title: High body mass index as a risk factor for skin overgrowth with the bone-anchored hearing aid.
abstract: OBJECTIVE
  To identify whether an increased body mass index (BMI) predisposes patients to more soft tissue problems after placement of a Bone-Anchored Hearing Aid implant.
  
  
  METHODS
  We retrospectively reviewed 88 adult patients who met criteria for inclusion in the study.
  
  
  RESULTS
  Ten (11.4%) of the 88 patients had significant soft tissue reaction requiring excision, revision of the skin graft, or placement of a longer abutment (8.5 mm). Of these 10 patients, 4 required placement of a longer abutment, whereas 4 underwent revision skin grafting. All 10 patients had scar excisions in the office. Of the 10 patients, 9 were considered obese with a BMI of 30 lb/in or greater. One patient was considered overweight with a BMI of 28.1 lb/in. The mean BMI for those patients with significant soft tissue reactions was 34.2 lb/in. The mean BMI for patients with no reaction or minor reactions was 27.6 and 27 lb/in, respectively. No patient lost an implant due to soft tissue reaction during the follow-up period.
  
  
  CONCLUSIONS
  Our study demonstrates that after Bone-Anchored Hearing Aid surgery, most patients (78/88, 88.6%) had no soft tissue reaction or had only a mild reaction that was easily treated. However, there are a definite percentage of patients who may develop significant scarring over time. This study identified a significant relationship between obesity (BMI > 30 lb/in) and extensive soft tissue reaction around the implant site.
authors.affiliation: Lippy Group for Ear, Nose and Throat, 3893 E. Market Street, Warren, OH 44484, U.S.A. info@lippygroup.com
authors.forename: Leonard P
authors.initials: LP
authors.lastname: Berenholz
authors.forename: John M
authors.initials: JM
authors.lastname: Burkey
authors.forename: William H
authors.initials: WH
authors.lastname: Lippy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006310:Hearing Aids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D053441:Suture Anchors / Q000009:adverse effects*