Marfatia Hetal, Priya Ratna, Sathe Nilam U, Mishra Shampa
Department of E.N.T., Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra India ; 52, Mahant Road, Gr. Floor, Suraj Bhuvan, Vile Parle (E), Mumbai, 57 Maharashtra India.
Department of E.N.T., Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra India ; 95, Sahyog apartments, Mayur vihar, Phase-1, Delhi, 110091 India.
Indian J Otolaryngol Head Neck Surg. 2016 Sep;68(3):317-21. doi: 10.1007/s12070-016-1002-4. Epub 2016 Jun 10.
Baha has proven performance and advantages for patients with aural atresia or chronic ear drainage. Being a per cutaneous osseo integrated implant the skin around the fixture is in contact with a foreign body that leads to chronic inflammatory reaction and complications such as skin irritation and overgrowth occur frequently. Challenges that are faced during Baha surgery include those during candidate selection, work up, anesthesia related as well as intra-operative and post operative complications. Ours was a retrospective and observational study where case records of 10 patients who underwent Baha surgery in the Department of E.N.T during the time period from January 2010 to June 2013 were reviewed. Here, the candidates were advised Baha either for congenital external ear deformity or single sided deafness. Out of 10 patients, who underwent Baha implantation, 8 underwent single staged Baha implant and two patients had two staged implant owing to bone thickness <3 mm behind temporo-parietal suture line on HRCT Temporal bone. The complications observed were skin infection (Holgers grade 2) around the site of implant in two patients, skin overgrowth due to more thickness of scalp (Holgers grade 4) in one of the patient. The patient had to undergo revision surgery to replace the abutment. And one of the patients underwent failure of osseointegration and was re-implanted later. Proper surgical technique and post operative wound care play an important role in avoiding complications.
骨锚式助听器（Baha）已被证明对耳道闭锁或慢性耳漏患者具有良好的性能和优势。作为一种经皮骨整合植入物，固定装置周围的皮肤与异物接触，这会导致慢性炎症反应，皮肤刺激和过度生长等并发症经常发生。Baha手术面临的挑战包括候选人选择、术前检查、麻醉相关以及术中及术后并发症等方面。我们进行了一项回顾性观察研究，回顾了2010年1月至2013年6月期间在耳鼻喉科接受Baha手术的10例患者的病例记录。在此，这些候选人因先天性外耳畸形或单侧耳聋而被建议使用Baha。在接受Baha植入的10例患者中，8例接受了单阶段Baha植入，2例患者因颞骨HRCT上颞顶缝线后方骨厚度<3mm而接受了两阶段植入。观察到的并发症包括2例患者植入部位周围的皮肤感染（霍尔格斯2级），1例患者因头皮增厚导致的皮肤过度生长（霍尔格斯4级）。该患者不得不接受翻修手术以更换基台。并且其中1例患者发生骨整合失败，后来重新植入。正确的手术技术和术后伤口护理在避免并发症方面起着重要作用。
