Author Topic: BAHA surgery  (Read 3597 times)

grega

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BAHA surgery
« on: April 06, 2010, 12:09:22 pm »
Hi all .... I have a few questions re baha surgery, hoping for a bit of advice.

Will meet tomorrow w/ baha surgeon in prep for my baha surgery on tax-day.  When we met a few weeks ago, doc mentioned a possible skin graft from thigh as part of the abutment placement.  Does anyone have any experience with this?  Why would that be necessary?  Appreciate any feedback .... cause these skinny legs don't have much to spare.

Also, I googled baha skin graft, and saw mostly abstracts from medical journals.  One that caught my eye is a June '09 "Baha clinical review" from Cochlear.  It mentions implant survival (loosening)being better w/ a 4mm implant vs a 3mm implant.  Do all baha kits now come with a 4mm implant?  Has anyone experienced loosening of their implant.... and what was done?

Thanks!
Greg
1.5 cm AN retrosig 11/04.
Drs. Henry Brem & Michael Holliday @ Johns Hopkins, Baltimore
SSD right. Tinnitus big-time, only when thinking of it.
BAHA since 7/20/10 ... really helps w/ hearing, specially after programming in subliminal message: "Hey, don't listen to your tinnitus!"

Pooter

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Re: BAHA surgery
« Reply #1 on: April 06, 2010, 12:57:57 pm »
A BAHA-related skin graft is a new one by me..  Knowing what I do about BAHA surgeries (not from personal experience), I'm not even sure why one would be necessary..  I hope someone else shares with the group..  Let us know if you hear anything else about it...  I'm curious now..

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

Sam Rush

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Re: BAHA surgery
« Reply #2 on: April 06, 2010, 03:01:00 pm »
They raise a skin flap for the BAHA surgery, not a skin graft, unless you have really thin skin at the BAHA site, a graft would not be needed.  Occasionally, (rarely), the BAHA abutement will come loose, but the Dr. will have a special tool to tighten it. In experienced hands, the surgery is simple and complication free. Make sure your Dr. is experienced!!!l
1 cm AN translab, Dr. Brackmann, Dr. Schwartz, Dr Doherety HEI   11/04   Baha 7/05

JerseyGirl2

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Re: BAHA surgery
« Reply #3 on: April 06, 2010, 03:50:12 pm »

 When we met a few weeks ago, doc mentioned a possible skin graft from thigh as part of the abutment placement.  Does anyone have any experience with this?

I didn't have a skin graft in conjunction with my BAHA implantation nor have I ever heard of anyone who did have one.

Catherine (JerseyGirl 2)
Translab surgery and BAHA implant: House Ear Institute, Los Angeles, 1/2008
Drs. J. House, Schwartz, Wilkinson, and Stefan
BAHA Intenso, 6/2008
no facial, balance, or vision problems either before or after surgery ... just hearing loss
Monmouth County, NJ

leapyrtwins

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Re: BAHA surgery
« Reply #4 on: April 06, 2010, 04:04:14 pm »
Grega -

no skin graft here either.

I only know one person who had a skin graft and a BAHA.  He's a patient of Dr. Richard Weit's and he had the BAHA implant at the same time as his AN surgery.

He told me that for some reason the skin on his BAHA site failed to heal "correctly" so it was necessary to have a skin graft.  I think it may have had something to do with blood flow to that area; the scalp is very vascular.  I can't recall if the graft was taken from his upper arm or his upper thigh, but I do know that the graft solved the problem.

I'd ask your doc why he feels a skin graft is necessary  ???  It's definitely not common, but then again, he's a doctor (and I'm not) and he may have a very good reason for it.

I've never had an issue with my abutment - infection, coming loose, etc. - but I think the key to the coming loose part is to wait 90 days for the abutment to calcify into the skull before you wear your device.  I know some who have worn their device earlier than 90 days and had issues.  You want to make sure that sucker is "cemented" into your head  :D

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

grega

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Re: BAHA surgery
« Reply #5 on: April 06, 2010, 07:09:25 pm »
Thanks all!

Perhaps the graft was for what you mention, Jan .... that failure to communicate .... err .... failure to heal!  Appologies to the late Strother.

I'll make sure I find out tomorrow.  One good statistic on that Cochlear clinical journal info I mentioned earlier .... upwards of 94% of their sample had no problems or reactions after baha surgery.  I'm looking to be in that group.

Keep  ;D -ing!
Greg
1.5 cm AN retrosig 11/04.
Drs. Henry Brem & Michael Holliday @ Johns Hopkins, Baltimore
SSD right. Tinnitus big-time, only when thinking of it.
BAHA since 7/20/10 ... really helps w/ hearing, specially after programming in subliminal message: "Hey, don't listen to your tinnitus!"

leapyrtwins

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Re: BAHA surgery
« Reply #6 on: April 06, 2010, 10:17:10 pm »
Greg -

forgot to address your question about the height of the abutment.

I have no idea if mine is 3 mm or 4 mm, but I'm fairly sure it's the standard one.

I'm guessing that 4 mm is standard since I've heard a few BAHA candidates refer to a "shorter" abutment being available.

The main thing with a BAHA is that you don't want too much or too little space between the device and the skull.  If the device lies too close to, or too far away from, the skull the sound quality of the device is compromised.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

grega

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Re: BAHA surgery
« Reply #7 on: April 07, 2010, 12:51:46 pm »
Hi ..... my doc said baha kit comes with both 3 and 4 mm long implants, and he usually uses the longer one.  What's that old cigarette commercial say .... "a silly millimeter longer" .... perhaps Cochlear should buy the copyright for that ....  ::)

Re the skin graft, the cutting tool that creats the flap where the implant will be has been known to damage that flap.  Doc had it happen once.  So he preps for that possibility from the upper thigh.  No biggie, as long as it's above my speedo line .......  :o ::)

JAJ .... (just a joke)
1.5 cm AN retrosig 11/04.
Drs. Henry Brem & Michael Holliday @ Johns Hopkins, Baltimore
SSD right. Tinnitus big-time, only when thinking of it.
BAHA since 7/20/10 ... really helps w/ hearing, specially after programming in subliminal message: "Hey, don't listen to your tinnitus!"

leapyrtwins

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Re: BAHA surgery
« Reply #8 on: April 07, 2010, 12:53:25 pm »
No biggie, as long as it's above my speedo line .......  :o ::)

LOL  :D

Actually it's refreshing to know your doc is prepared for situations like skin flap damage.  Nothing like a doc who's prepared in my book.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways