Complications of Bone-Anchored Hearing Devices

Abstract

Complications of bone-anchored hearing devices occur with both soft tissue and bone. Soft tissue complications are much more common and most often involve irritation of the skin surrounding the implant. Other complications include: skin flap necrosis, wound dehiscence, bleeding or hematoma formation, and persistent pain. Bone complications are classified as either early or late. Early complications are due to failure of osseointegration, while late complications are usually the result of either chronic infection or trauma. Pediatric patients are a unique group of implant patients and are more likely to have complications of both soft tissue and bone. Most complications can be managed in the office with topical therapy and wound care, although revision surgery may be required in extensive skin overgrowth cases. Proper patient selection, meticulous surgical technique, and patient hygiene around the implant are the most critical aspects in minimizing complications in patients with osseointegrated implants.

Speech Understanding with a New Implant Technology: A Comparative Study with a New Nonskin Penetrating Baha System

“…One of them is a tendency to low-grade infections around the abutment [9, 10], another personal preference, and cosmetic factors. Some patients who could benefit significantly from a system such as the Baha depicted in Figure 1(a) decline because of the skin penetrating implant behind the ear.…”

Minimal Reporting Standards for Active Middle Ear Hearing Implants

“…Late complications, (1 year or more postoperative) including implant or wire extrusion, dislocation of transducer/coupler assembly and loss of coupling (e.g., increase in in situ thresholds) need to be reported, as well as technical complications and device failures. If a revision surgery was necessary, it must be stated whether it was due to medical/ surgical (procedure) or device-related reasons [Ernst et al, 2016;Gavilan et al, 2015;Hobson et al, 2010;Lassaletta et al, 2016;Mohamad et al, 2016;Van Rompaey et al, 2011;Wazen et al, 2011;Zwartenkot et al, 2016].…”

Acute Otologic Infections in Pediatric Patients

“…More severe infection can result in implant exposure, extrusion, or compromise osseointegration and may require device removal. 82 Granulation tissue can generally be treated easily in the clinic with chemical cautery using silver nitrate or with topical steroid creams (e.g., clobetasol). 83 Regular follow-up and meticulous wound care are important to minimizing infectious complications of BCHAs.…”