Chenault, MN. Bone-anchored hearing aid: a comparison of surgical techniques. Otol Neurotol 2010;31:129–35CrossRefGoogle ScholarPubMed
9Holgers, KM, Tjellström, A, Bjursten, LM, Erlandsson, BE. Soft tissue reactions around percutaneous implants: a clinical study of soft tissue conditions around skin-penetrating titanium implants for bone-anchored hearing aids. Am J Otol 1988;9:56–9Google ScholarPubMed
10Wazen, JJ, Young, DL, Farrugia, MC, Chandrasekhar, SS, Ghossaini, SN, Borik, J et al. Successes and complications of the Baha system. Otol Neurotol 2008;29:1115–19CrossRefGoogle ScholarPubMed
11Mudry, A. Bone-anchored hearing aids (BAHA): skin healing process for skin flap technique versus linear incision technique in the first three months after the implantation. Rev Laryngol Otol Rhinol (Bord) 2009;130:281–4Google ScholarPubMed
12Badran, K, Arya, AK, Bunstone, D, Mackinnon, N. Long-term complications of bone-anchored hearing aids: a 14-year experience. J Laryngol Otol 2008;123:170–6CrossRefGoogle Scholar