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Published in: European Archives of Oto-Rhino-Laryngology 9/2015

01-09-2015 | Case Report

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

Authors: A. Devèze, S. Rossetto, R. Meller, M. Sanjuan Puchol

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2015

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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.
Literature
1.
go back to reference Devèze A (2014) Implantable hearing aids. Recent advances. In: Lalwani A, Pfister M (eds). Otolaryngology head and neck surgery, 3rd edn. Jaypee 148–185 Devèze A (2014) Implantable hearing aids. Recent advances. In: Lalwani A, Pfister M (eds). Otolaryngology head and neck surgery, 3rd edn. Jaypee 148–185
2.
go back to reference Håkansson BE, Carlsson PU, Tjellström A, Lidén G (1994) The bone-anchored hearing aid: principal design and audiometric results. Ear Nose Throat J 73:670–675PubMed Håkansson BE, Carlsson PU, Tjellström A, Lidén G (1994) The bone-anchored hearing aid: principal design and audiometric results. Ear Nose Throat J 73:670–675PubMed
3.
go back to reference Hultcrantz M (2011) Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial. Otol Neurotol 32:1134–1139PubMedCrossRef Hultcrantz M (2011) Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial. Otol Neurotol 32:1134–1139PubMedCrossRef
4.
go back to reference 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 140:573–578PubMedCrossRef 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 140:573–578PubMedCrossRef
5.
go back to reference 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 33:1445–1451PubMedCrossRef 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 33:1445–1451PubMedCrossRef
6.
go back to reference 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) 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)
7.
go back to reference 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 34:275–281PubMedCrossRef 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 34:275–281PubMedCrossRef
8.
go back to reference Centric A, Chennupati SK (2014) Abutment-free bone-anchored hearing devices in children: initial results and experience. Int J Pediatr Otorhinolaryngol 78:875–878PubMedCrossRef Centric A, Chennupati SK (2014) Abutment-free bone-anchored hearing devices in children: initial results and experience. Int J Pediatr Otorhinolaryngol 78:875–878PubMedCrossRef
9.
go back to reference 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. 24:59–64PubMedCrossRef 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. 24:59–64PubMedCrossRef
10.
go back to reference 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 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
11.
go back to reference 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 34:1076–1083PubMedCrossRef 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 34:1076–1083PubMedCrossRef
12.
go back to reference 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 9:56–59PubMed 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 9:56–59PubMed
13.
go back to reference 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 122:1368–1370PubMedCrossRef 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 122:1368–1370PubMedCrossRef
14.
go back to reference Zawawi F, Kabbach G, Lallemand M, Daniel SJ (2014) Bone-anchored hearing aid: why do some patients refuse it? Int J Pediatr Otorhinolaryngol 78:232–234PubMedCrossRef Zawawi F, Kabbach G, Lallemand M, Daniel SJ (2014) Bone-anchored hearing aid: why do some patients refuse it? Int J Pediatr Otorhinolaryngol 78:232–234PubMedCrossRef
15.
go back to reference 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 195:2–12PubMed 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 195:2–12PubMed
16.
go back to reference Badran K, Arya AK, Bunstone D, Mackinnon N (2009) Long-term complications of bone-anchored hearing aids: a 14-year experience. J Laryngol Otol 123:170–176PubMedCrossRef Badran K, Arya AK, Bunstone D, Mackinnon N (2009) Long-term complications of bone-anchored hearing aids: a 14-year experience. J Laryngol Otol 123:170–176PubMedCrossRef
17.
go back to reference House JW, Kutz JW Jr (2007) Bone-anchored hearing aids: incidence and management of postoperative complications. Otol Neurotol. 28:213–217PubMedCrossRef House JW, Kutz JW Jr (2007) Bone-anchored hearing aids: incidence and management of postoperative complications. Otol Neurotol. 28:213–217PubMedCrossRef
18.
go back to reference 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 73:112–114PubMed 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 73:112–114PubMed
19.
go back to reference Van de Berg R, Stokroos RJ, Hof JR, Chenault MN (2010) Bone-anchored hearing aid: a comparison of surgical techniques. Otol Neurotol. 31:129–135PubMedCrossRef Van de Berg R, Stokroos RJ, Hof JR, Chenault MN (2010) Bone-anchored hearing aid: a comparison of surgical techniques. Otol Neurotol. 31:129–135PubMedCrossRef
20.
go back to reference 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 140:573–578PubMedCrossRef 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 140:573–578PubMedCrossRef
21.
go back to reference Hultcrantz M (2011) A clinical trial using the bone anchored hearing aid (Baha) method without the skin-thinning step. Otol Neurotol 32:1134–1139PubMedCrossRef Hultcrantz M (2011) A clinical trial using the bone anchored hearing aid (Baha) method without the skin-thinning step. Otol Neurotol 32:1134–1139PubMedCrossRef
22.
go back to reference 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–e306 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–e306
23.
go back to reference Pelosi S, Chandrasekhar SS (2011) Soft tissue overgrowth in bone-anchored hearing aid patients: use of 8.5 mm abutment. J Laryngol Otol 125:576–579PubMedCrossRef Pelosi S, Chandrasekhar SS (2011) Soft tissue overgrowth in bone-anchored hearing aid patients: use of 8.5 mm abutment. J Laryngol Otol 125:576–579PubMedCrossRef
24.
go back to reference 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 31:612–614PubMed 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 31:612–614PubMed
25.
go back to reference 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 35:1486–1491PubMedCrossRef 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 35:1486–1491PubMedCrossRef
26.
go back to reference 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 35:1238–1241PubMedCentralPubMed 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 35:1238–1241PubMedCentralPubMed
27.
go back to reference Browning GG (1990) The British experience of an implantable, subcutaneous bone conduction hearing aid (Xomed Audiant). J Laryngol Otol 104:534–538PubMedCrossRef Browning GG (1990) The British experience of an implantable, subcutaneous bone conduction hearing aid (Xomed Audiant). J Laryngol Otol 104:534–538PubMedCrossRef
28.
go back to reference 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 52:151–154PubMed 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 52:151–154PubMed
29.
go back to reference 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 105:40–45PubMedCrossRef 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 105:40–45PubMedCrossRef
30.
go back to reference 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–E27PubMed 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–E27PubMed
Metadata
Title
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
Authors
A. Devèze
S. Rossetto
R. Meller
M. Sanjuan Puchol
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 9/2015
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-015-3521-0

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