European Archives of Oto-Rhino-Laryngology

, Volume 272, Issue 9, pp 2563–2569 | Cite as

Switching from a percutaneous to a transcutaneous bone anchored hearing system: the utility of the fascia temporalis superficialis pedicled flap in case of skin intolerance

  • A. Devèze
  • S. Rossetto
  • R. Meller
  • M. Sanjuan Puchol
Case Report

Abstract

Objectives

To present the option to use a Fascia Temporalis Superficialis pedicled flap for the implantation of a transcutaneous magnetic osseointegrated auditory implant in selected revision procedures.

Background

Osseointegrated auditory implants represent a reliable option for patients. Skin intolerance and aesthetic issue are two clear limitations of percutaneous system. Magnetic transcutaneous devices have been developed to overcome such drawbacks. The current new experience of such a device shows that they are well tolerated in primary cases. However, switching from a previous percutaneous system raises the question of skin tolerance. Hence, previous implanted abutments with skin penetration and skin reduction are more likely cause to skin intolerance and complication.

Methods

We described here the option to use a Fascia Temporalis Superficialis flap to cover the implanted magnet.

Conclusion

When switching from percutaneous osseointegrated auditory implant to transcutaneous system in case of high risk of skin intolerance, this procedure may provide sufficient tissue coverage to prevent skin intolerance, pain and delayed extrusion.

Keywords

Skin reaction Transcutaneous baha Bone anchored hearing implant 

Notes

Acknowledgments

The authors would like to thank Mrs Emilia Ong-Daoud for proofreading the English version of the manuscript.

References

  1. 1.
    Devèze A (2014) Implantable hearing aids. Recent advances. In: Lalwani A, Pfister M (eds). Otolaryngology head and neck surgery, 3rd edn. Jaypee 148–185Google Scholar
  2. 2.
    Håkansson BE, Carlsson PU, Tjellström A, Lidén G (1994) The bone-anchored hearing aid: principal design and audiometric results. Ear Nose Throat J 73:670–675PubMedGoogle Scholar
  3. 3.
    Hultcrantz M (2011) Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial. Otol Neurotol 32:1134–1139PubMedCrossRefGoogle Scholar
  4. 4.
    Wilkinson EP, Luxford WM, Slattery WH 3rd, De la Cruz A, House JW, Fayad JN (2009) Single vertical incision for Baha implant surgery: preliminary results. Otolaryngol Head Neck Surg 140:573–578PubMedCrossRefGoogle Scholar
  5. 5.
    Larsson A, Wigren S, Andersson M, Ekeroth G, Flynn M, Nannmark U (2012) Histologic evaluation of soft tissue integration of experimental abutments for bone anchored hearing implants using surgery without soft tissue reduction. Otol Neurotol 33:1445–1451PubMedCrossRefGoogle Scholar
  6. 6.
    Wade PS, Halik JJ, Chasin M (1992) Bone conduction implants: transcutaneous vs. percutaneous. Otolaryngol Head Neck Surg 106:68–74 (Erratum in: Otolaryngol Head Neck Surg 1992;106:412–413)Google Scholar
  7. 7.
    Denoyelle F, Leboulanger N, Coudert C, Mazzaschi O, Loundon N, Vicaut E et al (2013) New closed skin bone-anchored implant: preliminary results in 6 children with ear atresia. Otol Neurotol 34:275–281PubMedCrossRefGoogle Scholar
  8. 8.
    Centric A, Chennupati SK (2014) Abutment-free bone-anchored hearing devices in children: initial results and experience. Int J Pediatr Otorhinolaryngol 78:875–878PubMedCrossRefGoogle Scholar
  9. 9.
    Işeri M, Orhan KS, Kara A, Durgut M, Oztürk M, Topdağ M, Calışkan S (2014) A new transcutaneous bone anchored hearing device—the Baha® attract system: the first experience in Turkey. Kulak Burun Bogaz Ihtis Derg. 24:59–64PubMedCrossRefGoogle Scholar
  10. 10.
    Kurz A, Flynn M, Caversaccio M, Kompis M (2014) Speech understanding with a new implant technology: a comparative study with a new nonskin penetrating baha system. Biomed Res In. 2014:416205. doi:10.1155/2014/416205 Google Scholar
  11. 11.
    Sprinzl G, Lenarz T, Ernst A, Hagen R, Wolf-Magele A, Mojallal H, Todt I, Mlynski R, Wolframm MD (2013) First European multicenter results with a new transcutaneous bone conduction hearing implant system: short-term safety and efficacy. Otol Neurotol 34:1076–1083PubMedCrossRefGoogle Scholar
  12. 12.
    Holgers KM, Tjellström A, Bjursten LM, Erlandsson BE (1988) Soft tissue reactions around percutaneous implants: a clinical study of soft tissue conditions around skin-penetrating titanium implants for bone-anchored hearing aids. Am J Otol 9:56–59PubMedGoogle Scholar
  13. 13.
    Van Rijswijk JB, Mylanus EA (2008) Intralesional triamcinolone acetonide injection in hypertrophic skin surrounding the percutaneous titanium implant of a bone-anchored hearing aid. J Laryngol Otol 122:1368–1370PubMedCrossRefGoogle Scholar
  14. 14.
    Zawawi F, Kabbach G, Lallemand M, Daniel SJ (2014) Bone-anchored hearing aid: why do some patients refuse it? Int J Pediatr Otorhinolaryngol 78:232–234PubMedCrossRefGoogle Scholar
  15. 15.
    Snik AF, Mylanus EA, Proops DW, Wolfaardt JF, Hodgetts WE, Somers T, Niparko JK, Wazen JJ, Sterkers O, Cremers CW, Tjellström A (2005) Consensus statements on the BAHA system: where do we stand at present? Ann Otol Rhinol Laryngol Suppl 195:2–12PubMedGoogle Scholar
  16. 16.
    Badran K, Arya AK, Bunstone D, Mackinnon N (2009) Long-term complications of bone-anchored hearing aids: a 14-year experience. J Laryngol Otol 123:170–176PubMedCrossRefGoogle Scholar
  17. 17.
    House JW, Kutz JW Jr (2007) Bone-anchored hearing aids: incidence and management of postoperative complications. Otol Neurotol. 28:213–217PubMedCrossRefGoogle Scholar
  18. 18.
    Tjellström A, Granström G (1994) Long-term follow-up with the bone-anchored hearing aid: a review of the first 100 patients between 1977 and 1985. Ear Nose Throat J 73:112–114PubMedGoogle Scholar
  19. 19.
    Van de Berg R, Stokroos RJ, Hof JR, Chenault MN (2010) Bone-anchored hearing aid: a comparison of surgical techniques. Otol Neurotol. 31:129–135PubMedCrossRefGoogle Scholar
  20. 20.
    Wilkinson EP, Luxford WM, Slattery WH 3rd, De la Cruz A, House JW, Fayad JN (2009) Single vertical incision for Baha implant surgery: preliminary results. Otolaryngol Head Neck Surg 140:573–578PubMedCrossRefGoogle Scholar
  21. 21.
    Hultcrantz M (2011) A clinical trial using the bone anchored hearing aid (Baha) method without the skin-thinning step. Otol Neurotol 32:1134–1139PubMedCrossRefGoogle Scholar
  22. 22.
    Calvo Bodnia N, Foghsgaard S, Nue Møller M, Cayé-Thomasen P (2014) Long-term results of 185 consecutive osseointegrated hearing device implantations: a comparison among children, adults, and elderly. Otol Neurotol 35:e301–e306Google Scholar
  23. 23.
    Pelosi S, Chandrasekhar SS (2011) Soft tissue overgrowth in bone-anchored hearing aid patients: use of 8.5 mm abutment. J Laryngol Otol 125:576–579PubMedCrossRefGoogle Scholar
  24. 24.
    Doshi J, McDermott AL, Reid A, Proops D (2010) The 8.5 mm abutment in children: the Birmingham bone-anchored hearing aid program experience. Otol Neurotol 31:612–614PubMedGoogle Scholar
  25. 25.
    Nelissen RC, Stalfors J, de Wolf MJ, Flynn MC, Wigren S, Eeg-Olofsson M, Green K, Rothera MP, Mylanus EA, Hol MK (2014) Long-term stability, survival, and tolerability of a novel osseointegrated implant for bone conduction hearing: 3-year data from a multicenter, randomized, controlled, clinical investigation. Otol Neurotol 35:1486–1491PubMedCrossRefGoogle Scholar
  26. 26.
    Foghsgaard S, Caye-Thomasen P (2014) A new wide-diameter bone-anchored hearing implant-prospective 1-year data on complications, implant stability, and survival. Otol Neurotol 35:1238–1241PubMedCentralPubMedGoogle Scholar
  27. 27.
    Browning GG (1990) The British experience of an implantable, subcutaneous bone conduction hearing aid (Xomed Audiant). J Laryngol Otol 104:534–538PubMedCrossRefGoogle Scholar
  28. 28.
    Tong MC, van Hasselt CA (1997) Cochlear implant surgery in a modified radical mastoidectomy cavity reconstructed utilizing the Hong Kong vascularized temporalis fascia flap technique. Adv Otorhinolaryngol 52:151–154PubMedGoogle Scholar
  29. 29.
    Tellioğlu AT, Tekdemir I, Erdemli EA, Tüccar E, Ulusoy G (2000) Temporoparietal fascia: an anatomic and histologic reinvestigation with new potential clinical applications. Plast Reconstr Surg 105:40–45PubMedCrossRefGoogle Scholar
  30. 30.
    Heywood RL, Patel PM, Jonathan DA (2011) Comparison of hearing thresholds obtained with Baha preoperative assessment tools and those obtained with the osseointegrated implant. Ear Nose Throat J 90:E21–E27PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • A. Devèze
    • 1
    • 2
  • S. Rossetto
    • 3
  • R. Meller
    • 1
  • M. Sanjuan Puchol
    • 1
  1. 1.Assistance Publique Hôpitaux de Marseille, Department of ORL and Skull Base SurgeryUniversity Hospital Nord, Chemin des BourrellyMarseilleFrance
  2. 2.Laboratory of Applied BiomechanismAix Marseille University IFSTTAR UMR T24MarseilleFrance
  3. 3.Assistance Publique Hôpitaux de Marseille, Department of ORL and Skull Base SurgeryUniversity Hospital Nord and Center for Hearing AidMarseilleFrance

Personalised recommendations