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      Prótese implantável de condução óssea (BAHA): relato de caso Translated title: Implanted prosthetics osseous Conduction (BAHA): reported cases

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          Abstract

          INTRODUÇÃO: A Prótese Implantável de Condução Óssea (BAHA) consiste em uma excelente opção na reabilitação auditiva de pacientes com perda auditiva condutiva e mista uni ou bilateral, e sensorioneural unilateral. Tem sido uma alternativa vantajosa sobre os aparelhos de condução óssea convencionais e os aparelhos de amplificação sonora individuais (AASI) quando o uso dos mesmos fica impossibilitado pela presença de otite externa crônica de difícil controle clínico. OBJETIVO: Apresentar o primeiro caso de BAHA realizado no Brasil, após a autorização da ANVISA, para a reabilitação da perda auditiva mista com episódios de otite externa crônica. MÉTODO: Paciente do sexo feminino, 50 anos, com perda auditiva de grau moderado à direita e severo à esquerda, zumbido bilateral, decorrente de otosclerose, submetida a quatro cirurgias de estapedotomia e com impossibilidade de uso de AASI devido a otorreia e otalgia bilateral. A avaliação médica e audiológica indicaram o benefício do BAHA. Realizada a cirurgia e implantação do sistema BAHA, a paciente apresentou melhora significativa nos limiares audiométricos, na percepção e discriminação da fala, além de relatar extrema satisfação relacionada ao fator estético. COMENTÁRIOS FINAIS: O processo cirúrgico do BAHA é seguro, simples e rápido, proporcionando excelentes resultados audiológicos e alto grau de satisfação por parte dos pacientes.

          Translated abstract

          INTRODUCTION: The implanted prosthetics osseous conduction (BAHA) consists an excellent option in the auditive rehabilitation of the patients with conductive and mixed auditive lost uni or bilateral, and sensoriumneural unilateral. Has been a good alternative over the osseous conduction conventional apparatus and individual sonorous amplification apparatus (ISAA) when the usage of them is impossible because of the chronic external otitis of hard clinic control. OBJECTIVE: To present the BAHA first case done in Brazil, after the ANVISA's authorization, for the rehabilitation's mixed auditive lost with chronic external otitis episodes. METHOD: Female gender patient, 50 years old, with auditive lost in moderate degree at right and severe at left, bilateral buzz, originated of otosclerosis, submitted to 04 cirurgies, stapedotomy and that can not use the ISAA due to an otorrhea and bilateral otalgia. The medical and audiologic evaluation indicated the BAHA benefit. The cirurgy was done and the BAHA system implanted, the patient showed significative improvement in audiometric limens, in perception and speech discrimination, beyond to present extreme satisfaction related to esthetic factor. COMMENTS FINAIS: The BAHA cyrurgic process is safe, simple and quick, offering excellent audiologic results and high degree of satisfaction in patients.

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          Most cited references14

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          Intraindividual comparison of the bone-anchored hearing aid and air-conduction hearing aids.

          Some patients have to stop using their air-conduction hearing aid(s) because it causes or exacerbates chronic otitis. Then, a solution is the use of a bone-conduction hearing aid such as the percutaneous bone-anchored hearing aid (BAHA).
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            Percutaneous implants in the temporal bone for securing a bone conductor: surgical methods and results.

            Clinical results of an extended follow-up of percutaneous titanium implants for application of bone conductors are presented. A simplified 1-stage surgical procedure is introduced. This study entails a consecutive series of 163 implants in 155 patients 9 to 80 years old who received a bone conductor coupled to a percutaneous titanium implant since June 1988 at the University Hospital Nijmegen. The maximum follow-up is 7 years. The bone conductor can be connected to a percutaneous abutment fixed to a titanium fixture anchored in the temporal bone. Several clinical trials from different clinics have shown its efficacy in patients with a conductive or mixed hearing loss. In this study attention is paid to the following issues: the occurrence of skin reactions, the condition of the skin around the abutment, the stability of the fixture, and a simplified surgical technique.
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              The bone-anchored hearing aid: a solution for previously unresolved otologic problems.

              A major challenge for otologists treating middle ear infection is to obtain a dry ear and optimal hearing. If the patient needs amplification and uses an air conduction hearing aid, the ear mold, occluding the ear canal, may provoke or aggravate the infection in the middle ear and thus cause otorrhoea. Continuous otorrhoea may cause cochlear damage in the long run. Bone conduction hearing aids offer an alternative for such patients.
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                Author and article information

                Contributors
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                Journal
                aio
                Arquivos Internacionais de Otorrinolaringologia
                Arquivos Int. Otorrinolaringol.
                Fundação Otorrinolaringologia (São Paulo )
                1809-4856
                June 2011
                : 15
                : 2
                : 249-255
                Affiliations
                [1 ] Universidade Federal do Paraná Brazil
                [2 ] Universidade Federal do Paraná Brazil
                [3 ] Santa Casa de Misericórdia de Curitiba Brazil
                [4 ] Fundação Fisch no Brasil
                [5 ] Hospital Pequeno Príncipe Brazil
                [6 ] Sociedade Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial
                [7 ] Universidade Federal de São Paulo Brazil
                [8 ] Hospital Universitário Evangélico de Curitiba Brazil
                [9 ] Universidade de São Paulo Brazil
                [10 ] Universidade Tuiuti do Paraná Brazil
                Article
                S1809-48722011000200020
                10.1590/S1809-48722011000200020
                9a4930b0-1af0-4519-b17f-02838b0d3a19

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1809-4872&lng=en
                Categories
                OTORHINOLARYNGOLOGY

                Otolaryngology
                prosthetics and Implants,auditive lost,external otitis,próteses e omplantes,perda auditiva,otite externa

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