A Comparison of the Operative Techniques and the Postoperative Complications for Bone-Anchored Hearing Aid Implantation

Abstract

Introduction Bone anchored hearing aids (BAHA) represent a useful surgical option for patients with single sided deafness. Objectives To compare multiple techniques for BAHA implantation regarding postoperative complications, operative time, and duration between the surgery and the first use of the BAHA. Methods A retrospective study was conducted of all patients receiving implantation of a BAHA from August of 2008 to October of 2014. Data collected included: patient age, gender, side operated, abutment length, operative time, duration until first use of the BAHA, operative technique, and postoperative complications. The statistical analysis was performed using analysis of variance (ANOVA), Tukey pairwise comparison, chi-square, and paired t -test. Statistical significance was determined using a level of p < 0.05. Results A total of 88 patients (43 female and 45 male) were included in the data analysis. A total of 80 complications were documented, and these complications were classified according to the Holgers criteria. A significant difference in the total postoperative complications existed between the six techniques used (ANOVA; p < 0.01). In addition, there was also a significant difference among the six techniques employed regarding the operative time (ANOVA; p < 0.01). The average time duration until fitting of the BAHA processor among the various techniques trended toward but did not reach statistical significance (ANOVA; p = 0.16). Conclusions Significant differences in the operative outcomes exist among the various techniques for BAHA implantation. Based on the statistical analysis of our data, the BAHA Attract system (Cochlear Ltd., Sidney, Australia) requires greater operative time, but it is associated with less postoperative complications than percutaneous techniques and its processor may be fitted significantly sooner.

Multicenter Clinical Investigation of a New Active Osseointegrated Steady-State Implant System

“…Recent publications report a single mild skin reaction in 20 to 30% of the implants and no revision surgery in a 3 to 5 year follow-up ( 7 , 30 ). Transcutaneous systems have been shown to be associated with less skin complications ( 31 ). In this study, skin complications were rare.…”

Comparison between linear incision and punch techniques for bone anchored hearing aid surgery

“…Surgical outcomes of different techniques have varied over the years 9 . The most common complications addressed have been skin infections, flap necrosis and skin overgrowth as well as numbness and poor cosmetic appearance 10 . All of these complications can impact the satisfaction and acceptance of the device by patients.…”

Longitudinal economic analysis of Bonebridge 601 versus percutaneous bone‐anchored hearing devices over a 5‐year follow‐up period

“…Concern regarding pBAHDs normally surrounds complications, particularly related to skin infections. 6,7,17,22 A recent systematic review demonstrated an approximately fivefold reduced ratio of events to ears for adverse events when comparing pBAHDs to the Bonebridge. 23 Cosmetic issues related to percutaneous abutments are also a significant concern for many, with 30% in one large case series rejecting pBAHD surgery for such reasons.…”

“…The presence of a percutaneous abutment with pBAHD commonly leads to skin complications with patients needing to perform daily abutment‐site skin care. Despite minimally invasive surgical approaches and advances in implant technologies, wound healing issues still affect nearly 25% of patients 5‐7 …”