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Evaluation of retroauricular skin mobility for bone-anchored solutions

Published online by Cambridge University Press:  05 September 2018

M Wróbel ,
P Sobolewski ,
G Greczka  and
W Gawęcki
M Wróbel*
Affiliation:
Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Warsaw, Poland
P Sobolewski
Affiliation:
Dermatology Department, Centre of Postgraduate Medical Education, Warsaw, Poland
G Greczka
Affiliation:
Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Warsaw, Poland
W Gawęcki
Affiliation:
Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Warsaw, Poland
*
Author for correspondence: Mr Maciej Wróbel, ul. Przybyszewskiego 49, 60–355 Poznań, Poland E-mail: [email protected] Fax: +48 61 8691 690
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Abstract

Background

A subset of patients with bone-anchored hearing aids develop skin reactions that may be related to excess skin mobility around the skin-penetrating abutments. However, there is a lack of reports on the extent of skin mobility within the retroauricular space, typical for the implant location.

Methods

This study was based on photographic analysis of the relative shifts between the skull and soft tissue of the head in the retroauricular region, detected under the physiological conditions of head support and facial muscle contraction.

Results

The mean calculated value for skin shifts at the implant site was 5.1 mm. In 84 per cent of cases, the extent of skin shift was greater with the head at rest, by an average of 3.1 mm. The extent of skin movement during facial muscle contraction ranged between 0 mm and 8.9 mm. No direct correlations were detected between the extent and direction of skin shifts and patients’ age, gender or body mass index.

Conclusion

There are no objective data that can predict individual skin movement at the osseointegrated implant site. The study confirmed high variability in terms of the direction and extent of skin shift, which should be discussed when managing related skin problems.

Keywords

SkullOsseointegrationSkinMuscle ContractionBone Conduction
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 802 - 806
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Mr M Wróbel takes responsibility for the integrity of the content of the paper

References

1Huber, AM, Sim, JH, Xie, YZ, Chatzimichalis, M, Ullrich, O, Roosli, C. The Bonebridge: preclinical evaluation of a new transcutaneously-activated bone anchored hearing device. Hear Res 2013;301:93–9Google Scholar
2Eeg-Olofsson, M, Hakansson, B, Reinfeldt, S, Taghavi, H, Lund, H, Jansson, KJ et al. The bone conduction implant–first implantation, surgical and audiologic aspects. Otol Neurotol 2014;35:679–85Google Scholar
3van de Berg, R, Stokroos, RJ, Hof, JR, Chenault, MN. Bone-anchored hearing aid: a comparison of surgical techniques. Otol Neurotol 2010;31:129–35Google Scholar
4Fontaine, N, Hemar, P, Schultz, P, Charpiot, A, Debry, C. BAHA implant: implantation technique and complications. Eur Ann Otorhinolaryngol Head Neck Dis 2014;131:69–74Google Scholar
5Tjellström, A, Lindström, J, Hallén, O, Albrektsson, T, Brånemark, PI. Osseointegrated titanium implants in the temporal bone. A clinical study on bone-anchored hearing aids. Am J Otol 1981;2:304–10Google Scholar
6Dumon, T, Medina, M, Sperling, NM. Punch and drill: implantation of bone anchored hearing device through a minimal skin punch incision versus implantation with dermatome and soft tissue reduction. Ann Otol Rhinol Laryngol 2016;125:199–206Google Scholar
7Gordon, SA, Coelho, DH. Minimally invasive surgery for osseointegrated auditory implants: a comparison of linear versus punch techniques. Otolaryngol Head Neck Surg 2015;152:1089–93Google Scholar
8Hultcrantz, M. Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial. Otol Neurotol 2011;32:1134–9Google Scholar
9Frey, M, Jenny, A, Giovanoli, P, Stussi, E. Development of a new documentation system for facial movements as a basis for the international registry for neuromuscular reconstruction in the face. Plast Reconstr Surg 1994;93:1334–49Google Scholar
10LeResche, L, Dworkin, SF. Facial expressions of pain and emotions in chronic TMD patients. Pain 1988;35:71–8Google Scholar
11Trotman, CA, Stohler, CS, Johnston, LE Jr. Measurement of facial soft tissue mobility in man. Cleft Palate Craniofac J 1998;35:16–25Google Scholar
12Bonci, T, Camomilla, V, Dumas, R, Cheze, L, Cappozzo, A. A soft tissue artefact model driven by proximal and distal joint kinematics. J Biomech 2014;47:2354–61Google Scholar
13Van Rompaey, V, Claes, G, Verstraeten, N, van Dinther, J, Zarowski, A, Offeciers, E et al. Skin reactions following BAHA surgery using the skin flap dermatome technique. Eur Arch Otorhinolaryngol 2011;268:373–6Google Scholar
14Stalfors, J, Tjellstrom, A. Skin reactions after BAHA surgery: a comparison between the U-graft technique and the BAHA dermatome. Otol Neurotol 2008;29:1109–14Google Scholar
15Wróbel, M, Popko, M, Szyfter, W. Presurgical evaluation of retroauricular subcutaneous tissue thickness in BAHA surgery. Otol Neurotol 2012;33:421–4Google Scholar
16De Greef, S, Vandermeulen, D, Claes, P, Suetens, P, Willems, G. The influence of sex, age and body mass index on facial soft tissue depths. Forensic Sci Med Pathol 2009;5:60–5Google Scholar