Three year experience with the cochlear BAHA attract implant: a systematic review of the literature

Abstract

BackgroundBone conduction devices are widely used and indicated in cases of conductive, mixed or single sided deafness where conventional hearing aids are not indicated or tolerated. Percutaneous bone-conduction devices gave satisfactory hearing outcomes but were frequently complicated by soft tissue reactions. Transcutaneous bone conduction devices were developed in order to address some of the issues related to the skin-penetrating abutment. The aim of this article is to present a systematic review of the indications, surgical technique and audiological, clinical and functional outcomes of the BAHA Attract device reported so far.MethodsA systematic computer-based literature search was performed on the PubMed database as well as Scopus, Cochrane and Google Scholar. Out of 497 articles, 10 studies and 89 reported cases were finally included in our review.ResultsThe vast majority of implanted patients were satisfied with the aesthetics of the device scoring highly at the Abbreviated Profile of Hearing Aid Benefit, Glasgow Benefit Inventory and Client Oriented Scale of Improvement. Overall, hearing outcomes, tested by various means including speech in noise, free field hearing testing and word discrimination scores showed a significant improvement. Complications included seroma or haematoma formation, numbness around the area of the flap, swelling and detachment of the sound processor from the external magnet.ConclusionsThe functional and audiological results presented so far in the literature have been satisfactory and the complication rate is low compared to the skin penetrating Bone Conduction Devices. Further robust trials will be needed to study the long-term outcomes and any adverse effects.

Why skin is so important for Baha Attract success: A preliminary analysis of the first 20 implantations

“…The mean soft tissue thickness was 6.1 ± 1.12 mm [4-7.5]. The mean daily use was 9.4 ± 3.45 hours [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. The mean strength of the SP magnet was 3 [1][2][3][4][5].…”

Minimal invasive pocket technique for magnet bone implant hearing aid without fixation

“…One patient developed transient cutaneous erythema in the magnet area resolved by decreasing the magnetization force of the external magnet from 4 to 3. Cooper et al [17] described this kind of transient erythema and skin irritation in 13.1% of cases of BAHA Attract and they imputed to the pressure of the magnet on the skin and maceration. These complications are resolved quickly with the use of a smaller magnetization force [12].…”

“…The second external magnet is coupled magnetically with the processor. Many studies [9][10][11][12][13] have proven the efficiency of BAHA Attract in patients with mixed or conductive hearing loss, or single-sided sensorineural deafness has been proven in many studies and audiometric results are the same as other BCHA.…”

“…The major complications described (5.2%) [12,[15][16][17] are hematomas or seromas, wound dehiscence or infection or, more rarely, cutaneous necrosis [15,18]. Minor complications, such as cutaneous numbness, pain, and erythema are reported in 13.1% of cases [17].…”

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

“…Recently, to overcome the pitfalls associated with the use of skin‐penetrating implants, the magnetic transcutaneous systems had been introduced . However, they still have some audiological limitations.…”