title: Skin Necrosis After Implantation With the BAHA Attract: A Case Report and Review of the Literature.
abstract: The bone-anchored hearing aid (BAHA) Attract is a transcutaneous bone conduction hearing aid that uses magnetic coupling to enable sound conduction. We report the first case of skin necrosis associated with the BAHA Attract and perform a literature review of soft tissue complications related to the device.
  
  
  
  A single patient who was found to develop skin necrosis 2 weeks after being fitted for the BAHA Attract speech processor.
  
  
  
  After the patient developed skin necrosis from the device, she was advised to immediately discontinue use of the Attract to allow complete wound healing, upon which the Attract was successfully converted to a percutaneous BAHA.
  
  
  
  We monitored for the development of skin complications from the BAHA Attract. The patient's immediate postoperative course was unremarkable and she was fitted with a speech processor of M5 magnet strength at 1 month postoperatively. After 1 week of use, she reported discomfort and was advised to downgrade to an M4 magnet; however, she continued to use the M5 and the following week was found to have developed skin necrosis around the device.
  
  
  
  Despite the infrequency of skin necrosis related to the BAHA Attract, it must be considered in counseling and managing candidates for the device.
authors.affiliation: *Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Columbia University College of Physicians & Surgeons †NewYork Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York.
authors.forename: Stephanie Y
authors.initials: SY
authors.lastname: Chen
authors.forename: Dean
authors.initials: D
authors.lastname: Mancuso
authors.forename: Anil K
authors.initials: AK
authors.lastname: Lalwani
mesh_terms: D000368:Aged; D001844:Bone Conduction; D005260:Female; D006310:Hearing Aids / Q000009:adverse effects*; D006801:Humans; D009336:Necrosis / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012871:Skin Diseases / Q000209:etiology*