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Bone Anchored Hearing Aid Surgery What is a bone-anchored hearing aid? This operation involves fitting a hearing aid behind the ear using a titanium fixture, which is placed directly into the bone. The surgery to implant the abutment (fixture) is usually performed under general anaesthetic. Ordinary hearing aids fit inside the ear, by use of a mould. However, with the bone-anchored aid, there is no need for a mould. The hearing aid fits directly onto the titanium abutment behind the ear. Why do I need to have a bone-anchored hearing aid? The reasons why it may be necessary for you to have a bone anchored aid will have been discussed with you during your Outpatients appointment. Reasons for offering this type of aid to patients include: Recurrent ear infections, which impede use of ordinary hearing aids. Sensitivity to the materials used to make the hearing aid moulds. How is the operation performed? For the placement of the titanium fixture it is necessary to raise a small flap of skin behind the ear, approximately 20mm in diameter. The fixture is then placed directly into the bone behind the ear, where the skin has been removed. To prevent hair growing around the titanium fixture, the surgeon will remove all hair follicles from the skin graft prior to it being replaced. This reduces irritation and wound healing problems 2 Bone anchored hearing aid
around the abutment due to hair growth. The graft is small and this removal of hair follicles will not be noticed once the wound has healed fully. Will it be painful? The area behind the ear will be sore for a while after the operation. Most patients find it uncomfortable rather than painful. You will be given painkillers when you go home. How long will I be in hospital? The operation is relatively quick. However, you will be required to stay in hospital overnight. Most patients are able to go home early the following morning. What happens after the operation? You will have a bandage over the ear, which will remain in place until the following morning. The nurse looking after you will remove it so that the Consultant may check the wound before you are discharged home. You will have a dressing covering the wound, which must stay in place for 5 days following surgery. There will also be some small sutures (stitches) around the skin graft, which will be removed 10-14 days after your surgery. You will need to visit the Nurse Practitioner at the hospital 5 days after your surgery to have the dressing changed and the abutment cleaned. The dressing will remain in place until we remove your sutures. You may either attend the hospital for removal or attend your Health Centre for the practice nurse to remove them. When may I wash my hair? You may wash your hair after the first dressing change as long as the dressing is kept dry and the wound is healing well. Some patients prefer to wait until after the sutures have been removed before washing their hair. Bone anchored hearing aid 3
What happens after the wound has healed? It is important that you clean around the abutment daily. Skin debris may build up around it, which may resemble a scab, and it is important that this is removed. You may do this by using a very soft baby toothbrush, soap and water, or baby wipes. The Nurse Practitioner will show you how to do this. Hair may be washed using a mild shampoo. However, it is best to avoid using hairspray and gels as these may irritate the site. The inside of the abutment should be cleaned weekly to prevent build up of debris, which may affect the use of the hearing aid. Some patients find that a soft interspace toothbrush is effective for this purpose. Is there anything else I should know? The sound processor (hearing aid) will be fitted approximately 3 months after surgery in the audiology department at Southmead Hospital. You will be given an appointment to see Marianne, who is the Specialist Bone-anchored Hearing Aid Audiologist. It is also important that you check regularly that the abutment is not loose. The specialist will show you how to do this. 4 Bone anchored hearing aid
Further information: Information about the Baha System available at: www.entific.com/aboutbaha.asp [accessed 23 September 2005] NHS Constitution. Information on your rights and responsibilities. Available at www.nhs.uk/aboutnhs/constitution [Last Accessed March 2010] Bone anchored hearing aid 5
How to contact us: ENT Unit 0117 340 5138 (out of hours) Nurse Practitioner 07699 781 604 www.nbt.nhs.uk If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. First Published October 2005. This third edition February 20010. NBT002082