title: Baha implant as a hearing solution for single-sided deafness after retrosigmoid approach for the vestibular schwannoma: surgical results.
abstract: Skull base tumors and, in particular, vestibular schwannoma (VS) are among the etiological reasons for single-sided deafness (SSD). Patients with SSD have problems in understanding speech in a noisy environment and cannot localize the direction of sounds. Baha is one of the most frequently used systems for SSD compensation. Out of 38 patients with SSD after retrosigmoid removal of VS who underwent testing with Baha softband, 16 were satisfied and were indicated for Baha implantation. Two surgical approaches have been used-the Nijmegen linear incision technique with subdermal thinning (Group I, implant BI300) and fast surgery technique without subdermal thinning (Group II, implant BIA400). The duration of the surgery, the implant stability measured by Ostell, and skin or soft tissue reactions in long range follow-up were evaluated and compared between Group I and II. There was a difference in duration of surgery, in Group II procedures averaged significantly faster (p > 0.001). In both groups, there was a similar trend of the gradual increase of implant stability. In the Group I and II, there was comparable rate of the skin or soft tissue reactions grade 0, I, II, or III. We have proved Baha to be a suitable possibility for SSD patients after the removal of VS, regardless of the approach. After the retrosigmoid approach to the VS, the key step of Baha implantation must be to reach intact healthy bone to avoid implantation into scar tissue.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic. jboucek99@seznam.cz.
authors.forename: Jan
authors.initials: J
authors.lastname: Boucek
authors.affiliation: Department of Phoniatrics, The First Faculty of Medicine, Charles University, Zitna 24, 120 00, Prague 2, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Vokral
authors.affiliation: Department of Phoniatrics, The First Faculty of Medicine, Charles University, Zitna 24, 120 00, Prague 2, Czech Republic.
authors.forename: Libor
authors.initials: L
authors.lastname: Cerny
authors.affiliation: Department of ENT, The Third Faculty of Medicine, Charles University, Srobarova 50, 100 34, Prague 10, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Chovanec
authors.affiliation: Department of ENT, The Second Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Skrivan
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic.
authors.forename: Eduard
authors.initials: E
authors.lastname: Zverina
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Betka
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Zabrodsky
mesh_terms: D005260:Female; D006310:Hearing Aids; D046088:Hearing Loss, Unilateral / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery; D010549:Personal Satisfaction; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D019919:Prosthesis Implantation / Q000379:methods*; D060489:Prosthesis Retention; D016896:Treatment Outcome
keywords: Baha; Implant stability; Ostell; Resonance frequency analysis; Retroauricular approach; Single-sided deafness; Vestibular schwannoma