Poor bone growth for Baha : (

[kixit]

Clarice,

I return for a recheck Sept 14th. I am assuming this Baha surgical site will need to heal before another attempt. I bought some calcium supplements to help strengthen my bones.

[leapyrtwins]

Jan, a titanium screw is screwed into the skull, after the skull is drilled into and then threaded.

Just looked all over the Cochlear website and find nothing that talks about the titanium implant being a screw or being screwed into the skull.  Yes, it has threads but they talk about it being "placed" in the skull.  Whatever.

Back to the topic at hand. 

Rhonda -

sorry to hear that your implant has fallen out, but on the bright side at least now the doc won't have to remove it in order to start over.

He should be able to find another place on your skull where the bone is denser and hopefully that will give you the end result you need.

My partner in crime, Lori (lori67) has her implant placed way back on her skull - pretty much at the base where you'd typically put a rubberband when putting your hair in a pony tail.  The placement works well for her; she's had it for years.

Best,

Jan

[LizAN]

Wow, Rhonda, you sure have had more than your share of bumps in this road to BAHA.  I agree with Clarice - UVA should not charge you for a redo, so there should be no problem with your insurance.  UVA and your surgeon should take full responsibility.

Just want to make sure I understand exactly what happened - the actual implant came out of your skull - it's not just that the abutment came off of the rod?

Liz

[james e]

There are several BAHA videos on the net that show a hole being drilled into the skull. A long rod is attached to the drill that shows the doc that a vertical hole is being drilled. The hole is then sized and the titanium screw is attached to the drill, and screwed into the skull. Water is dripped onto the skull to keep the skull cool. The screw should not fall out on its own. I am sure it can be reinstalled in a better place, and life will go on.

James

[kixit]

@Liz-

What I have in a baggie is the healing cap with the abutment with a triangular (3 to 4 mm) end. I don't know if the triangular end is the part screwed into the bone. I was told there was nothing to do at this point just keep the area clean and apply copious (sp?) amounts of Bacitracin. I am assuming that the area will have to heal before the next Baha attempt. My second recheck appt is 9/14 for this Baha surgery.

[spgreenfield]

I have heard from reliable sources that Cochlear changed the abutment formation to prevent cross use of the processor with Oticon's version.....curious if the changed the screw or just the abutment.  Have an appointment today with my ENT and will ask!!!!

Pam

[james e]

There are 3 components that make up what most of us call the abutment, and to call it that is just a generic term to me. There is a titanium post that is threaded. There is a tiny gold screw, and there is the abutment. The titanium post is screwed into a hole that is drilled in the skull. The abutment looks like a small coffee cup that does not have a handle. The gold screw runs through the abutment, and is screwed into the titanium post. Your skull grows into the titanium post. The BAHA snaps onto the abutment, and then you can hear.

I routinely refer to the components as the abutment. Jan and I have the old style abutment and it will accept other BAHAs. You very likely have the new abutment, and only the Cochlear BAHA will fit it. You can watch a BAHA surgery on youtube...very interesting.

I am a Virginia boy...Norfolk. I went to Va Tech and my brother has a bachelor and masters from UVa. That is beautiful country out there. I am wishing you the very best luck. It will all work out well in the end.

James

[kixit]

Thanks James! I am actually in your area this week vacationing at Va Beach (I am from Roanoke). I looked at the abutment again and well everything is there, the abutment and screw. It wasnt backwards it just didnt drop through the triangular area because of dried debris.

UVA is a wonderful medical facility and they treat me well there.

[spgreenfield]

Just returned from my followup appt. and asked about this whole situation.  ENT gave a few reasons that this could happen.....none of which was that the bone location wasn't good.  He said:

1. Infection in the site can cause the bone to reject the implant
2. poor healing in general
3. bone that has been irradiated....it doesn't heal well at all....

Pam

[kixit]

The Baha site is healing nicely. No sign of infection but I am having some on/off stabbing pain around the area but the not surgical site itself. I do see the permenant hairloss area  where it was to be.

I wonder how long I will have to wait before another attempt? I guess I'll find out when I have my follow appt on 9/14 but the waiting is killing me, lol.

Family and friends are "trying" to be funny by saying "she really does have a screw loose". My reply is --no I lost my screw and the contents that went with it!! Ahhh, all I can do is laugh at this point 

[spgreenfield]

I can't imagine having to wait that long!  Have they given you a reason why such a long wait?  To let it heal?

Pam

[leapyrtwins]

I have heard from reliable sources that Cochlear changed the abutment formation to prevent cross use of the processor with Oticon's version.....curious if the changed the screw or just the abutment. 

This is something that happened approximately 2 years ago.  Cochlear changed their "equipment" - rod, abutment, etc., - so that those that opt for a Cochlear BAHA implant can no longer use an Oticon processor; the processor won't fit. 

I use the word "equipment" because it's not just the abutment - which is the part that the processor attaches to.  Abutment changes are very simple - done with a screw driver in the doc's office.  When Cochlear bought out Entific they changed abutments and those with Entific abutments who wanted to upgrade had to have their abutments changed to Cochlear ones. 

This isn't possible with the new Cochlear equipment; you can't just have an abutment change and use an Oticon processor.  Seems Cochlear decided they didn't want to share their BAHA processor monopoly with Oticon when they entered the market a few years ago. 

As James mentioned, he and I have the older Cochlear equipment so we can use Oticon as well as Cochlear processors; but at this point, I have no intention of switching.  I never had an issue with my Cochlear Divino - which still works - and although I had some slight issues with my Cochlear BP100 when I first got it, they were all resolved.

Jan

[leapyrtwins]

Just returned from my followup appt. and asked about this whole situation.  ENT gave a few reasons that this could happen.....none of which was that the bone location wasn't good. 

I know someone with bilateral BAHAs - not an AN patient, he was born with Treacher Collins Syndrome - who had both of his implants fall out years after they were implanted.  So, bone location / density can definitely be an issue.

Jan

[kixit]

Ok Baha veterans I need some imput. I just located a picture of abutment with titanium screw. I was oh so wrong (happily I think). The whole implant didn't fall out, just the abutment with healing cap. The screw is still in-somewhere.  The hole is closing up. Any imput on what could possibly happen next? Can they surgeon open it back up and screw the abutment back on? I will contact him in the morning but would like your opinion.

Thanks!!

[james e]

You are lucky. Yes they can open your scalp, and put a new abutment and gold screw in! I had a translab surgery just like you did, and my doc also did my BAHA surgery at the same time. He installed the titanium post and sewed me back up. Three months later, he scalped me, and installed the abutment and screw. Get your doc to look at the post and make sure the angle is correct. Lucky You!!!!!!!

James