The transcutaeneous BAHA Attract Implants

The transcutaeneous BAHA Attract Implants
Mark Yardley, Jaydip Ray
ENT Department; Sheffield Teaching Hospitals

Introduction: It has been observed that much of the soft tissue problems in bone anchored hearing solutions are related to the percutaneous nature of the coupling of the device which requires lifelong aftercare. Hence tissue preservation and non skin penetration (transcutaneous) are felt to be the direction of travel. Our experience with the first 50 BAHA Attract transcutaneous implant systems is reported.

Methods: This is a prospective longitudinal study of 50 consecutive cases of BAHA Attract surgery since September 2013. Perioperative data included indications, audiology, incision type, surgical technique, skin thickness, fixture, bone polishing and surgical time and postoperatively (at 1 week, 4 weeks and 3 months). Post operative data included audiological outcome measures, soft tissue status, pain and numbness.

Results: The 50 patients were a mix of adult and paediatric cases with a small minority transitioning from percutaneous to the transcutaneous device. Age range was 36 – 60years. The commonest indications were conductive deafness and single sided sensorineural loss. 4 cases were performed under local anesthesia only. The incision in all cases was “C” shaped with the open limbs facing inferiorly. Average surgical time was 40minutes. All received the 4mm fixture. Average skin thickness in the midpoint was 6.2mm. There was minimal nursing care required post operatively as the wound healed neatly by 1 week without any hair loss and minimal numbness in the surrounding area. No wound complications were reported. Two reported some pain after a month but settled conservatively. None reported any swelling or skin tenderness. Majority were loaded with the processes in 6 weeks and the magnet strengths varied from 2 to 4 with average use of 6hours per day.

Conclusion: The initial experience with the non skin penetrating BAHA Attract is positive with negligible post operative care and no complications or patient morbidity. The results are aesthetically pleasing and has high patient satisfaction due to absence of skin penetrating abutment, no bald patch and no aftercare.