[Two rare complications in patients with bone-anchored hearing aids]

In our program of bone-anchored hearing aids we experienced two rare complications: a child with a hearing aid fell on her head and got an intrusion of the bone-screw into the intracranial space with a fracture of tabula externa and interna. There were no further intracranial complications, no hematoma or infection. The screw was explanted immediately with oto-microsurgical instruments and diamond burrs. The site of the screw was covered with a local skin flap. There were no complications in wound healing and the child got a second implant on the other side. A patient got an infection of his bone fixation screw and we took out the external fixation but left in place the bone screw, which was obviously still well fixed and the adjacent bone was without signs of infection. There was good secondary wound healing with local and systemic antibiotics. With almost completely healed external wound the patient got an intracranial abscess, that needed neurosurgical drainage. After long-time antibiotic treatment the patient is well again.