Subdural hematoma--a rare complication of removal of osseointegrated auricular prosthesis retention system

Subdural Hematoma: A Rare Adverse Complication From Bone-Anchored Hearing Aid Placement

OBJECTIVE

Bone-anchored hearing aids (BAHA) are bone conduction hearing aids commonly implantated by Ear, Nose, and Throat surgeons. We present the first documented case of a subdural hematoma secondary to primary fixation of a BAHA.

PATIENT

We present a 65-year-old male patient undergoing a left sided BAHA for bilateral chronic ear infections and difficulty wearing conventional hearing aids. The procedure was uneventful, however, the patient developed a postoperative large acute left temporoparietal intracerebral hematoma associated with an ipsilateral acute subdural hematoma. This required emergency transfer to the local tertiary neurosurgical center for a left decompressive craniotomy and evacuation of the hematoma.

RESULTS

The patient required a prolonged stay on an intensive care unit and was eventually discharged to the community for on-going neurological rehabilitation.

CONCLUSION

This is a rare and devastating complication BAHA surgery. Otologist, general ENT surgeons, and neurosurgeons should be aware of this life-threatening complication of BAHA surgery.

Using Osseointegrated Implants Concomitant With Onlay Bone Grafting for Auricular Reconstruction

Conventional dental implants have been reported for nasal and orbital regions but due to limited thickness of calvarium they are not used in mastoid region. Onlay bone grafting in skull concomitant with implants is a predictable method and experimental animal studies confirm it. Parietal bone and lateral mandibular ramus are suggested source of bone grafts and dental implants with 7 mm length can be used safely. Increased fixture length may lead to increase survival in long term.