The implant-site split-skin graft technique for the bone-anchored hearing aid 1

Abstract

We describe the technique of implant-site split-skin grafting for the bone-anchored hearing aid (BAHA). Twenty-five patients have undergone this procedure (20 adults and five children) since 1993 with a minimum follow-up of 1 year. Fifteen adults were operated upon as single stage surgery, all other cases (including all children) were performed in two stages. In four patients (16%) significant early graft inflammation was encountered which settled with outpatient treatment. In one the abutment had to be temporarily removed to allow the graft to settle. All patients now have a stable graft site. This surgical technique is straightforward and a separate graft donor site is avoided. It would appear this technique results in a stable BAHA graft site with low associated morbidity.

Skin Reactions After BAHA Surgery

“…Successful treatment should thus address the factors causing inflammation. This hypothesis is supported by the result of studies in which antibiotics have been used systematically, but despite this, a high frequency of adverse skin reactions is noted (15,25). In our study, no patient received systemic antibiotics.…”

“…Different surgical techniques have been described, but most authors emphasize the importance of reducing the soft tissue (4,7,14,15). The frequency of skin reactions has been reported to be 33% (16), 28.6% (8), 22.4% (17), and 21% (7).…”

Surgery for the Bone-Anchored Hearing Aid

“…A good wound healing and no soft tissue overgrowth are the first goals of a successful Baha implantation [4]. The skin around the implant should be thin and without hair follicles [5].…”

Bone anchored hearing aid in children—Prevention of complications

“…The flap may be easily thinned with the manufacturer's dermatome for single stage procedures. However, for two-stage procedures, the dermatome should not be used due to tearing of flap caused by tenting by healing screw, unless the flap is first ballooned with local anesthetic [8]. As an alternative, the flap must be carefully thinned with a scalpel (including removal of hair follicles) for second stage procedures.…”