Shorter Baha abutment?

[hearncl]

I've had my abutment for a month. At my post-surgery visit to the doctor, he mentioned that a slightly shorter abutment, than the one he installed, was available. I don't know if I will be a candidate for a shorter abutment, but I am curious about what is involved in replacing an abutment. I know that the titanium abutment is screwed into the titanium implant, which is what osseointegrates with the bone. I assume that a replacement has to be done by the doctor and involves unscrewing the original abutment.

Related questions: How is the abutment "locked" into the implant? What prevents it from accidentally unscrewing?

[leapyrtwins]

Hearn -

just had a conversation with my neurotologist last week about replacing abutments.  We were discussing the fact that in addition to Cochlear manufacturing BAHA devices, that Oticon is also manufacturing them now.  At this point Cochlear and Oticon use the same abutments but I wondered if this would always be the case.  And if one of them were to change what patients would do.

My doc told me that when Entific was taken over by Cochlear an abutment change was necessary and that it's a very simple office procedure.  The rod that is implanted into the skull remains there - the top of the abutment is what is unscrewed and replaced.  He assured me it was no big deal - which I interpreted to mean it was quick and painless.

I don't know how an abutment is "locked" into the implant, but I've had my BAHA for almost 2 years now and have had no issues.  There are many on this Forum who've had BAHAs much longer and I've never heard this being an issue with them either.

I'm curious as to why your doctor thinks you should have a shorter abutment.  Are you having problems with the one you currently have?  Did it not "sink" enough?  Abutments do sink closer to the skull post op.

Also, if you only had your BAHA surgery a month ago you aren't even wearing your processor yet.  I would imagine you'd want to see how your abutment is once you attach your processor and if you find problems with that, make a change then.

Jan

[hearncl]

I'm curious as to why your doctor thinks you should have a shorter abutment.  Are you having problems with the one you currently have?  Did it not "sink" enough?  Abutments do sink closer to the skull post op.

I don't think the doc was suggesting a shorter abutment, just making sure I had the information. I have no problems with my abutment, but I imagine that the Baha device might be more secure sitting as close to the skull as possible. It remains to be seen whether I'll investigate having the abutment replaced with a shorter one. The engineer in me is just curious about the mechanical details, not that they are important for most people.

[leapyrtwins]

If the doctor placed your abutment correctly - and I am confident he did - you should have no problem with the abutment you currently have.  You also don't want your processor/device sitting too close to your skull because then it won't work properly.  There needs to be some space between your skull and the device; they should not touch.

I'd definitely wait and see how your device attaches to the abutment you currently have.  As I mentioned the BAHA site sinks as it heals; I was surprised to see how close to my skull my abutment ended up compared to where it was 1 month post op. 

Alot will also depend on the device you chose.  I currently have a Divino which has a fairly long "stem", but I'm upgrading to the BP100 in a few weeks and the stem on it is much shorter.  If you decided on the Oticon Ponto Pro it has no stem at all - it snaps around the abutment.

So I'd wait until you snap your device on, see what the sound quality is like, see if the doc thinks it sticks out too far, etc., and go from there.

Jan