Skin reactions following BAHA surgery using the skin flap dermatome technique

Abstract

The objectives of the study were to determine the incidence of skin reactions and complications associated with bone-anchored hearing aid (BAHA) implantation. The study is a retrospective case review done in a tertiary referral center. One hundred thirty-eight consecutive patients between 1998 and 2008 underwent implantation of a BAHA and were regularly seen for follow-up. Indications included conductive or mixed hearing loss where a hearing aid cannot be used and since 2000 also had contralateral single-sided perceptive hearing loss. BAHA implantation was done by creating a pedicled flap using the skin flap dermatome technique. Postoperative incidence of skin reactions and complications were measured. Significant postoperative complications requiring revision surgery occurred 37 times in 30 patients. Normal skin healing was seen in 52 patients (63.4%), while abnormal skin healing occurred in 30 patients (36.6%). This study showed that skin problems occur more often than expected. Because of the skin problems with the skin flap technique, the authors have switched to the linear incision technique, hoping to decrease the incidence of skin problems.

Histologic Evaluation of Soft Tissue Integration of Experimental Abutments for Bone Anchored Hearing Implants Using Surgery Without Soft Tissue Reduction

“…Soft tissue reactions ranging from red and slightly moist tissue to the occurrence of infections requiring removal of the implant have been reported to occur in up to 30% of the patients at some point in time; however, most reactions are reported to be mild (4). In addition, soft tissue overgrowth requiring local treatment or revision surgery is a relatively frequently reported complication (5,6). It should be noted that recent developments in Baha A abutment design have shown improved clinical outcomes, in terms of a significant reduction in adverse skin reactions, when used with soft tissue reduction compared with previous generation abutments (7).…”

A Five-Year Follow-up on the Osseointegration of Bone-Anchored Hearing Device Implantation Without Tissue Reduction

“…In the test group, the skin and peri-implant area revealed little to no scar tissue with normal hair growth and a good aesthetic outcome. In the DT group, skin reactions occurred more often than expected when compared with other studies, as 92% of the DT patients experienced periimplant infections that were often scored more severely according to Holgers' scale (24). The DT group also required permanent removal of the abutment more frequently.…”

Percutaneous bone-anchored hearing implant surgery: dermatome versus linear incision technique

“…In the field of the latter, both the dermatome and linear incision technique became popular in many centres. However, studies regarding the dermatome technique reported an overall higher rate of skin problems [35–37] compared to the linear incision technique [8, 19], although methodological variability could influence these outcomes and impair adequate comparison [16]. The linear incision technique is more and more used as the preferred technique in many clinics.…”

“…Nevertheless, as compared to other studies, the grade of skin thickening noticed was relatively mild. There was no overgrowth of skin reported and revision surgery was performed in only 2 patients (one from each group) [8, 11, 16, 35, 36]. …”