Bone-Anchored Hearing Aid: A Comparison of Surgical Techniques

Raymond van de Berg*, Robert J. Stokroos, Janny R. Hof, Michelene N. Chenault

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: To determine which bone-anchored hearing aid (BAHA) implantation surgical technique is associated with the fewest major postoperative complications and shortest time between surgery and use of the BAHA. The techniques evaluated were 1) a free retroauricular "full-thickness" skin graft, 2) a pedicled parieto-occipital epidermal graft, 3) a dermatome-edicled parieto-occipital dermal graft, and 4) two broad pedicled local epidermal skin envelopes/skin flaps. Study Design: Retrospective case study. Setting: Tertiary referral center. Patients: One hundred forty-three patients who received a BAHA at Maastricht University Medical Center between November 1996 and January 2007. Number and mean age of patients in each group: Technique 1 (n = 30; mean age, 55 yr), Technique 2 (n = 45; mean age, 54 yr), Technique 3 (n = 47; mean age, 55 yr), and Technique 4 (n = 21; mean age, 54 yr). Main Outcome Measures: Cumulative proportion of implants that remained free of major complications versus follow-up interval, time between surgery and use of BAHA. Results: Technique 4 (2 broad pedicled local epidermal envelopes/skin flaps) has a significantly higher proportion of implants that remained free of major complications during first year of follow-up (91%; p = 0.021). Pairwise comparisons revealed that Technique 4 also has a significantly shorter time until use (2 mo) than Techniques 1 (2.5 mo), 2, and 3 (both 2.3 mo). Conclusion: Two broad pedicled, local epidermal envelopes/flaps are associated with significantly fewer major complications and have one of the shortest times between surgery and use of the BAHA. The use of a dermatome is not associated with fewer major complications. We recommend Technique 4 as the preferred standard in BAHA surgery to minimize complications, postoperative medication, discomfort, and cost.
Original languageEnglish
Pages (from-to)129-135
JournalOtology & Neurotology
Issue number1
Publication statusPublished - Jan 2010


  • Bone-conduction hearing
  • Hearing aids
  • Postoperative complications
  • Reoperation
  • Skin grafting
  • Surgical flaps
  • Surgical procedures


Dive into the research topics of 'Bone-Anchored Hearing Aid: A Comparison of Surgical Techniques'. Together they form a unique fingerprint.

Cite this