Bone-anchored hearing aid abutment skin overgrowth reduction with clobetasol.

OBJECTIVES: The bone-anchored hearing aid (BAHA) osseointegrated cochlear stimulator can treat hearing loss in a variety of clinical situations. Occasionally skin/scar overgrowth may cover the abutment. This overgrowth interferes with affixing the BAHA to the abutment. Surgical scar revision/excision has been used to treat this problem. Clobetasol (0.05%), a steroid gel, can reduce skin overgrowth. Experience with skin overgrowth and the efficacy of clobetasol to treat this problem was reviewed. SUBJECTS AND METHODS: The authors conducted a retrospective analysis of patients who underwent BAHA abutment implantation from January 2003 through December 2006. RESULTS: Eighty-eight patients (2 patients received bilateral BAHAs) were reviewed. Twenty (22%) of 90 sites developed overgrowth. Thirteen of 20 sites were treated with clobetasol. The overgrowth resolved in 11 (85%) of 13 sites after treatment. Patients with incomplete skin graft survival were significantly more likely to develop skin overgrowth (P = 0.0017). CONCLUSION: Clobetasol is an effective treatment for abutment skin/scar overgrowth. Clobetasol allows patients to resume BAHA use and obviates the need for scar revision.

Duke Scholars

Author David Marcus Kaylie Otology, Neurotology & Skull Base Surgery