Long-term soft tissue outcomes for hydroxyapatite-coated bone-anchored hearing implant surgery

Abstract

Purpose: To investigate skin-related postoperative outcomes following a tissue preservation technique in percutaneous hydroxyapatite-coated bone-anchored hearing aid (BAHA) abutment implantation.

Methods: A retrospective medical records review of adult patients, who underwent single-stage BAHA implantation between July 2013 and November 2017 at a tertiary centre was conducted. Surgical procedures were performed by a single surgeon using a linear incision soft tissue preservation technique. Patients were reviewed at 1 week, 4 weeks, 3 months, 6 months, and annually postoperatively and soft tissue reactions were graded using Holger's score RESULTS: There were 102 patients included with a slight female preponderance (female:male 56:46). There were 586 follow-up episodes during the study period. From the recorded follow-up episodes, Holger's scores were documented as follows: Holger score 0 (89%); 1 (7%); 2 (2%); 3 (1.9%). Three patients (3%) required peri-abutment soft tissue excision (Holger 3) and insertion of longer abutments. One patient (1%) reported atraumatic implant loss. The BAHA was re-implanted in two patients (2%) due to traumatic dislodgement. There was a statistically significant association (p = 0.009) when the mean time to minor skin complications was compared with mean time to a significant skin reaction.

Conclusion: Tissue preservation technique is the procedure of choice for BAHA abutment implant surgery. It confers excellent soft tissue outcomes and an excellent implant survival rate.

Keywords: Abutment; BAHA; Linear incision soft tissue preservation techniques; Minimally invasive surgery; Osseointegrated device.