69711 Removal or repair of electromagnetic bone conduction hearing device in temporal bone

Name of the Procedure:

Removal or Repair of Electromagnetic Bone Conduction Hearing Device in Temporal Bone

Summary

In this procedure, a damaged or malfunctioning electromagnetic bone conduction hearing device, which is implanted in the temporal bone, is either removed or repaired. This involves accessing the device through a surgical opening in the skull, making the necessary adjustments or replacements, and ensuring proper postoperative healing.

Purpose

This procedure addresses issues with implanted bone conduction hearing devices that may no longer function properly due to wear, damage, or complications. The goal is to restore optimal hearing function either by repairing the existing device or by removing it safely to prevent further complications.

Indications

• Malfunction or failure of the electromagnetic bone conduction hearing device.
• Chronic infections or complications around the implant site.
• Persistent pain or discomfort associated with the device.
• Patient experiencing decreased hearing ability despite the device.

Preparation

• Fasting typically required for 8-12 hours before the procedure.
• Adjustments to blood-thinning medications as directed by the physician.

• Baseline hearing tests and imaging assessments (such as CT or MRI) to evaluate the position and condition of the implanted device.

  Procedure Description

  1. The patient is placed under general anesthesia.
  2. An incision is made near the implant site to access the temporal bone and the device.
  3. The surgeon identifies and assesses the device for any malfunction or damage.
  4. Depending on the findings, the device is either repaired or entirely removed.
  5. If a new device needs to be implanted, the surgeon may proceed with the replacement.
  6. The surgical area is cleaned and closed with sutures.
  7. A dressing is applied to protect the site.

Duration

The procedure typically takes about 1-3 hours, depending on the complexity and whether a new device is being implanted.

Setting

Usually performed in a hospital or a specialized surgical center equipped with the necessary facilities.

Personnel

• Otolaryngologist or specialized ear surgeon
• Anesthesiologist
• Surgical nurses
• Audiologist (pre- and post-procedure consultations)

Risks and Complications

• Infection
• Bleeding
• Adverse reaction to anesthesia
• Damage to surrounding structures (e.g., facial nerve)
• Device failure or incorrect functioning after repair
• Prolonged hearing loss or no improvement in hearing

Benefits

• Restoration of optimal hearing functionality.
• Relief from pain or discomfort caused by a malfunctioning device.
• Prevention of further complications such as infections.

Recovery

• Hospital stay for 1-2 days for observation.
• Pain management with prescribed medications.
• Avoiding strenuous activities for a few weeks.
• Regular follow-up appointments to monitor healing and device function.
• Audiometric evaluations to assess hearing improvement.

Alternatives

• Use of external hearing aids instead of bone conduction devices.
• Other types of implantable hearing devices.
• Cochlear implants, depending on the severity and type of hearing loss.

Patient Experience

• During the procedure, the patient will be under general anesthesia and will not feel anything.
• Post-procedure pain and discomfort will be managed with medications.
• The patient may experience some swelling and bruising around the surgical site, which typically subsides in a few days.
• Gradual improvement in hearing once healing is complete and the device is properly functioning.

Pain management strategies and supportive care measures will be provided to ensure patient comfort throughout the recovery period.