Skip to main content Accessibility help

A one-stage surgical procedure for placement of percutaneous implants for the bone-anchored hearing aid

  • E. A. M. Mylanus (a1) and C. W. R. J. Cremers (a1)


The bone-anchored hearing aid (BAHA) is an alternative to the conventional bone conduction hearing aid. The transducer is coupled to a percutaneous titanium implant which is traditionally inserted into the temporal bone in two stages. This study focusses on a one-stage surgical technique for the implantation of percutaneous implants. The preliminary clinical results of 33 one-stage implants in 33 patients are presented.

Post-operative necrosis of the skin grafts did not occur. After a follow-up which varied from nine to 25 months, 31 out of the 33 fixtures (94 per cent) were anchored firmly in the skull. Twenty-six out of the 33 implants (79 per cent) remained free from potentially dangerous skin reactions. The results were statistically comparable to those obtained with two-stage implants at the same clinic. Although longer follow-up is needed before a general statement can be made about replacing the two-stage technique, the preliminary one-stage results are promising.


Corresponding author

Mr E. A. M. Mylanus. University Hospital Nijmegen, ENT Department, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Fax: 80540251.


Hide All

This study was supported by grants from, the Fund to initiate investigative medicine of the University Hospital Nijmegen, and from the fund of Investigative Medicine of the Ziekenfondsraad of The Netherlands.



Hide All
Abramson, M., Fay, T. H., Kelly, J. P., Wazen, J. J., Liden, G., Tjellström, A. (1989) Clinical results with a percutaneous bone anchored hearing aid. Laryngoscope 99: 707710.
Adell, R., Lekholm, U., Rockler, B., Brånemark, P.-I. (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. International Journal of Oral Surgery 10: 387416.
Albrektsson, T., Brånemark, P.-I., Hansson, H.-A., Lindström, J. (1981) Osseointegrated titanium implants. Requirements for ensuring long lasting, direct bone-to-implant anchorage in man. Acta Orthopaedica Scandinavia, 52: 155170.
Albrektsson, T., Brånemark, P.-I., Jacobsson, M., Tjellström, A. (1986) Present clinical applications of osseointegrated percutaneous implants. Plastic and Reconstructive Surgery 79: 721730.
Bonding, P., Ahlgien, P., Dige-Petersen, H. (1992) Permanent, skin penetrating, bone anchored titanium implants. A clinical study of host reaction in bone and soft tissue. Acta Oto-laryngologica (Stockholm) 112: 455461.
Brånemark, P.-I., Albrektsson, T. (1982) Titanium implants permanently penetrating human skin. Scandinavian Journal of Plastic and Reconstructive Surgery 16: 1721.
Brånemark, P.-I., Breine, U., Adell, R., Hansson, B.-O.. Linström, J., Ohlsson, A. (1969) Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scandinavian Journal of Plastic and Reconstructive Surgery 3: 81100.
Cutler, S. J., Ederer, F. (1958) Maximum utilization of the life table method in analyzing survival. Journal of Chronic Disorders 8: 699712.
Håkansson, B., Tjellström, A.. Rosenhall, U., Carlsson, P. (1985) The bone-anchored hearing aid: principle design and a psychoacoustical evaluation. Acta Oto-laryngologica (Stockholm) 100: 229239.
Håkansson, B., Liden, B., Tjellström, A., Ringdahl, A., Jacobsson, M., Carlsson, P., Erlandsson, B.-E. (1990) Ten years of experience with the Swedish bone-anchored hearing system. Annals of Otology, Rhinology and Laryngology 99 (Suppl. 151): 116.
Holgers, K.-M., Tjellström, A., Bjursten, L. M., Erlandsson, B.-E. (1988) Soft tissue reaction around percutaneous implants: a clinical study of soft tissue conditions around skin-penetrating titanium implants for bone anchored hearing aids. American Journal of Otology 9: 5659.
Lindström, J., Brånemark, P.-I., Albrektsson, T. (1981) Mandibular reconstruction using the preformed autologous bone graft. Scandinavian Journal of Plastic and Reconstructive Surgery 15: 2938.
Mylanus, E., Cremers, C., Snik, A., Van den Berge, N. (1994) Clinical results of percutaneous implants in the temporal bone. Archives of Otolaryngology, Head and Neck Surgery 120: 8185.
Proops, D., Wake, M. (1993) A single stage technique for the BAHA. Book of Abstracts. Third International Winter Seminar on Implants in Craniofacial Rehabilitation and Audiology,Selva Val Gardena Biomaterials Club, University of Götebora,Sweden. p 45.
Tjellström, A., Rosenhall, U., Lindström, J.. Hallen, O., Albrektsson, T., Brånemark, P.-I. (1983) Five-year experience with skin penetrating bone-anchored implants in the temporal bone. Acta Oto-laryngologica (Stockholm) 95: 568575.
Tjellström, A. (1985) Percutaneous implants in clinical practice. CRC Critic Reviews Biocompatibility 1: 205228.
Tjellström, A. (1991) A one or a two-stage procedure? Book of Abstracts. First International Winter Seminar on Implants in Craniofacial Rehabilitation and Audiology,Lech am Arlberg Biomaterials Club. University of Göteborg,Sweden, p 36.
Tjellström, A., Granström, G. (1993) The one-stage procedure for implant in the mastoid. Book of Abstracts. Third International Winter Seminar on Implants in Craniofacial Rehabilitation and Audiology,Selva Val Gardena Biomaterials Club, University of Göteborg,Sweden, p 46.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed