骨锚式助听器术后皮肤并发症的处理及预防

Prevention and treatment of skin complications following BAHA implantation

目的 分析骨锚式助听器（bone-anchored hearing aid,BAHA）植入术后的皮肤并发症,为预防和处理BAHA并发症提供参考经验.方法 总结北京协和医院2010年12月至2013年3月行BAHA植入手术的16例患者术后皮肤并发症的发生情况和处理方法.结果 16例患者中共发生皮肤并发症4例（占1/4）.根据Holgers分级标准,皮肤反应1～2级2例（占1/8）,3级皮肤反应2例（占1/8）.对1～2级皮肤反应者给予局部抗生素处理；3级反应者行二次手术切除增生皮肤及肉芽组织,其中1例患者更换9 mm桥基.结论 桥基周围皮肤感染、皮肤过度增生是BAHA植入术常见的皮肤并发症.手术应严格按标准规程操作,术后定期清洁桥基周围皮肤可预防皮肤并发症发生.出现严重并发症时应及时行二次手术处理.

Objective To discuss the skin complications of 16 cases received bone-anchored hearing aid （BAHA） implantations, and the clinical experience for prevention and treatment skin complications following BAHA. Methods Retrospective review 16 patients who received BAHA implantation from December 2010 to March 2013, and summarize the complications and treatment. Results Four patients（ 1/4 ） suffered from skin complications. According to Holgers classification, two patients （1/8） had a Holgers Grade 1-2 skin reaction and cured by local application of antibiotics. Two patients （ 1/8 ） experienced Holgers Grade 3 skin reaction received revision surgeries for excessive soft tissue growth. One patient replaced the BAHA abutment with a longer 9. 0mm one. Conclusions Infection and skin overgrowth around the abutment was the common complications of BAHA implantation. Standardize the peri- operative managements, and clean the skin regularly would prevent the skin complication. Additional surgical intervention should be applied timely in the cases of severe complications.