Abstract
Bone-anchored hearing aids (BAHAs) provide better wearing comfort and sound quality compared to air conduction hearing aids or conventional bone conduction hearing aids in some patients with congenital external auditory canal anomalies or a middle ear postoperative state. However, BAHAs can cause postoperative skin complications, including inflammatory skin reactions, skin overhang and implant extrusion. In the present study, five ears of four patients who underwent BAHA surgery at our hospital or other institutes, but who needed a re-operation for their severe skin complications were enrolled. The follow-up periods between BAHA surgeries and re-operations ranged from nine to 91 months (mean: 62.6±33.5 months). All the ears had grade 3 skin reactions, and four ears showed skin overhang more than one time after the BAHA surgeries. The remaining ear had repetitive grade 2 or 3 skin reactions nine months post-surgery. Subcutaneous tissue resection was performed for two ears, and a combination of infectious skin and subcutaneous tissue resections with split-thickness skin grafting was carried out in the other three ears. The findings of re-operations included granulation tissue around the implant flange and a gap between the implant flange and bone. Up to now, no ears have experienced more than a grade 1 skin reaction following the re-operation. Using a long abutment may therefore represent a treatment option if further surgery is needed.
