Skin Overgrowth Research Articles

Staged implantation of active transcutaneous bone conduction hearing devices (BCHD) after explantation of older generation bone anchored hearing aids (BAHAs): Surgical outcomes and approach to management

PurposeTo evaluate outcomes following explantation of percutaneous or transcutaneous bone conduction implants (pBCIs or tBCIs) and subsequent implantation of transcutaneous active bone conduction hearing devices (BCHDs); to provide guidance regarding staging of surgery and adjunctive procedures. Materials and methodsRetrospective chart review of eight adult subjects (ten ears) with pBCIs or tBCIs who underwent explantation of their device and subsequent implantation with a BCHD [MED-EL BONEBRIDGE™ (n = 7, 70 %) or Cochlear™ Osia® (n = 3, 30 %)]. ResultsReasons for pBCI or tBCI explantation were pain (60 %, 6/10), infection (60 %, 6/10), skin overgrowth (50 %, 5/10), and inability to obtain new processors (20 %, 2/10). Median time between pBCI or tBCI removal and BCHD staged implant was 4.7 (IQR 2.2–8.1) months. Two subjects developed complications following BCHD implantation. One had a persistent wound overlying the osseointegrated screw after removal of the pBCI abutment, requiring removal and temporalis rotational flap. Staged Osia® implantation was performed, but ultimately wound dehiscence developed over the device. The second subject experienced an infection after BONEBRIDGE™ implantation (32 days after pBCI explant), necessitating washout and treatment with intravenous antibiotics. There was subsequent device failure. ConclusionThe transition from a pBCI or tBCI to a novel transcutaneous device is nuanced. Staged pBCI or tBCI explantation and novel BCHD implantation with sufficient time for wound healing is vital. Adjunctive procedures to augment soft tissue in cases of prior attenuation may be required to avoid complications with larger internal devices.

Juvenile Hyaline Fibromatosis- Child with Scalp Swellings

Juvenile hyaline fibromatosis is a recessive autosomal hereditary disorder characterized by abnormal growth of hyalinized fibrous tissue. Its clinical presentation is manifested by benign skin lesions, bone lesions, joint contractures, and gingival hyperplasia. The underlying cause is an abnormal growth of hyalinized fibrous tissue with cutaneous, mucosal, osteoarticular, and systemic involvement. This report presents a case of a 4-year-old male child; with complaints of multiple painful body swellings and pus discharge from scalp swellings for the past two years admitted at Dr. Ruth Pfau Civil Hospital, Karachi, 2021. This patient had right occipital scalp swelling of 10x 10 cm due to which surgery was done and the excision was successful. Other findings included stiff joints, skin overgrowth over the scalp and back + buttocks, multiple firm cystic swellings on the scalp, back, trunk, and whole body involving the face (nose), anal region, gum hypertrophy, and various papules over the nose.

413 Percutaneous Bone Anchored Hearing Rehabilitation in Adults - the Nottingham Experience Over a 5 Year Period

Abstract Aim Percutaneous bone anchored hearing aid (BAHA) is an effective hearing rehabilitation option. However, complications including granulation, skin overgrowth and infections may lead to revision surgeries. This study aim was to assess the complication rate and potential contributing factors leading to revision surgeries. Method Adult patients who underwent BAHA connect (Cochlear Corp) operations between 2016 to 2021 were included. Patient notes were retrospectively reviewed. Results 166 patients received a BAHA connect. Twenty-nine (17.5%) patients required revision surgery; 2 for granulation, 10 for skin overgrowth, 9 for infection, 7 for traumatic extrusion and 1 for failure of osteointegration. Excluding traumatic extrusion patients, 22 (13.3%) required revision surgery. 56% of patients were performed under local anaesthetic, with no difference in complication rate compared to general anaesthetic. 70% patients with Holger’s grade 4 changes and 40% patients with grade 3 findings required revision. 31% cases required revision when primary surgeon was trainee, compared with consultant (17%). There was no difference in post-operative skin problems between skin incisions made in-line vs separate from abutment. Cases with intra-operative complications, including re-siting of initial hole due to bleeding or loose fixture, had higher rate of revision. Of revision surgery patients, 14% were active smokers and 21% ex-smokers. 31% required multiple revision operations. Conclusions Percutaneous BAHA insertion can be performed under local and general anaesthetic. Grade of primary surgeon and intra-operative problems appear to be risk factors for requiring revision surgery. Smoking and site of incision does not appear to be risk factors for postoperative skin problems.

A custom auricular implant healing abutment: A dental technique

Skin overgrowth is a complication that hinders bone-anchored prosthetic ear rehabilitation. In order to accurately transfer the healing skin for prosthetic reconstruction, this article introduces a custom-made autopolymerizing acrylic resin auricular cap (button) through indirect pick up of the metal housing. The caps are secured during the healing stage to shape the skin, preventing surgical edema, swelling, and skin overgrowth in patients suffering from keloid reactions from covering the implant abutments. Since skin height and form are changeable, the caps can be relined directly or indirectly if greater skin compression is required. Moreover, these custom-made caps can be utilized during prosthetic silicone ear fabrication to retain the metal housing.

Outcomes after Application of Active Bone Conducting Implants

Background: A bone conducting implant is a treatment option for individuals with conductive or mixed hearing loss (CHL, MHL) who do not tolerate regular hearing aids, and for individuals with single-sided deafness (SSD). An active bone conducting implant (ABCI) was introduced in 2012 with indication in CHL, MHL, and SSD, and it is still the only ABCI available. With complete implantation of the active transducer and consequent intact skin, a decrease in infections, skin overgrowth, and implant losses, all common disadvantages with earlier passive bone conducting implants, could be expected. Our Ear, Nose and Throat Department, a secondary care center for otosurgery that covers a population of approximately 365,000 inhabitants, was approved to implant ABCIs in 2012. Objectives: Our aim was to conduct an evaluation of audiological and subjective outcomes after ABCIs. Method: A cohort study with retrospective and prospective data collection was performed.The first 20 consecutive patients operated with an ABCI were asked for informed consent. The main outcome measures werepure tone and speech audiometry and the Glasgow Benefit Inventory (GBI). Results: Seventeen patients accepted to participate and 15 were able to complete all parts. Six patients had CHL or MHL. In this group the pure tone audiometry tests are comparable with an average functional hearing gain of 29.8 dB HL. With bilateral hearing, the mean Word Recognition Score (WRS) in noise was 35.7% unaided and 62.7% aided. Ten patients had the indication SSD. With the hearing ear blocked, the pure tone average was >101 dB HL, compared to 29.3 dB HL in sound field aided. With bilateral hearing, the mean WRS in noise was 59.7% unaided and 72.8% aided. The mean of the total GBI score was 42.1 in the group with CHL or MHL and 20.6 in the group with SSD. Conclusions: The patients benefit from their implants in terms of quality of life, and there is a substantial hearing gain from the implant for patients with conductive or MHL. Patients with SSD benefit less from the implant than other diagnoses but the positive outcomes are comparable to other options for this group.

The use of CO2 laser in skin complications following BAHA implantation: our experience in the eight patients.

1 Skin reactions are the most common complications after BAHA implantation. 2 The excess of soft tissue leads to inability to tack the hearing ad to the abutment which prevents the effective use of sound processor. 3 This is a prospective case series of 8 patients with skin overgrowth around the BAHA abutments treated with CO2 laser. 4 This case-series suggest that CO2 laser is safe and easy method for the treatment of the skin overgrowth around the BAHA abutment. 5 This is the first case series presentation of the CO2 laser surgery for treatment of the skin overgrowth around the abutment of BAHA This article is protected by copyright. All rights reserved.

Minimally Invasive Ponto Surgery compared to the linear incision technique without soft tissue reduction for bone conduction hearing implants: study protocol for a randomized controlled trial

BackgroundOver the last years, less invasive surgical techniques with soft tissue preservation for bone conduction hearing implants (BCHI) have been introduced such as the linear incision technique combined with a punch. Results using this technique seem favorable in terms of rate of peri-abutment dermatitis (PAD), esthetics, and preservation of skin sensibility. Recently, a new standardized surgical technique for BCHI placement, the Minimally Invasive Ponto Surgery (MIPS) technique has been developed by Oticon Medical AB (Askim, Sweden). This technique aims to standardize surgery by using a novel surgical instrumentation kit and minimize soft tissue trauma.MethodsA multicenter randomized controlled trial is designed to compare the MIPS technique to the linear incision technique with soft tissue preservation. The primary investigation center is Maastricht University Medical Center. Sixty-two participants will be included with a 2-year follow-up period. Parameters are introduced to quantify factors such as loss of skin sensibility, dehiscence of the skin next to the abutment, skin overgrowth, and cosmetic results. A new type of sampling method is incorporated to aid in the estimation of complications. To gain further understanding of PAD, swabs and skin biopsies are collected during follow-up visits for evaluation of the bacterial profile and inflammatory cytokine expression.The primary objective of the study is to compare the incidence of PAD during the first 3 months after BCHI placement. Secondary objectives include the assessment of parameters related to surgery, wound healing, pain, loss of sensibility of the skin around the implant, implant extrusion rate, implant stability measurements, dehiscence of the skin next to the abutment, and esthetic appeal. Tertiary objectives include assessment of other factors related to PAD and a health economic evaluation.DiscussionThis is the first trial to compare the recently developed MIPS technique to the linear incision technique with soft tissue preservation for BCHI surgery. Newly introduced parameters and sampling method will aid in the prediction of results and complications after BCHI placement.Trial registrationRegistered at the CCMO register in the Netherlands on 24 November 2014: NL50072.068.14. Retrospectively registered on 21 April 2015 at ClinicalTrials.gov: NCT02438618. This trial is sponsored by Oticon Medical AB.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1662-0) contains supplementary material, which is available to authorized users.

Adverse skin reactions following percutaneous bone conduction implant surgery using the linear incision technique with and without subcutaneous tissue reduction

Conclusions: Adverse skin reactions were equally distributed among age groups, surgical technique, or presence of a retroauricular incision. Implant loss was observed more frequently in children when compared to adults and elderly.Objective: A bone conduction (osseointegrated) implant can be used for rehabilitation of patients with conductive hearing loss or single-sided deafness. The surgical technique has been modified to minimize adverse skin reactions and other complications. Two commonly used techniques are the linear incision technique with subcutaneous tissue reduction and the technique without tissue reduction. The primary aim is to compare the complication rate between the two surgical techniques.Methods: Retrospective study on all bone conduction implant cases implanted between April 1990 and July 2014 at a tertiary referral center. Skin reactions were graded by Holgers’ scale (grade 0–1: ‘normal’, grade 2–3: ‘adverse’). The worst follow-up available was reported.Results: Of the 289 bone conduction implants, 25 were implanted in children, 220 in adults, and 44 in elderly. Implant loss occurred in 2.8% of all cases: 8.0% in children, 2.3% in adults, and 2.3% in the elderly. Skin overgrowth was seen in 4.2%: 4% in children, 4.8% in adults, and 3.5% in the elderly. No differences were observed in the amount of adverse skin reactions (16.8% vs 14.7%) or skin overgrowth (4.6% vs 2.9%) between the surgical techniques. There was no difference in adverse skin reactions if the patient had a retroauricular incision (14.4% with vs 17.8% without prior incision).

A Systematic Review on Complications of Tissue Preservation Surgical Techniques in Percutaneous Bone Conduction Hearing Devices.

To investigate skin-related postoperative complications from tissue preservation approaches in percutaneous bone conduction device (BCD) implantations. PubMed, Embase, and Cochrane Library. We identified studies on BCDs including the opted surgical technique and derived complications. Retrieved articles were screened using predefined inclusion criteria. Critical appraisal included directness of evidence and risk of bias. Studies that successfully passed critical appraisal were included. Outcome measures included patient demographics, surgery time, follow-up time, and complications reported by Holgers classification. We selected 18 articles for data extraction; encompassing 381 BCDs implanted using non-skin thinning approaches. Four studies reported an implantation technique using the punch method (81 implants), 13 studies applied the linear incision technique without soft tissue reduction (288 implants) and one study used the Weber technique (12 implants). Holgers 3 was described in 2.5% following the punch technique, in 5.9% following the linear incision technique, and in no implants following the Weber technique. One patient was mentioned having Holgers 4, skin overgrowth was reported in 6 patients, and 10 studies compared their non-skin thinning technique with a skin-thinning technique. Overall, the soft tissue preservation technique had a similar or superior complication rate, shorter surgical time, and better and faster healing, compared with the soft tissue reduction technique. Tissue preservation surgical techniques for percutaneous BCDs have limited postoperative skin complication rates. Moreover, these techniques are suggested to have at least similar complications rates compared with skin-thinning techniques.

Challenges During Baha Surgery: Our Experience.

Baha has proven performance and advantages for patients with aural atresia or chronic ear drainage. Being a per cutaneous osseo integrated implant the skin around the fixture is in contact with a foreign body that leads to chronic inflammatory reaction and complications such as skin irritation and overgrowth occur frequently. Challenges that are faced during Baha surgery include those during candidate selection, work up, anesthesia related as well as intra-operative and post operative complications. Ours was a retrospective and observational study where case records of 10 patients who underwent Baha surgery in the Department of E.N.T during the time period from January 2010 to June 2013 were reviewed. Here, the candidates were advised Baha either for congenital external ear deformity or single sided deafness. Out of 10 patients, who underwent Baha implantation, 8 underwent single staged Baha implant and two patients had two staged implant owing to bone thickness <3mm behind temporo-parietal suture line on HRCT Temporal bone. The complications observed were skin infection (Holgers grade 2) around the site of implant in two patients, skin overgrowth due to more thickness of scalp (Holgers grade 4) in one of the patient. The patient had to undergo revision surgery to replace the abutment. And one of the patients underwent failure of osseointegration and was re-implanted later. Proper surgical technique and post operative wound care play an important role in avoiding complications.

Has the use of the linear incision reduced skin complications in bone-anchored hearing aid implantation?

To compare the skin-related complications of the traditional skin flap method with a linear incision method of implantation. All cases of bone-anchored hearing aid surgery performed by a single surgeon (n = 117) were compared over two periods: 1999-2011, when the traditional method of skin flap and soft tissue removal was used (group 1; n = 86), and 2012-2013, when linear incision without soft tissue removal was used (group 2; n = 31). All patients were followed up for one year and complications were recorded for that period. There were 21 (24.4 per cent) skin-related complications in group 1 (skin overgrowth = 12, wound infection = 8 and numbness = 1) and 3 (9.7 per cent) complications in group 2 (wound infection = 3). Analysis using independent t-tests showed the results to be significant (p < 0.05; 95 per cent confidence interval = 0.0800-0.4473). The linear incision without soft tissue removal method for bone-anchored hearing aid implantation reduces skin complication rates.

Bone-anchored hearing device placement with translabyrinthine tumor removal.

Translabyrinthine resection of intracranial tumors results in single-sided deafness, which can be treated by surgical and nonsurgical means. Here we describe the first series examining complication and device usage rates among patients receiving a surgically implanted bone-anchored hearing device (BAHD) at the time of translabyrinthine tumor removal. Case series with chart review. Private tertiary neurotologic referral center. Patients (N = 154) undergoing concurrent BAHD placement and translabyrinthine tumor resection. Concurrent BAHD placement and translabyrinthine tumor removal. Postoperative complication rates and BAHD usage. Of the 154 patients, 121 (78.6%) had no device-related complications. The most common device-related complications were skin overgrowth (8.4%), acute infection (5.2%), and chronic infection (3.2%). The overall and specific complication rates did not differ from published BAHD complication rates. One patient (0.6%) developed a cerebrospinal leak through the surgical site for the device. At the time of last follow-up (mean, 39.8 months), 151 patients (95.0%) were still using their devices. Patients undergoing concurrent translabyrinthine tumor removal and BAHD placement exhibit similar device-related complication profiles as patients undergoing standard device placement. Based on these outcomes and the high long-term usage rates, BAHD insertion at the time of translabyrinthine intracranial surgery can be considered a safe and useful procedure.

Surgical implantation of the Sophono transcutaneous bone conduction system

Bone conduction implantable devices are an effective means of rehabilitation for ipsilateral conductive hearing loss and in a contralateral routing of signal (CROS) configuration for single-sided deafness. Percutaneous systems provide excellent sound quality but suffer from the complications of recurrent infection, skin overgrowth, and cosmetic concerns. The Sophono transcutaneous bone conduction system uses an internal retention magnet to hold an external force plate and sound processor to the scalp, allowing for transcutaneous bone conduction and stimulation of the cochlea. Implantation consists of a simple incision, drilling a shallow recess for the bilobed magnet in the cranium, and securing of the implant with standard plating screws. Surgical considerations such as placement, flush positioning to the bone, and maintaining or augmenting overlying tissue thickness are important to ensuring postactivation wearability. Fitting considerations such as time to fitting, magnet strength determination, and graduated wearing schedules are also critical to patient outcomes.

Translabyrinthine Tumor Removal with Concurrent Bone‐Anchored Hearing Aid Placement

Objectives: (1) Describe the safety profile of performing translabyrinthine tumor removal and bone-anchored hearing aid placement during the same surgical procedure. (2) Describe the overall patient satisfaction of those individuals who underwent the above procedure. Methods: Retrospective review from a tertiary neurotologic referral center of 154 patients who underwent concurrent translabyrinthine tumor resection and bone-anchored hearing device placement between 2004 and 2012. Patient records were reviewed to identify postoperative complication rates and bone-anchored hearing device usage. A Fisher’s exact test was used to compare the qualitative variables and Student t test was used for the quantitative comparison. Results: One hundred twenty-one (78.6%) of 154 patients undergoing concurrent translabyrinthine tumor removal and bone-anchored hearing device placement had no device-related complications. The most common device-related complications were skin overgrowth (8.4%), acute infection (5.2%), and chronic infection (3.2%). The overall and specific complication rates did not statistically differ from published bone-anchored device complication rates (all P &lt; .05). One patient (0.7%) developed a cerebrospinal fluid leak at the placement site of the bone-anchored device. Of the 145 patients with at least 1-year follow-up, 137 (95.5%) were still regularly using their bone-anchored hearing devices. Conclusions: Patients undergoing concurrent translabyrinthine tumor removal and bone-anchored hearing device placement exhibit similar device-related complication profiles as patients undergoing standard device placement. Based on these outcomes and the high long-term usage rates, translabyrinthine intracranial surgery and bone-anchored hearing device insertion can be considered a useful and safe procedure.

The paradox of FGFR3 signaling in skeletal dysplasia: Why chondrocytes growth arrest while other cells over proliferate

Somatic mutations in receptor tyrosine kinase FGFR3 cause excessive cell proliferation, leading to cancer or skin overgrowth. Remarkably, the same mutations inhibit chondrocyte proliferation and differentiation in developing bones, resulting in skeletal dysplasias, such as hypochondroplasia, achondroplasia, SADDAN and thanatophoric dysplasia. A similar phenotype is observed in Noonan syndrome, Leopard syndrome, hereditary gingival fibromatosis, neurofibromatosis type 1, Costello syndrome, Legius syndrome and cardiofaciocutaneous syndrome. Collectively termed RASopathies, the latter syndromes are caused by germline mutations in components of the RAS/ERK MAP kinase signaling pathway. This article considers the evidence suggesting that FGFR3 activation in chondrocytes mimics the activation of major oncogenes signaling via the ERK pathway. Subsequent inhibition of chondrocyte proliferation in FGFR3-related skeletal dysplasias and RASopathies is proposed to result from activation of defense mechanisms that originally evolved to safeguard mammalian organisms against cancer.

Longer length baha™ abutments decrease wound complications and revision surgery

To study the complication rates of skin overgrowth, infection, and the need for revision surgery in longer length Baha™ abutments. Prospective observational cohort study compared with a retrospective historical control. After the University of Nebraska Medical Center (UNMC) Institutional Review Board approval was obtained, data was collected from a prospective 8.5-mm abutment study group of 21 subjects with informed consent from October 2011 through October 2012, and was compared to a retrospective 5.5-mm abutment historical cohort of 23 patients who had undergone Baha™ by the same surgeon from May 2010 to October 2011. Patient demographics, body mass index (BMI), smoking status, and wound complications (skin overgrowth, infection, the need for revision surgery) were statistically investigated and compared between the groups. Forty-four patients were studied. The groups were similar in smoking status, diabetes, and a female preponderance. The 8.5-mm abutment group was older (P = 0.012). The average BMI for both groups was classified as overweight and nearly obese (BMI 28.8). Rates of infection, skin overgrowth, and the need for revision surgery related to wound complications were significantly decreased in the longer 8.5-mm abutment group (P = 0.020, P = 0.012, P = 0.007, respectively). BMI did not correlate with decreased infection, skin overgrowth, and the need for revision surgery based on abutment length as hypothesized (P = 0.214, P = 0.206, P = 0.408). The 8.5-mm abutment lends to decreased complications postoperatively, including infection, skin overgrowth, and the need for revision surgery. 3b.

Single‐Stage Surgery for Placement of Pediatric Bone‐Anchored Hearing Aids

Objectives: 1) Determine the incidence of skin overgrowth and failure of osseointegration in pediatric patients undergoing single-staged placement of a bone anchored hearing aid. 2) Compare these results to patients undergoing staged surgery. Methods: Pediatric patients who underwent placement of a bone anchored hearing aid in an academic pediatric medical center from July 1, 2006, to December 2012 were identified in a retrospective manner using CPT code 69714. Cause of hearing loss, surgical technique, staging of surgery, and postoperative findings including skin overgrowth and failure of osseointegration were recorded. Results: Sixty-six patients underwent placement of a bone anchored hearing aid, with 11 patients undergoing bilateral surgery. Sixty-four sides were performed in 1 stage and 13 sides in 2 stages. The overall osseointegration failure rate was 4.5%, all in patients who underwent single-staged surgery. Two of these patients had Treacher-Collins syndrome, and the other patient had craniofacial abnormalities. Five patients (7.5%) required revision surgery for skin overgrowth, with 4 having single-stage surgery and the other having staged surgery. Conclusions: Single-staged surgery placement of a bone anchored hearing aid is an acceptable alternative to staged surgery with low rates of osseointegration failure or skin overgrowth.

Surgical Outcome of Bone Anchored Hearing Aid (Baha) Implant Surgery: A 10 Years Experience

Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9%) patients had bilateral microtia and canal atresia, 3 (9.1%) patients had unilateral microtia and canal atresia and 1 (3.0%) patients have SSD following labyrinthitis. One patient (3.2%) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1%). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7%). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.

Single Vertical Incision Technique without Skin Thinning for the Bone Anchored Hearing Aid Surgery

Background and ObjectivesZZAfter the bone anchored hearing aid (BAHA) surgery, soft tissue problems have frequently been reported. To solve this problem, a surgical procedure that routinely involves so-called skin thinning using BAHA dermatome has been utilized. But, this procedure includes many peri-implant complications and cosmetic trouble. Recently, a single vertical incision technique that does not involve skin thinning has been reported with favorable results. In this study, we evaluated the benefits of performing this procedure without skin thinning compared with the dermatome technique. Subjects and MethodZZWe evaluated 10 patients who were operated on without skin thinning using longer (8.5 mm) abutments (the test group) and 5 patients with the routine skin thinning and 5.5-mm abutments (the control group). A mean follow-up time was 11.3 months, the mean age was 34.2 years in the test group, the mean follow-up time was 54.5 months and a mean age is 24.5 years in the control group. ResultsZZThe mean time required for surgery was 25 minutes and 55 minutes for the test and control groups, respectively. The wound healing time was 28 days and 56 days for the test and control groups, respectively. Fixture extrusion, skin infection and skin overgrowth were not observed in the test group but fixture extrusion case, two skin infection cases and two skin overgrowth cases were observed in the control group. Two cases of abutment loosening were observed in the test group. ConclusionZZThe single vertical incision technique without skin thinning has many benefits when compared with the BAHA dermatome. With this technique, infection and skin overgrowth could be reduced, and a more rapid procedure and a more short healing time could also be possible. Moreover, the aesthetic outcome was far better when no skin thinning was involved.� Korean J Otorhinolaryngol-Head Neck Surg 2012;55:151-4 Key WordsZZHearing aid ㆍPostoperative complication ㆍOsseointegration ㆍBone conduction hearing ㆍSurgery.

埋め込み型骨導補聴器の聴覚成績と術中，術後合併症の検討

The bone-anchored hearing aid (BAHA) has advantages over conventional hearing aids in sound quality and speech reception in silence, but requires surgery and may have peri-and postoperative complications. We evaluated audiological findings and complications in 12 subjects (13 ears)-8 men and 4 women aged 20-71--undergoing BAHA surgery from September 2001 to October 2005. Surgery was for single-sided deafness in one subject. Mean warble tone thresholds with BAHA were 29.9dB and 65.2dB without. Functional gains ranged from 16 to 52dB (mean: 35.3dB). Dural exposure or venous hemorrhage was seen in 4 ears, and mastoid cells opened and a skin flap was damaged in 1 ear each. No severe complications occurred perioperatively. Skin reactions categorized into grade 1 or more were recognized in nearly 70% of ears during the first postoperative year but most were a grade 1 reaction and skin reactions decreased with time. Skin overgrowth occurred in 1 ear immediately after an abutment separated accidentally from the fixture. All complications were treated in outpatient clinics. No fixture extrusion occurred. The decision to proceed with BAHA surgery thus required fully informed consent based on knowledge of peri-and postoperative complications.