Information Leaflet for parents. Bone Anchored Hearing Aid

Transcription

1 Information Leaflet for parents Bone Anchored Hearing Aid Revised January 2005

2 Introduction The fitting of a bone-anchored hearing aid involves surgery, which is usually carried out in two stages. We hope that this information will help you to understand what the surgery and admission to hospital entails. Benefits of surgery The benefits of having this surgery is that your child will no longer need to wear the conventional bone conducting hearing aid, once both stages of the operation are complete. Risks and complications of the surgery No operation is entirely risk-free. The risk of serious or life threatening complications following this surgery is very low. There is a small chance of bleeding after both stages of the operation, but it is rare. There is a chance that there will be an area of bruising around the abutment site after the second stage of operation. This soon subsides. Most children who have this operation do not complain of any pain at either stage. It is advisable to have some paracetomol/calpol available just in case they have any pain after the operation.

3 Alternative treatments The alternative is not to have the surgery and continue to use the conventional bone conduction aid. Stage One Your child will be admitted on the day of the operation and should be able to go home that same day. You are most welcome to stay with your child during the admission. Before the operation nurses and doctors will see your child. If you have any concerns please do not hesitate to mention them. You are able to go with your child to the anaesthetic room until they are asleep. A nurse from the ward will also be with your child so if you feel unable to go to the anaesthetic room your child will be with a nurse he/she knows. Under a general anaesthetic the surgeon will make an incision behind the ear. Two small titanium fixtures 3-4mm long are placed in the bone and the incision is closed with dissolvable stitches.

4 After the operation ~ Stage One When your child returns from theatre they will have a head bandage on. The nurses on the ward will explain how to remove this bandage at home the day after the surgery. Your child will be given painkillers in theatre. They may experience a little discomfort for the next hours, so we advise regular paracetomol/calpol as required. Going home ~ Stage One As already mentioned, you should be able to go home later on the day of the operation. You will have an appointment to come back to the hospital for the second stage of the surgery three-four months after the first stage. The time between the two stages of the surgery allows for the fixture to 'knit' into the bone. This is called osseointegration. The wound ~ Stage One As mentioned, the stitches used are dissolvable at this stage, so there is no need for them to be removed. However we advise you to look at the wound every day to make sure that it is healing satisfactorily. When looking at the wound the things to look for are:

5 Pain Swelling Redness A discharge If your child has a temperature An offensive smell Stage Two This stage is performed three-four months after the first stage. Your child will be admitted on the day of the operation and should be able to go home that same day. You are most welcome to stay with your child during the admission. Before the operation nurses and doctors will see your child. If you have any concerns please do not hesitate to mention them. You are able to go with your child to the anaesthetic room until they are asleep. A nurse from the ward will also be with your child so if you feel unable to go to the anaesthetic room your child will be with a nurse he/she knows. Under a general anaesthetic the previous wound will be opened again. It is at this stage that the abutment is connected to the fixture through the skin. The abutment provides direct connection between the hearing aid and the fixture. At this stage the surgeon

6 will thin the layers of tissue under the skin. This is performed so that the skin lies very flat on the child's head. Also it is hoped by doing this, that the hair follicles are removed so that hair will not grow around the abutment site. The surgeon closes the wound with stitches, which sometimes need to be removed. The surgeon also puts a dressing around the abutment site, which will be removed about a week following the operation. After the operation ~ Stage Two When your child returns from theatre they will have a head bandage on. The nurses on the ward will explain how to remove this bandage at home the day after the surgery. Your child will be given painkillers in theatre. They may experience a little discomfort for the next hours, so we advise regular paracetomol/calpol as required. Going home ~ Stage Two You should be able to go home later on the day of the operation. You will have an appointment to come back to the hospital to see the nurse 7-10 days after the operation.

7 Possible problems that you may encounter in the future Sometimes there are problems with the skin around the abutment. This can happen at any time. To reduce the chances of this happening, it is vital that good hygiene and skin care are maintained on a daily basis. Sometimes children experience problems with pain around the abutment site and also headaches. It is important that your child receives some painkillers and if it becomes an ongoing problem that they are seen by the ENT team at the hospital. We do have occasions where the fixtures come out or they fail. This may be because the child has had a knock to the head or sometimes it is unexplained. (This is the reason why two screws are placed at the first stage, so that there is a spare!) In this situation it is important to contact the hospital as soon as possible.

8 Please use this space to write down any notes or questions you might have

9 Further information If you have any concerns please contact the Advanced Nurse Practitioner, ENT... through switchboard on or bleep For further information you can visit the following website: Internet access is available in the Child and Family Information Centre. This is on the Ground Floor of the hospital near the Welcome Desk. Thank you to the ENT Department for producing this leaflet. Medical Illustration Department, Birmingham Children's Hospital NHS Trust, Steelhouse Lane, Birmingham B4 6NH