A Comparison of the Operative Techniques and the Postoperative Complications for Bone-Anchored Hearing Aid Implantation

doi:10.1055/s-0037-1613685

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Original Research • Int. Arch. Otorhinolaryngol. 22 (04) • Oct-Dec 2018 • https://doi.org/10.1055/s-0037-1613685 linkcopy

A Comparison of the Operative Techniques and the Postoperative Complications for Bone-Anchored Hearing Aid Implantation

About the SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction Bone anchored hearing aids (BAHA) represent a useful surgical option for patients with single sided deafness.

Objectives To compare multiple techniques for BAHA implantation regarding postoperative complications, operative time, and duration between the surgery and the first use of the BAHA.

Methods A retrospective study was conducted of all patients receiving implantation of a BAHA from August of 2008 to October of 2014. Data collected included: patient age, gender, side operated, abutment length, operative time, duration until first use of the BAHA, operative technique, and postoperative complications. The statistical analysis was performed using analysis of variance (ANOVA), Tukey pairwise comparison, chi-square, and paired t-test. Statistical significance was determined using a level of p< 0.05.

Results A total of 88 patients (43 female and 45 male) were included in the data analysis. A total of 80 complications were documented, and these complications were classified according to the Holgers criteria. A significant difference in the total postoperative complications existed between the six techniques used (ANOVA; p< 0.01). In addition, there was also a significant difference among the six techniques employed regarding the operative time (ANOVA; p< 0.01). The average time duration until fitting of the BAHA processor among the various techniques trended toward but did not reach statistical significance (ANOVA; p= 0.16).

Conclusions Significant differences in the operative outcomes exist among the various techniques for BAHA implantation. Based on the statistical analysis of our data, the BAHA Attract system (Cochlear Ltd., Sidney, Australia) requires greater operative time, but it is associated with less postoperative complications than percutaneous techniques and its processor may be fitted significantly sooner.

Keywords hearing aids; deafness; otologic surgical procedures

Grade	Description
0	Reaction-free skin around the abutment
1	Redness with slight swelling around the abutment
2	Redness, moistness, and moderate swelling
3	Redness, moistness, and moderate swelling with tissue granulation around the abutment
4	Overt signs of infection resulting in removal of the implant

Characteristic	Dermatome	Linear	Biopsy Punch (BP)	Linear with BP	U-shaped Flap	Attract	p
	n = 6	n = 25	n = 6	n = 15	n = 23	n = 13
Mean age(years)	54.8	55.8	60.5	58.9	59.3	56	0.94
Location(% right-sided)	50	44	66.7	46.7	47.8	38.5	0.92
Gender(% male)	33.3	56	83.3	60	34.8	53.8	0.26
Complications(Total)	6	19	12	20	22	1	< 0.01
Major complications(Holgers 3 & 4)	3	14	6	13	9	0	?
Average. surgical time (min.)	67	54	30	51	41	62	< 0.01
Average. time to 1st use (days)	90	91	97	88	92	59	0.16

Holgers Classification	1	2	3	4	Total Complications	Total cases	Cases without complications (%)
Dermatome	2	1	2	1	6	6	50
Linear	5	0	9	5	19	25	44
Biopsy Punch (BP)	3	3	5	1	12	6	33.3
Linear with BP	7	0	12	1	20	15	26.7
U-shaped Flap	7	6	8	1	22	23	43.5
Attract	1	0	0	0	1	13	92.3
Total					80	88	47.7

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Fundação Otorrinolaringologia Rua Artur de Azevedo 46, Zip code 05404-000,, São Paulo/SP, Brazil, Phone: +55 11 3062 4097, E-mail: iaorl@iaorl.org - São Paulo - SP - Brazil
E-mail: iaorl@iaorl.org

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro