BAHA Abutment Vanished

[milhaus]

I am having a very strange complication after my BAHA surgery which was just a week and a half ago on the 29th of July. My abutment seems to have been completely swallowed by my skin. Its like the hole that they made for the abutment in my skin has slowly migrated downward, and now the abutment is completely buried under my skin and all that is left is a big hole right into my head! The hole is leaking tons of fluid and I'm really worried about getting an infection because it is just a completely uncovered hold right into my head.

I called my doctor's office to tell them what was going on this morning (their office is only open from 8 am to 1130 am on Fridays. I told them it seemed the skin was growing over my abutment and so they prescribed me some antibiotics because they assumed the issue was that the swelling was just too great around the abutment. However, I can tell you that the swelling is almost completely gone. Its the lowest it has ever been since the operation. Now their office is closed and I will have no way to contact them until Monday and I don't know what to do. I have to work night shift and so will have to work in a dusty environment with a literal hole in my head.

Has this happened to anyone else? What should I do?

[CHD63]

Hi milhaus .....

If I were you I would put a bandage over the site and cover it with a hat/cap/sweatband/etc. to wear at work. The last thing you want is a massive infection at the surgery site.  I would also call the doctor on call and ask if it is OK to put Neosporin or some kind of antibiotic ointment directly on the site.  ..... and be sure to take the antibiotics they prescribed.

Many prayers and good luck.

Clarice

[leapyrtwins]

I don't want to alarm you, but this is not normal.  As you say, it's a strange complication.

I agree with Clarice that you need to keep the site covered with a bandage but I also feel that your doctor needs to see your BAHA site.

I'd call first thing Monday morning and get an appointment.

This is the type of thing your doctor needs to see, not just hear about.  In the end it may be less serious than you think, but the doctor should be making that assessment after seeing it for himself/herself.

Good luck and please keep us posted,

Jan

[milhaus]

Thank you for your replies. I ended up calling the hospital and asking them to page my doctor. I sent him a picture and he had me meet him at his office even though it was closed. He decided it was badly infected and that had caused the skin to start moving in ways we didn't want it to. He put me on antibiotics and has my wife cleaning and disinfecting the site twice a day.

He wants me to send another picture on Monday and if it doesn't look better I will have to have another procedure this week to fix it. So far it seems the infection is dying down but the abutment is still almost entirely hidden under my skin. The hole is closing up a little but is still just an open hole in my head.

He also wants me off work for another week. That will be a total of two and a half weeks off just for a baha surgery because of all the complications I have had so far.

[leapyrtwins]

Thanks for keeping us posted.

I'm glad you called your doctor.  It's better to have him look at it and tell you it's nothing than to just assume it's nothing (when it could be something).

Sounds like you have quite a nasty infection, but your doc is on top of things. 

I, thankfully, had no complications from my implant and it's not the norm, but I'm so sorry you are having to deal with this.

Hope things get better soon 

Jan

[Kristena]

Hi Milhaus, I hope your situation has improved. I too had complications with my BAHA, and I understand the fear and anxiety of having an open hole in your scalp! My site didn't heal properly and was open for several days, but the doctor didn't seem too concerned about it as long as I kept gobbing on the antiobiotic ointment. Let us know how you are doing.

[jaylogs]

Hi there. Yes, good thing you did get it seen quickly.  I was having issues with the skin around mine as well, but not to the extent yours did.  It would leak around the abutment periodically, then heal, then leak again.  The doctor took out the abutment to allow the area to heal.  I'm going in at the end of the month to see about getting it back in.  Good luck with yours!!
Jay

[CHD63]

Just as a point of clarification on bone-anchored hearing devices ..... the procedure includes three parts: 1) the titanium implant imbedded and osseointegrated into the skull bone 2) the abutment, which is the screw attached to the implant and 3) the processor, which snaps onto the screw.  Since the bone grows around the implant, it can only be removed by removing part of the skull, which is a significant surgical procedure.

In most cases of poor healing, the treatment is to take off the screw (abutment) and allow the area to heal completely.  Then the skin can be opened again and the abutment screwed back on, often with a longer post, if needed, and allowed to heal cleanly and completely again before snapping on the processor again.

Hope that makes sense.

Clarice

[leapyrtwins]

Just wanted to mention that the implant isn't always titanium and there isn't always an abutment and screw.

Some time ago, Cochlear introduced something called BAHA Attract that uses magnets (just like Cochlear Implants) instead of a titanium rod and an abutment (which is now called BAHA Connect).  A magnet is placed under a skin flap made in the skull; another magnet is placed on the processor (aka device).  No rod is placed into the skull; no drills are involved.

Magnets and MRIs are typically a no-no, so that generally prevents those of us who have had an AN from getting a BAHA Attract, but I have heard of some AN patients who have opted for them.  It's one of those things that depends on your doctor.

I asked my audiologist about it yesterday, when I was having my BAHA 5 programmed, and she said that my doc's practice is still recommending the rod/abutment/screw because the magnets place shadows on the MRI film.  It can be hard to determine if "something" on an MRI is AN regrowth or a magnet shadow. 

Jan

[Kristena]

My BAHA Attract surgery still included an implant drilled into the skull (the surgery guide is available by typing "Baha Attract Surgery" into your browser. It looks like there is at least one YouTube video too, but I didn't watch it  ). After the magnet was removed due to poor healing, the implant was still used to hold the abutment. However, maybe things have changed in the past year.

[leapyrtwins]

You might be right.  The implant may hold the magnet in place; kind of like an anchor, so it doesn't slip or slide out of place.

I've never watched a BAHA implant video - not able to "stomach" it.  Although I was wide awake during my implant, it's a little different when you can't see what's going on (due to your face being draped) or feel a thing other than a little pressure when the drill is used.   You hear sounds which are muffled since you're laying on your "good" ear.   Everything is very surreal. Seeing it isn't for me though - so I'll pass on that.

Jan