Abstract
Objective: Osseointegrated hearing implants have been readily available and extensively used in developed countries for over twenty years. Despite a great need for this technology, use of these implants in developing countries has been limited due to the prohibitive cost of the surgical implant system as well as the implant devices themselves. To address this problem we have developed a drill and implant system that mimics the currently available instrumentation using materials that are readily available at a fraction of the cost. Study Design: Proof of Concept. Methods: The construction of the drill and implant system will be described. Testing of the system so that it adhered to Cochlear’sTM Bone anchored hearing aid system specifications including the drill speed and torque settings were measured. Temperature readings were also recorded during procedures performed on human cadaveric temporal bones. Results: The speed of the drill with the guide drill and countersink drill bits ranged from 1400 revolutions per minute (rpm) to 2300 rpm’s. The temperature change of the room temperature temporal bones varied from 0 degrees to +0.2 degrees Fahrenheit during the drilling process with both drill bits. All five implants were stable in the cadaver bone after being checked for initial stability. Conclusion: This low cost implant system may make the BAHA technology more easily available to developing countries pending future studies with animal models.
Highlights
The Bone Anchored Hearing Aid (BAHA) was first implanted in 1977 by Dr Anders Tjellström in Sweden
The current BAHA implant system that is available from CochlearTM Corporation is a combination of a precision single speed drill and a variable selective torque wrench
Developed countries are able to improve hearing through the various technologies available ranging from cochlear and brainstem implants to ossicular chain reconstructions
Summary
The Bone Anchored Hearing Aid (BAHA) was first implanted in 1977 by Dr Anders Tjellström in Sweden. The BAHA is a reliable method of auditory rehabilitation and improves the quality of life for patients with middle and external ear deformities [2,3,4,5,6,7] Further modifications of this CochlearTM osseointegrated hearing device continue to develop and OticonTM corporation has developed a device on the same principle. The current BAHA implant system that is available from CochlearTM Corporation is a combination of a precision single speed drill and a variable selective torque wrench. The drill rotates at 2000 rpm to create both the initial guide hole perpendicular to the bone and the subsequent countersink hole at a depth of 3 to 4 mm This will accommodate the titanium implant (abutment) in the step. The drill can be dismantled and autoclaved for sterility (Cochlear Baha Surgery Guide, CochlearTM Baha®.) Critical variables in the procedure include not touching the IJOHNS
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