Successful Placement of a BAHA Implant in a Patient With Epidermolysis Bullosa: A Case Report and Review of the Literature

2017 ◽  
Vol 126 (11) ◽  
pp. 778-780 ◽  
Author(s):  
Jason R. Brown ◽  
D. Micah Milgraum ◽  
Farhaad R. Riyaz ◽  
Marla N. Jahnke ◽  
Prasad John Thottam
Keyword(s):  
Hearing Loss ◽  
Epidermolysis Bullosa ◽  
Hearing Aids ◽  
External Auditory Canal ◽  
Skin Irritation ◽  
Minor Trauma ◽  
Mixed Hearing Loss ◽  
Osseointegrated Implant ◽  
Bone Anchored Hearing Aid ◽  
Conductive Hearing

Introduction: Epidermolysis bullosa (EB) is a spectrum of mechanobullous disorders characterized by blistering following minor trauma or traction to the skin. Hearing loss in this population is poorly described in the otolaryngology literature, and its treatment oftentimes results in external auditory canal skin irritation. Case Presentation: We present the case of a 26-year-old female with EB and mixed hearing loss unable to wear conventional hearing aids due to sequelae of the external auditory canals. An osseointegrated implant was used as other hearing aids were deemed to be too destructive of the external auditory canal skin. Management and Outcome: Our patient underwent placement of a right bone-anchored hearing aid with minimal disruption of the surrounding skin using a minimally invasive punch technique. Over 1 year of follow-up, her course was complicated by 1 simple cellulitic infection at the surgical site treated successfully with oral antibiotics. Discussion: The literature regarding the otolaryngologic manifestations of EB is sparse. The otologic sequelae are particularly overlooked in the workup and management. Based on the results of this case study, it appears that an osseointegrated implant can be safely utilized to treat significant mixed or conductive hearing loss in patients with EB.

An approach to bilateral bone-anchored hearing aid surgery in children: contralateral placement of sleeper fixture

2008 ◽  
Vol 123 (5) ◽  
pp. 555-557 ◽  
Author(s):  
J M Bernstein ◽  
P Z Sheehan
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Hearing Aid ◽  
Contralateral Side ◽  
Two Stage ◽  
Calvarial Bone ◽  
Optimal Position ◽  
Bone Anchored Hearing Aid ◽  
Conductive Hearing

AbstractObjective:Bone-anchored hearing aid surgery in younger children is a two-stage procedure, with a titanium fixture being allowed to osseointegrate for several months before an abutment is fitted through a skin graft. In the first procedure, it has been usual to place a reserve or sleeper fixture approximately 5 mm from the primary fixture as a backup in case the primary fixture fails to osseointegrate. This ipsilateral sleeper fixture is expensive, is often not used, and is placed in thinner calvarial bone where it is less likely to osseointegrate successfully. The authors have implanted the sleeper fixture on the contralateral side, with the additional objective of reducing the number of procedures for bilateral bone-anchored hearing aid implantation, providing a cost-effective use for the sleeper.Methods:The authors implanted the bone-anchored hearing aid sleeper fixture in the contralateral temporal bone instead of on the ipsilateral side in seven successive paediatric cases with bilateral conductive hearing loss requiring two-stage bone-anchored hearing aids, treated at the Royal Manchester Children's Hospital, UK.Results:The seven patients ranged in age from five to 15 years, with a mean age of 10 years; in addition, a 20-year-old with learning disability was also treated. In each case, the contralateral sleeper fixture was not needed as a backup fixture, but was used in four patients (57 per cent) as the basis for a second-side bone-anchored hearing aid.Conclusions:In children with bilateral conductive hearing loss, in whom a bilateral bone-anchored hearing aid is being considered and the second side is to be operated upon at a later date, we recommend placing the sleeper fixture on the contralateral side at the time of primary first-side surgery. Our technique provides a sleeper fixture located in an optimal position, where it also offers the option of use for a second-side bone-anchored hearing aid and reduces the number of procedures needed.

Bone Conduction Implants: Transcutaneous vs. Percutaneous

1992 ◽  
Vol 106 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Phillip S. Wade ◽  
Jerry J. Halik ◽  
Marshall Chasin
Keyword(s):  
Clinical Trial ◽  
Hearing Loss ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Mixed Hearing Loss ◽  
Hearing Devices ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing ◽  
Conductive Hearing

Clinical experience with transcutaneous bone conduction implants has demonstrated that they are most beneficial for patients with purely conductive hearing loss in at least one ear. Percutaneous bone conduction implants, however, have been reported to provide adequate benefit for patients with mixed hearing loss with bone conduction pure-tone averages up to 45 db hl (Tjellstrom, 1989). The results of 24 Xomed Audiant osseointegrated bone conduction hearing devices (including a clinical trial on two patients using a new, larger magnet [Neodynium Iron Boron]), plus the results of eleven patients implanted and fitted with the percutaneous bone-anchored hearing aid are reported. Aided results with these devices will be presented. In addition, general comparisons of benefit obtained with the two devices will be made for patients who exhibit similar hearing losses. Finally, a direct comparison will be made on two patients who have undergone both implant procedures.

Speech and voice rehabilitation in selected patients fitted with a bone anchored hearing aid (BAHA)

1996 ◽  
Vol 110 (21) ◽  
pp. 47-51 ◽  
Author(s):  
Julie Thomas
Keyword(s):  
Hearing Loss ◽  
Speech Therapy ◽  
Conductive Hearing Loss ◽  
Treacher Collins Syndrome ◽  
Voice Rehabilitation ◽  
Osseointegrated Implant ◽  
Spontaneous Improvement ◽  
Bone Anchored Hearing Aid ◽  
Characteristic Features ◽  
Conductive Hearing

AbstractWithin the Birmingham osseointegrated implant programme there have been several patients with severe pre-lingual conductive hearing loss. The majority of these have been patients with Treacher Collins syndrome.There are characteristic features of speech and voice in those with long-standing conductive hearing loss. In addition, the associated abnormalities of jaw, teeth and palate may amplify the problem. There may be spontaneous improvement in features such as voice pitch, quality and intensity following the fitting of a BAHA. However, in those with a pre-lingual hearing impairment, speech therapy may be necessary. Patients assessed as suitable for BAHA have a full assessment of communication skills including audio recording of speech and voice. Post-operative training improves auditory discrimination and perception and is followed by training in the production of the newly perceived speech sounds.

Evolving Applications in the Use of Bone-Anchored Hearing Aids

2002 ◽  
Vol 11 (2) ◽  
pp. 96-103 ◽  
Author(s):  
Jaclyn B. Spitzer ◽  
Soha N. Ghossaini ◽  
Jack J. Wazen
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Patient Outcomes ◽  
Patient Selection ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Effective Means ◽  
Design Features ◽  
Bone Anchored Hearing Aid ◽  
Conductive Hearing

The bone-anchored hearing aid (BAHA) is an effective means of intervention, its use being well documented in persons with chronic conductive pathology and congenital aural anomalies. This article describes the standard guidelines (both auditory and extraauditory aspects) for patient selection and expands the criteria to include bilateral BAHA implantation, unilateral conductive hearing loss, and unilateral profound sensorineural hearing loss. The BAHA’s development, design features, and patient outcomes are also reviewed. Suggestions are presented for fitting, counseling, and following BAHA users.

The Birmingham bone anchored hearing aid programme: referrals, selection, rehabilitation, philosophy and adult results

1996 ◽  
Vol 110 (21) ◽  
pp. 13-20 ◽  
Author(s):  
H. R. Cooper ◽  
S. P. Burrell ◽  
R. H. Powell ◽  
D. W. Proops ◽  
J. A. Bickerton
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Hearing Aid ◽  
Questionnaire Data ◽  
Speech Discrimination ◽  
Suppurative Otitis Media ◽  
Hearing In Noise ◽  
Bone Anchored Hearing Aid ◽  
Conductive Hearing

AbstractThe Birmingham bone anchored hearing aid team is part of the Birmingham osseointegrated programme. In the first seven years of its existence it has received 309 referrals. Twenty-six per cent had suffered a congenital conductive hearing loss and 74 per cent had an acquired conductive hearing loss; the majority secondary to chronic suppurative otitis media.This report is of 68 out of 106 adults wearing bone anchored hearing aids (BAHAs). Ninety-eight per cent showed audiological improvement with the congenital group demonstrating marginally the best freefield thresholds and speech discrimination. Questionnaire data as to the patient experience confirms the benefits especially hearing in noise, and comfort, and the vast majority were more satisfied with the bone anchored hearing aid than their previous aid.

Total Implantation of the Active Hearing Implant Tica for Middle Ear Disease: A Temporal Bone Study

2001 ◽  
Vol 110 (10) ◽  
pp. 912-916 ◽  
Author(s):  
Marcus M. Maassen ◽  
Rolf Lehner ◽  
I. Baumann ◽  
Hans Leysieffer ◽  
Hans P. Zenner
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Hearing Aids ◽  
Ossicular Chain ◽  
Coupling Element ◽  
Mixed Hearing Loss ◽  
Hearing Devices ◽  
Stapes Prosthesis ◽  
Middle Ear Disease ◽  
Conductive Hearing

A subpopulation of hearing-impaired patients has conductive hearing loss that cannot be improved by classic tympanoplasty. Other patients have a mixed hearing loss and cannot be helped by present forms of ear surgery or by hearing aids. Possible help for some patients may come from current implantable hearing devices if these are modified for the patient's specific anatomic situation. The TICA LZ 3001 is a hearing implant for total implantation used to treat moderate to severe sensorineural hearing loss. Most patients who use it have a normal ossicular chain that allows coupling of the implant to the incus. The present temporal bone study demonstrates that the TICA can also be used in patients with an interrupted ossicular chain. If the incus long process shows a defect, the TICA may be coupled to the incus body, and connection between the stapes and the long process of the incus can be achieved with a commercially available titanium-angle prosthesis or liquid ionomeric cement. In cases of an absent incus, the coupling axis of the transducer may be coupled to the stapes head via a modified coupling element. With an absent stapes, the coupling axis may be coupled directly to the perilymph by a coupling element similar to a gold stapes prosthesis.

Use of hearing AIDS

1976 ◽  
Vol 14 (12) ◽  
pp. 45-46
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Auditory Training ◽  
Lip Reading ◽  
Conductive Hearing

Up to 3 million people in Britain might be helped by hearing aids.1 2 Most are over 65 years of age, but some are infants. All should be referred to specialist centres for assessment as soon as possible. Hearing aids generally help most in disorders of the middle ear (conductive hearing loss); they can also help those with sensorineural and other forms of hearing loss. The use of an aid often needs to be supplemented by lip reading and other means of auditory training.1 3

scholarly journals Stapedotomy post-operative results and complications

2020 ◽  
Vol 6 (8) ◽  
pp. 1442
Author(s):  
Hanumant S. Giri ◽  
Ram C. Bishnoi ◽  
Pooja D. Nayak ◽  
Ninad S. Gaikwad
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Major Complication ◽  
Safe Procedure ◽  
Hearing Results ◽  
Post Surgery ◽  
Localized Disease ◽  
Conductive Hearing

<p class="abstract"><strong>Background:</strong> Otosclerosis is a hereditary localized disease of the bone derived from the otic capsule. It is characterized by alternating phases of bone formation and resorption and patient presents with conductive hearing loss. Treatment of otosclerosis can be of two kinds: hearing aids and surgery. Stapedectomy and stapedotomy are the two surgical procedures done for treatment of otosclerosis. Present study was conducted on 30 patients with otosclerosis who underwent stapedotomy to assess the hearing results post-surgery by serial Audiometric studies and to study the complications of stapedotomy surgery.</p><p class="abstract"><strong>Methods:</strong> This prospective observational study conducted on 30 patients of otosclerosis who fulfilled the inclusion and exclusion criteria.  </p><p class="abstract"><strong>Results:</strong> In this study of thirty cases of otosclerosis which were operated for small fenestra stapedotomy, we conclude that Hearing gain post-surgery was remarkable especially for patients with a pure conductive hearing loss. There was no deterioration in hearing after two years of follow-up. In our study on 30 patients we encountered minor complication in 4 patients (13.33%) and 1 major complication of profound sensorineural hearing loss 3.33%.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that stapedotomy is a relatively safe procedure with significant post-surgery hearing benefit.</p>

scholarly journals Assess the hearing of contralateral ear in patients with unilateral chronic squamosal otitis media

2020 ◽  
Vol 6 (5) ◽  
pp. 886
Author(s):  
Raphella Khan ◽  
Anirudh Kasliwal
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Sensorineural Hearing ◽  
Retraction Pocket ◽  
Mixed Hearing Loss ◽  
Contralateral Ear ◽  
The Right ◽  
Conductive Hearing

<p class="abstract"><strong>Background:</strong> Chronic squamosal otitis media can occur due to many conditions affecting the middle ear. Most common sign of developing a chronic squamosal otitis media is formation of a retraction pocket in the tympanic membrane leading to further development of a cholesteatoma and if not treated properly, may lead to development of dangerous complication in the affected ear. These etiological factors may also affect the other ear. It is therefore very necessary to assess and diagnose the contralateral ear, so that the disease can be intervened and treated at the right time, to prevent any deterioration in hearing of the contralateral ear.</p><p class="abstract"><strong>Methods:</strong> The prospective study was done in 100 patients with unilateral chronic squamosal otitis media, where the contra lateral ear was examined and assessed for any hearing loss.  </p><p class="abstract"><strong>Results:</strong> We found hearing loss in the contra lateral ear ranging from mild conductive hearing loss to sensorineural hearing loss with the maximum patients with mild conductive hearing loss (42%) and lowest in sensorineural hearing loss (1%).  </p><p class="abstract"><strong>Conclusions:</strong> In our study, 76 patients were seen with conductive hearing loss. Out of that, 42% patients were seen with mild conductive hearing loss, 30% with moderate conductive hearing loss and 4% with severe conductive hearing loss. 20% patients were seen with normal hearing. 3% patients were seen with mixed hearing loss and only 1% patient was seen with sensorineural hearing loss in contralateral ear.</p>

The first reported treatment of Nager syndrome associated hearing loss with bone-anchored hearing aids: case report

2011 ◽  
Vol 126 (1) ◽  
pp. 76-78 ◽  
Author(s):  
G P Davies ◽  
I J M Johnson
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Literature Review ◽  
Current Literature ◽  
Hearing Aids ◽  
Clinical Case ◽  
Conductive Hearing Loss ◽  
First Case ◽  
Nager Syndrome ◽  
Conductive Hearing

AbstractObjective:To report the first case of treatment of Nager syndrome associated conductive hearing loss with bone-anchored hearing aids, in a three-year-old boy.Method:Clinical case report and current literature review regarding the use of bone-anchored hearing aids in the treatment of conductive hearing loss in children.Results:A three year eight month old boy with Nager syndrome was successfully treated for conductive hearing loss using bilateral bone-anchored hearing aids.Conclusion:This is the first case report of the use of bone-anchored hearing aids to treat Nager syndrome associated conductive hearing loss. Treatment was safe and successful in this case.

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