Author Topic: Poor bone growth for Baha : (  (Read 15641 times)

kixit

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Poor bone growth for Baha : (
« on: August 10, 2012, 04:17:37 pm »
I had my 10 day post-op appt for the Baha surgery today at UVA. Didn't get good news  :(  The doctor said the bone wasn't growing to the implant, it was loose on one side. He also said that we are just over a week post-op so he's not discouraged yet. I asked what happens if it doesn't osseointergrate--he replied with it will just fall out and we will start over  ;D. Possible reason for no growth is weak bone due to AN surgery.

I have to wear the healing cap until next appt (9/14) and it's best not to get the surgical site wet (I'm beach bound next week but was given the okay to go in the water but not submerge my head in the ocean or pool). So it's washing the hair in the shower leaning over to one side (kind of comical due to my balance issues) for another month and gob on the Bacitracin twice daily.

Although I am a little discouraged about the news, I am all so very greatful for the surgery. This year has been a rough one for me but through it all I've seen nothing but God's Grace.
left side AN 9mm diagnosed 2/2012
SSD, loud tinnitis left ear
Translab 5/24/12
Baha surgery 8/1/2012 at UVA
Baha hook up 11/09/2012  : ) 

I am a happy camper : )

CHD63

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Re: Poor bone growth for Baha : (
« Reply #1 on: August 10, 2012, 04:54:22 pm »
Oh my!  So sorry!!  Not fair after what all you have gone through in this process.

Many, many prayers that it will heal and osseointegrate without further surgery needed!!

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

leapyrtwins

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Re: Poor bone growth for Baha : (
« Reply #2 on: August 12, 2012, 10:55:31 am »
Sorry to hear about this set back. 

Although I'm not a doctor and I don't want to second guess yours, I'm puzzled as to why your implant wasn't placed in an area of denser bone right upfront.

I know at least three people who don't have their implant in the "conventional" place (a little bit behind and above the ear), but they only had to go through the implant surgery once.  Their docs realized from the start that bone density was an issue for them.

I'm hopeful that your implant will continue to calcify and you won't need to have it placed again.

Prayers,

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

kixit

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Re: Poor bone growth for Baha : (
« Reply #3 on: August 12, 2012, 02:22:04 pm »
Thanks for the imput Jan, I was waiting on you to post because of your experience with the Baha. The doctor went further behind the ear>2 1/4 joints of pointer finger< (I wear glasses) and up (like the 1st bend of the finger length), this is the best way I can describe the location.

 My daughter watched as he removed the healing cap to inspect the implant. She said it was tight on one side, didn't move at all while the other side was loose just as he had said. He had told me before surgery that he had only had 1 patient not take to it and it was a little boy (childrens bones are thinner?). He re-did that child the day before my appt.

I go back in one month and hopefully all is well. I asked if it was the way I slept (I normally sleep on the AN side but since the surgeries tried not too). When I did catch myself sleeping on the left side somehow subconciously I guess, my hand would cradle the ear/implant site so nothing was touching it.

left side AN 9mm diagnosed 2/2012
SSD, loud tinnitis left ear
Translab 5/24/12
Baha surgery 8/1/2012 at UVA
Baha hook up 11/09/2012  : ) 

I am a happy camper : )

LizAN

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Re: Poor bone growth for Baha : (
« Reply #4 on: August 13, 2012, 10:45:10 am »
Hmm...

Kixit, I certainly can't give you a medical opinion, but it doesn't sound like your doctor is worried.  Do I understand correctly that it takes a full 3 months for complete osseointegration?  Seems like ten days is only a small part of that time.  A lot can happen between now and 3 months.

I will be thinking about you.  Please do give us an update after your next appointment.

Liz
8/20/2010 - 9mm AN on left side 
Fullness, tinnitus, mild hearing loss
2/20/2011 - 8mm
4/20/2012 - 12.4 mm
Moderate to severe hearing loss, LOUD tinnitus, deteriorating balance
Facial numbness and twitching, which subsided pre-surgery
Translab at House, 7/3/2012, Slattery and Schwartz

james e

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Re: Poor bone growth for Baha : (
« Reply #5 on: August 14, 2012, 01:55:00 pm »
I'm not sure how it can be loose on one side and tight on the other. The abutment is titanium, and it screws into your skull. The skin flap might appear loose around the abutment , but the abutment is not just floating around in a hole. I'm sure the bone has not grown into the abutment screw yet...it may have started growing, and 90 days is the norm, but I think some people have plugged in after 60 days. The drill that is used to prep your skull is designed to make a perfect hole, just the right size. It even cuts threads. The most important job for you right now is to tend to your scalp. Keep it clean and dry. You will be really excited when you get to plug in that BAHA!

leapyrtwins

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Re: Poor bone growth for Baha : (
« Reply #6 on: August 14, 2012, 07:57:34 pm »
The "equipment" that is implanted isn't just an abutment.  It's a titanium rod, which (to my knowledge) doesn't screw into the skull - it's sunken into the skull and depends on the bone of the skull to calcify and hold it in.  Which is why poor bone density leads to a loose rod.   On top of the titanium rod is the abutment, which is screwed into the rod.  The processor is then attached to the abutment.  Abutments are easily changed with a screw driver; rods, since they are sunken into the skull, are harder to get out.  If the bone calcifies it is very difficult to remove the titanium rod - I read somewhere that they'd actually have to remove the area of the skull that it's sunken into.  But rods that aren't calcified aren't that difficult to remove; basically they are "loose".

90 days used to be the norm for calcification, but Cochlear changed their equipment in the not so distance past - the material it's made of now is similar to what is used for dental implants - and supposedly the waiting period is only 60 days.  However, not all docs are going with the 60 days, some (like mine who is very conservative) are still sticking to the 90 days.

When I had my first post implant appt. with my doc, he never mentioned whether or not it was calcifying so I can't tell you where my implant was "at" 10 days after my surgery. 

As Liz said, 10 days out of 90 is a pretty short time frame and a lot can happen in the interim, plus we all heal differently and at different rates.  Maybe what takes one person 10 days to accomplish takes another 20. 

In the meantime, I'm keeping my fingers crossed  :)

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

jaylogs

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Re: Poor bone growth for Baha : (
« Reply #7 on: August 14, 2012, 10:01:22 pm »
Awww Liz...sorry to hear about your possible issue...I do hope that thing takes.  While I didn't have the bone issue, it was the skin around my abutment that I had major issues with.  But all is good now and am enjoying the heck out of my BAHA.  Let us know how it goes! Take care!
Jay
8.1mm x 7.8mm x 8.2mm AN, Left Ear, Middle Fossa surgery performed on 12/9/09 at House by Drs. Brackmann/Schwartz. Some hearing left, but got BAHA 2/25/11 (Ponto Pro) To see how I did through my Middle Fossa surgery, click here: http://www.caringbridge.org/visit/jaylogston

kixit

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Re: Poor bone growth for Baha : (
« Reply #8 on: August 15, 2012, 07:44:12 am »
Well peeps it fell off! I cleaned the area last night. I woke up this morning and checked it, it was still there. I made my bed and sat down I felt something hanging in my hair. There it was, the healing cap with abutment.
left side AN 9mm diagnosed 2/2012
SSD, loud tinnitis left ear
Translab 5/24/12
Baha surgery 8/1/2012 at UVA
Baha hook up 11/09/2012  : ) 

I am a happy camper : )

spgreenfield

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Re: Poor bone growth for Baha : (
« Reply #9 on: August 15, 2012, 07:54:47 am »
Hey Liz! 

I was typing and you replied that it fell off!   That's awful!  I'm still going to post what I typed though, because I hope you'll do it again, just maybe this time he'll find better bone.  My quack ENT that I didn't use actually did a CAT scan to "find bone" - I personally think it's because he has a private scanner and staff and needs to fund them....but maybe there's something to this procedure in your case?

Before you posted about it falling out............
I'm somewhat where you are in the surgical journey, but am blessed with a great implant happening. (implant 8/3/12) Here's my question - would you taking additional calcium (I do because I have osteopenia) and also something I take called Strontium that promotes building of healthy bone.....  I would also think maybe allowing a little sun exposure in the earliest part of the day would be healthy as well to encourage healing....?  I'm not sure if this has had any impact on my healing because the surgeon was crowing about how great the bone was that he put the implant into....but I would think logically if the body can heal broken bones to the point where the break is stronger than the original bone was, it just might....

Pam
Pam in South Dakota

MRI & DX on 10/17/11, 2.8 x 2.3 x 2.3 cm cystic & solid mass
Left suboccipital Surgery with Dr. Tew at Mayfield Clinic in Cincinnati on 1/10/12
SSD but no nerves cut in surgery. BAHA implant 8/2012
Facial weakness almost gone!
Acupuncture helping face
Tear duct plug on 4/4/12

james e

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Re: Poor bone growth for Baha : (
« Reply #10 on: August 15, 2012, 09:26:09 am »
Sorry to hear it fell out. Jan, a titanium screw is screwed into the skull, after the skull is drilled into and then threaded. The abutment is then screwed into the titanium implant. You can see pictures of it on Cochlear's web site. The implant is not just left in a void, hoping the bone will grow into it.

spgreenfield

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Re: Poor bone growth for Baha : (
« Reply #11 on: August 15, 2012, 09:51:01 am »
I'm just learning, but since bone is a growing living thing I would imagine that the "snugness" (if that's a word) is the issue alng with the bone incorporating this new foreign object and growing around it to "firm" up the implant?  I know from feeding animals raw meat that bone is really quite soft when not cooked - resulting in a need for the body to make its own changes around the implant.  Otherwise we'd get a processor the day of the implantation surgery....right?  So helping the body to do this nutritionally isn't too far off the mark....right?

Pam
Pam in South Dakota

MRI & DX on 10/17/11, 2.8 x 2.3 x 2.3 cm cystic & solid mass
Left suboccipital Surgery with Dr. Tew at Mayfield Clinic in Cincinnati on 1/10/12
SSD but no nerves cut in surgery. BAHA implant 8/2012
Facial weakness almost gone!
Acupuncture helping face
Tear duct plug on 4/4/12

kixit

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Re: Poor bone growth for Baha : (
« Reply #12 on: August 15, 2012, 10:15:57 am »
I just heard back from UVA. I am to keep the area clean and continue to apply the Bacitracin ointment. I hope the insurance company doesn't give me any flak about fixing or re-doing the Baha implant.

Thanks for your support everyone!

Rhonda (not Liz..lol)
left side AN 9mm diagnosed 2/2012
SSD, loud tinnitis left ear
Translab 5/24/12
Baha surgery 8/1/2012 at UVA
Baha hook up 11/09/2012  : ) 

I am a happy camper : )

CHD63

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Re: Poor bone growth for Baha : (
« Reply #13 on: August 15, 2012, 11:02:58 am »
Rhonda .....

So very puzzled as to how that could happen ..... certainly not the norm for these things.  UVA should not charge you for a redo if the doctor did not place it in solid bone ..... just my humble opinion.

When do you return to the doctor to have it checked?

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

james e

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Re: Poor bone growth for Baha : (
« Reply #14 on: August 15, 2012, 11:31:10 am »
I am sure this will work out for you. There are always a few bumps in the road, and this one will soon be in the past. UVA is a beautiful school, and you will get the best treatment available. My fingers are crossed for you!