Michele - the BAHA process

[Guest guest]

Michele,

I'll copy this from Entific - Kennedy is having the 2 stage process: basically

- put the screw in the mastoid bone - wait for it to integrate with the bone

then the abutment is put on. One month after this (for healing time) we go back

to get it all turned on and set up.

Topic:

Surgery Language:

Question:

What is involved in the surgical procedure?

Answer:

The procedure is simple and straightforward and does not involve any surgery

in the ear itself. It can be carried out in one or two stages. The following

summary describes the one-stage procedure which is the standard protocol for

adults (where no clinical problems are anticipated) and for cases with good bone

quality. The two-stage procedure is the standard protocol for children and for

any cases where bone quality may be in doubt.

The one stage procedure:

The fixture sight is marked and located using a special indicator. It is

important that the sound processor, when fitted, does not touch the auricle as

this can cause acoustic feedback. The incision is made down to the periosteum,

which is incised separately and raised from the bone.

Drilling begins with a 3mm drill and continues with a 4 mm drill if there is

sufficient bone. Once the depth is established a countersink drill and screw-

tap are used to prepare both the surface of the bone and the inside of the site

for the fixture itself. Irrigation is extremely important during all drilling

procedures to avoid overheating the bone.

The fixture is then inserted at a very low speed using specially designed

instruments and adequate cooling.

The skin is excised down to the periosteum and removed along with sufficient

subcutaneous tissue to allow the edges of the skin to drop down to the

periosteum without any tension.

A very thin hairless skin graft is taken, thinned out as much as possible and

sutured in position. A hole is then punched in the graft to allow the abutment

to be screwed on to the fixture head.

A healing cap is then attached to the abutment. Ointment soaked gauze should

be wound around the abutment under this cap in order to both hold down the graft

and to prevent haematoma.

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