DOI: 10.1093/bjs/znad258.343 ISSN:

413 Percutaneous Bone Anchored Hearing Rehabilitation in Adults - the Nottingham Experience Over a 5 Year Period

T Hao, W S Cho, A Kasbekar
  • Surgery



Percutaneous bone anchored hearing aid (BAHA) is an effective hearing rehabilitation option. However, complications including granulation, skin overgrowth and infections may lead to revision surgeries. This study aim was to assess the complication rate and potential contributing factors leading to revision surgeries.


Adult patients who underwent BAHA connect (Cochlear Corp) operations between 2016 to 2021 were included. Patient notes were retrospectively reviewed.


166 patients received a BAHA connect. Twenty-nine (17.5%) patients required revision surgery; 2 for granulation, 10 for skin overgrowth, 9 for infection, 7 for traumatic extrusion and 1 for failure of osteointegration. Excluding traumatic extrusion patients, 22 (13.3%) required revision surgery. 56% of patients were performed under local anaesthetic, with no difference in complication rate compared to general anaesthetic. 70% patients with Holger’s grade 4 changes and 40% patients with grade 3 findings required revision. 31% cases required revision when primary surgeon was trainee, compared with consultant (17%). There was no difference in post-operative skin problems between skin incisions made in-line vs separate from abutment. Cases with intra-operative complications, including re-siting of initial hole due to bleeding or loose fixture, had higher rate of revision. Of revision surgery patients, 14% were active smokers and 21% ex-smokers. 31% required multiple revision operations.


Percutaneous BAHA insertion can be performed under local and general anaesthetic. Grade of primary surgeon and intra-operative problems appear to be risk factors for requiring revision surgery. Smoking and site of incision does not appear to be risk factors for postoperative skin problems.

More from our Archive