Side effect as therapy goal: Local infiltration of steroids to achieve skin flap atrophy after Bonebridge Implantation. A case report.

Introduction Bonebridge is an active transcutaneous bone conduction hearing implant and can be used in conductive or mixed hearing loss. The speech processor is positioned over the implant through magnetic forces.

Patient We present a case of a 14 year old boy with adiposity (165cm, 79kg, BMI 29.0). In the initial implantation of the Bonebridge, asurgical flap thinning was presumed not to bei indicated. Unfortunately, after surgery there was no sufficient retention of the speech processor, so a revisioin with surgical soft tissue thinning was performed. Six month after revision surgery, there was still no sufficient retention.

Ultrasound examination revealed that the soft tissue over the implant was too thick. We performed three subcutaneous injections of cortisone to achieve soft tissue atrophy.

Results Before cortisone injection, ultrasound measurement of the soft tissue over the implant showed a thickness of 11 +/-2mm. After three injections of cortisone we could demonstrate a reduction of soft tissue to a thickness of 8 +/-2mm.

Speech processor retention in rest was firm after the second application, after the third application of cortisone the processor retention was good even in movement.

Discussion Subcutaneous atrophy is a well-known side effect of cortisone injection, and commonly used in plastic surgery for various indications.

In this case we were able to show a subcutaneous tissue atrophy with cortisone injection in order to achieve a firm retention of the speech processor .

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Artikel online veröffentlicht:
10. Juni 2020