Hostname: page-component-84c44f86f4-wthsd Total loading time: 0 Render date: 2025-10-14T11:23:44.320Z Has data issue: false hasContentIssue false

Percutaneous bone-anchored hearing rehabilitation in adults: the Nottingham experience over a five-year period

Published online by Cambridge University Press:  04 April 2025

Tony Hao*
Affiliation:
Department of ENT, Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Lenton, Nottingham
Anand Kasbekar
Affiliation:
Department of ENT, Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Lenton, Nottingham
*
Corresponding author: Tony Hao; Email: tony.hao2@nhs.net

Abstract

Objective

Bone-conduction hearing devices provide good hearing outcomes for conductive/mixed hearing losses. Complications post-insertion can lead to additional procedures. Identifying factors that may increase likelihood of developing complications can mitigate risk and inform patients.

Method

A retrospective cohort analysis of 166 adults receiving bone-anchored hearing aid connect operations from 2016–2021 was performed assessing complication rate and contributing factors causing revision procedures.

Results

Twenty-nine per cent of patients had post-operative complications. In total, 17.5 per cent needed additional procedures. Skin overgrowth/infection, granulation and traumatic extrusion were most common reasons. No difference was found in complication rate between different surgical techniques, surgeon grade or general versus local anaesthetic. More complications were observed in decreasing age, male gender and severity of skin reaction.

Conclusion

Revision procedure and complication rates are similar to those reported in published literature. Patient characteristics are important in identifying those likely to develop complications. Non-patient factors did not seem to affect complication rate.

Information

Type
Main Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Tony Hao takes responsibility for the integrity of the content of the paper

Earlier work was presented as a poster at a meeting, however not with all results in this paper. British Society of Otology Annual Meeting, 04/05/2023, London, UK

References

National Institute for Health and Care Excellence (NICE). Hearing Loss in Adults. In: https://cks.nice.org.uk/topics/hearing-loss-in-adults [8 January 2024]Google Scholar
Tjellström, A, Granström, G. 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 1994;73:112–14CrossRefGoogle ScholarPubMed
Grant, G. Choosing the right bone conduction solution for your patients. Cochlear Pro News. In: https://pronews.cochlear.com/which-baha-system-is-right-for-your-patients [8 January 2024]Google Scholar
NHS Commissioning Board. Clinical Commissioning Policy: Bone Anchored Hearing Aids. April 2013. Reference: NHSCB/D09/P/a [8 January 2024]Google Scholar
Kiringoda, R, Lustig, LR. A meta-analysis of the complications associated with osseointegrated hearing aids. Otol Neurotol 2013;34:790–4CrossRefGoogle ScholarPubMed
Robinette, K, Sims, J, Pang, B, Babu, S. Transcutaneous versus percutaneous bone-anchored hearing aids: a quality of life comparison. Am J Otolaryngol 2023;44:103758CrossRefGoogle ScholarPubMed
Hobson, JC, Roper, AJ, Andrew, R, Rothera, MP, Hill, P, Green, KM. Complications of bone-anchored hearing aid implantation. J Laryngol Otol 2010;124:132–6CrossRefGoogle ScholarPubMed
Shirazi, MA, Marzo, SJ, Leonetti, JP. Perioperative complications with the bone-anchored hearing aid. Otolaryngol Head Neck Surg 2006;134:236–9CrossRefGoogle ScholarPubMed
Brinkman, D, Hill, R, Hone, S, Kieran, S. Bone-anchored hearing aids: percutaneous versus transcutaneous attachments – a health economics comparison in paediatric patients. Int J Pediatr Otorhinolaryngol 2023;175:111773CrossRefGoogle ScholarPubMed
Shapiro, S, Ramadan, J, Cassis, A. BAHA Skin complications in the pediatric population: systematic review with meta-analysis. Otol Neurotol 2018;39:865–73CrossRefGoogle ScholarPubMed
Cochlear Limited. MRI guidelines for professionals. In: https://www.cochlear.com/us/en/professionals/resources-and-training/mri-guidelines [1 November 2024]Google Scholar
Cochlear Limited. MRI Considerations. In: www.cochlear.com/mriGoogle Scholar
Cochlear Limited. Cochlear BAHA Connect System. Radiographer’s Instructions. MRI for Baha Connect System. In: https://assets.cochlear.com/api/public/content/8e34cf5320524d00a67c73951eaf772c [4 November 2024]Google Scholar
Aukema, TW, Teunissen, EM, Janssen, AM, Hol, MKS, Mylanus, EAM. Post-implantation clinical cost analysis between transcutaneous and percutaneous bone conduction devices. Eur Arch Otorhinolaryngol 2024;281:117–27CrossRefGoogle ScholarPubMed
Lagerkvist, H, Carvalho, K, Holmberg, M, Petersson, U, Cremers, C, Hultcrantz, M. Ten years of experience with the Ponto bone-anchored hearing system – a systematic literature review. Clin Otolaryngol 2020;45:667–80CrossRefGoogle ScholarPubMed
Holgers, KM, Tjellström, A, Bjursten, LM, Erlandsson, BE. 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 1988;9:56–9Google ScholarPubMed
Fontaine, N, Hemar, P, Schultz P, Charpiot, A, Debry, C. BAHA implant: Implantation technique and complications. Eur Ann Otorhinolaryngol Head Neck Dis 2014;131:6974CrossRefGoogle ScholarPubMed
Ricci, G, Della, Volpe AFaralli, M, Longari, F, Gullà, M, Mansi, N, et al. Results and complications of the Baha system (bone-anchored hearing aid). Eur Arch Otorhinolaryngol 2010;267:1539–45CrossRefGoogle ScholarPubMed
Lustig, LR, Arts, HA, Brackmann, DE, Francis, HF, Molony, T, Megerian, CA, et al. Hearing rehabilitation using the BAHA bone-anchored hearing aid: results in 40 patients. Otol Neurotol 2001;22:328–34CrossRefGoogle ScholarPubMed
House, JW, JW, Kutz. Bone-anchored hearing aids: incidence and management of postoperative complications. Otol Neurotol 2007;28:213–17CrossRefGoogle ScholarPubMed
Gillett, D, Fairley, JW, Chandrashaker, TS, Bean, A, Gonzalez, J. Bone-anchored hearing aids: results of the first eight years of a programme in a district general hospital, assessed by the Glasgow benefit inventory. J Laryngol Otol 2006;120:537–42CrossRefGoogle Scholar
Badran, K, Arya, AK, Bunstone, D, Mackinnon, N. Long-term complications of bone-anchored hearing aids: a 14-year experience. J Laryngol Otol 2009;123:170–6CrossRefGoogle ScholarPubMed
Omar, A, Khan, H. 9 Complications of bone-anchored hearing aids (BAHA) in patients. Br J Surg 2022;109(suppl 6);znac269.186CrossRefGoogle Scholar
Peñaranda, D, Garcia, JM, Aparicio, ML, Montes, F, Barón, C, Jiménez, RC, et al. Retrospective analysis of skin complications related to bone-anchored hearing aid implant: association with surgical technique, quality of life, and audiological benefit. Braz J Otorhinolaryngol 2018;84:324–31CrossRefGoogle ScholarPubMed
Kraai, T, Brown, C, Neeff, M, Fisher, K. Complications of bone-anchored hearing aids in pediatric patients. Int J Pediatr Otorhinolaryngol. 2011;75:749–53CrossRefGoogle ScholarPubMed
Marfatia, H, Priya, R, Sathe, NU, Mishra, S. Challenges during Baha surgery: our experience. Indian J Otolaryngol Head Neck Surg 2016;68:317–21CrossRefGoogle ScholarPubMed
Wazen, JJ, Young, DL, Farrugia, MC, Chandrasekhar, SS, Ghossaini, SN, Borik, J, et al. Successes and complications of the Baha system. Otol Neurotol 2008;29:1115–19CrossRefGoogle ScholarPubMed
de Souza, MA, Vallejos Riart, SL, de Souza, SR, de Brito, R, Bento, RF. Complications of transcutaneous protheses – a systematic review of publications over the past 10 years. Int Arch Otorhinolaryngol 2022;26:e50512Google Scholar
Miura, MS, Ogando, PB, Pasqualini, MP, Neves, H, Lubianca Neto, JF. Surgical results of transcutaneous bone-anchored hearing aid comparing the C-shaped and linear incision techniques. Eur Arch Otorhinolaryngol 2023;280:2749–54CrossRefGoogle ScholarPubMed
De Stefano, S, Mochi, P, Murri, A, Cuda, D. Comparison between linear incision and punch techniques for bone anchored hearing aid surgery. Acta Otorhinolaryngol Ital 2021;41:474–80CrossRefGoogle ScholarPubMed
Amaral, MSAD, Santos, FRD, Danieli, F, Massuda, ET, Reis, ACMB, Hyppolito, MA. Surgical and audiological results of bone-anchored hearing aids: comparison of two surgical techniques. Braz J Otorhinolaryngol 2022;88:533–8CrossRefGoogle ScholarPubMed
Steehler, MW, Larner, SP, Mintz, JS, Steehler, MK, Lipman, SP, Griffith, S. A comparison of the operative techniques and the postoperative complications for bone-anchored hearing aid implantation. Int Arch Otorhinolaryngol 2018;22:368–73Google ScholarPubMed
Bezdjian, A, Smith, RA, Gabra, N, Yang, L, Bianchi, M, Daniel, SJ. Experience with minimally invasive Ponto surgery and linear incision approach for pediatric and adult bone anchored hearing implants. Ann Otol Rhinol Laryngol 2020;129:380–7CrossRefGoogle ScholarPubMed
Candreia, C, Birrer, R, Fistarol, S, Kompis, M, Caversaccio, M, Arnold, A, et al. Predisposing factors for adverse skin reactions with percutaneous bone anchored hearing devices implanted with skin reduction techniques. Eur Arch Otorhinolaryngol 2016;273:4185–92CrossRefGoogle ScholarPubMed
Zeitler, DM, Herman, BS, Snapp, HA, Telischi, FF, Angeli, SI. Ethnic disparity in skin complications following bone-anchored hearing aid implantation. Ann Otol Rhinol Laryngol 2012;121:549–54CrossRefGoogle ScholarPubMed
Gardiner, L, Lavallee, M, Sima, A, Coelho, DH. Tobacco use and skin reactivity in patients with percutaneous auditory osseointegrated implants. Otol Neurotol 2021;42:740–5CrossRefGoogle ScholarPubMed