abutment skin overgrowth

[qtrhrse15]

I have had my baha for years with minimal swelling that was always resolved with medications.  This time the swelling is not subsiding and looking at skin removal this next week. My question is has any one use clobetasol for swelling and been successful ?  My other question is if you had skin removal how did the removal go and did you go back to work the same day ?  Was told it would take very little time an I would be in and out in no time.  Ones who had removal did you get overgrowth again ? I know so many questions just that i have weathered infections and always did fine and now this.  A bit worried about this procedure.  Will be done at a surgical center because my doctor does not have a sterile area in his office to do removal.  Thank you in advance for your help.

[donjehle]

Thank you for your great post, qtrhrse15!

While I do not have baha (and no skin removal), I would be very curious to hear from others and the experience they have had with clobetasol and how their skin removal went.

And please update us on how it went after your surgery goes so that others can learn from your experience.

Best wishes!
Don

[james e]

Late to reply but I hope this helps someone. I have used clobetasol on my overgrowth for years. Got my BAHA in 2012 and within months my skin started growing over it. Here it is 2023 and it still happens sometimes. It works every time within a day or two, usually in the winter.

[throwloyalty]

Late to reply but I hope this helps someone. I have used clobetasol on my overgrowth for years. Got my BAHA in 2012 and within months my skin started growing over it. Here it is 2023 and it still happens sometimes. It works every time within a day or two, usually in the winter.

Does it have a strong impact on the skin?

[james e]

Well, here it is January 2024 and the skin around my abutment has almost covered it and I cannot wear my BAHA. The ointment does not seem to be working. I have an appointment with my doctor on Jan 24.

Dr Kutz at Southwestern in Dallas recommended last May I get a longer abutment. Cochlear recommends you R&R the abutment in a surgery ward. He said he may have a few different length abutments on hand. If I remember from then the next longer abutment is 4mm longer, and I hesitated because that seemed too much. At this point my choices are have the abutment removed and let the skin grow over and quit using the BAHA or get the longer abutment installed.

I will probably get the longer abutment.

Will keep you informed.

[james e]

Visit with Dr Kutz went well. He is going to remove and replace my abutment with a longer one.

Several steps to get this done. My first diagnosis from 2009 was I had bilateral ANs but not NF2. The right one was removed translab and BAHA installed. Moved to Dallas and have a new doctor here and he wanted a current MRI about 8 years ago. He was not sure I had another AN on the left and wanted me to get an annual MRI. After the second one he was still unsure. He has a monthly meeting with other doctors that have problem cases and they try to come to a conclusion as a group. Some of the docs are skull based surgeons and radiologist. The group decided I have a small AN. My doc was still not agreeing. After a few more MRIs I quit going. I'm in my 70s and I really didn't care anymore.

It has been 3 years since my last MRI and Dr Kutz wants another MRI to see if he can figure out what is going on in my head, and my wife wants to keep me around so I have a MRI set up.

I have an appointment with an audiologist for a hearing test and they will order abutments for my surgery. Surgery will probably be end of February or early March.

The surgery should take about 10 minutes unless there is some unknown issue. I will keep you updated.

[donjehle]

I hate to say this, james e, but from what you have stated, I don't have a lot of confidence in Dr. Kutz.

I really think if I were you that I would consult another specialist who has a lot of experience working with acoustic neuromas before I proceeded any further.  The Mayo Clinic (and other places around the country) do free consults with some of the top AN specialists in the country.  And they should be able to take one look at your multiple MRIs (without consulting skull-based surgeions and radiologists who might not have much experience with acoustic neuromas) and tell you definitively whether you have an AN or not.

Best wishes!
Don

[james e]

Don, your lack of knowledge regarding Dr Kutz is apparent. He is an assistant professor at The University of Texas Southwestern in Dallas. He trained 2 years at the House Clinic and specializes in ANs, cochlear implants, and researches in implantable hearing devices, and NF2. He is highly qualified.

My case is very unusual. My initial diagnosis many years ago was “bilateral ANs” by a radiologist in Austin. I do not have NF2. I about 1954 I was treated with radiation several times to shrink my adenoids. It was becoming a common practice for ENTs at the time. Recent studies of children that had that treatment, develop ANs at an off-scale rate from the general public. It also destroyed or damaged thyroids. I had half of my thyroid removed about 25 years ago because of a tumor.

Dr Kutz can read an MRI just as well as a radiologist. What ever growth I have in my skull, based on my medical history does not look like an AN to a highly knowable AN surgeon. He is not willing to do a surgery or radiation without knowing what is going on, so I am in a watch and wait situation.

In the future I hope you pull back on your personal beliefs without a full understanding of the facts. I know you meant no harm however if you said something like that to a new AN patient you would do more harm than good.

[donjehle]

I am sorry, james e.  I do not know Dr. Kutz at all.  It does my heart good to know that he trained at the House Clinic and specializes in ANs.

I simply based my concern for you on the basis of what you said in the post when you stated, "He was not sure I had another AN," and "After the second [MRI] he was still unsure," and "The group decided I have a small AN. My doc was still not agreeing," and "After a few more MRIs I quit going," and "Dr Kutz wants another MRI to see if he can figure out what is going on in my head."

As I stated, "from what you have stated, I don't have a lot of confidence in Dr. Kutz."  Again, I don't know him at all.  I was just going by all the statements you made about how he was unsure about the AN  and how he is trying to figure out what is going on in your head.  They were not confidence-inducing statements.

I understand that your situation is very unusual, and I certainly did not mean any harm.  I was not going on my personal beliefs, but my concern for you was simply based on your statements on how the doctor was unsure.  I apologize to you that I jumped to conclusions based upon that.

I truly wish you the very best and hope that Dr. Kutz is able to figure this out for you.
Don