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Published on: February 29, 2020
Peri-operative cerebrospinal fluid leak during single-stage bone-anchored hearing aid implantation: case report
G Dimbleby1, A Mitchell-Innes1, J Murphy1
1Department of Otolaryngology Head and Neck Surgery,Russells Hall Hospital,Dudley,UK.
Background:
A bone-anchored hearing aid uses the principle of bone conduction and osseointegration to transfer sound vibrations to a functioning inner ear. It consists of a permanent titanium implant, and removable abutment and sound processor. Informed consent requires discussion of the procedural benefits, alternatives and complications. The risks of bone-anchored hearing aid surgery include infection, soft tissue hypertrophy, skin graft or flap failure, osseointegration failure, and the need for further surgery.
Case Report:
A case of cerebrospinal fluid leak in a patient undergoing bone-anchored hearing aid surgery is reported and discussed.
Conclusion:
Bone-anchored hearing aid surgery poses a risk of breaching the inner table of the temporal bone and dura, resulting in a cerebrospinal fluid leak; the risk of meningitis is rare but serious. The surgeon should discuss the possibility of cerebrospinal fluid leak when consenting patients. Pre-operative computerised tomography scanning should be considered in certain individuals to aid implant placement.
