Application of the Bonebridge implant with simultaneous reconstruction of the posterior wall of the external auditory canal with autogenous material.

Objectives: Considering the size of the electromagnetic bone conduction floating mass transducer of Bonebridge implant, its implantation requires adequate anatomical conditions. In case of patients after radical ear surgeries placement of internal part in the typical position, which is in the sinodural angle, may be difficult due to bone defects. The aim of this paper is presentation of a novel technique of Bonebridge implantation with one-time reconstruction of the posterior wall of the external auditory canal (EAC) with autogenous material in a patient after a radical surgery. We present a case of a patient with bilateral mixed hearing loss of moderate degree who, based on the results of laryngological and audiological evaluation, underwent surgery for a Bonebridge implantation. In view of the post-radical ear surgery status of the ear selected for implantation it has been decided to perform at the same time reconstruction of the posterior EAC wall with autogenous bone dust. Material and Methods: In this paper we present the surgical procedure of one-time implantation and reconstruction of the EAC wall as well as the assessment of the effects of the device application. At 12 months after surgery we have noted preserved and correct healing of the posterior EAC wall and hearing benefits involving improved hearing sensitivity and speech discrimination. Results and Conclusions: In the presented case the surgical technique combining simultaneous reconstruction of the posterior EAC and implantation of a bone conduction device has enabled reducing the size of the postoperative cavity, thus facilitating its future debridement and, by covering the floating mass transducer has separated it from the external environment allowing its proper placement. Stable auditory results and local conditions after the posterior EAC wall reconstruction in our case suggest that this method may be an alternative for other bone conduction devices in patients with extensive bony defects. [ABSTRACT FROM AUTHOR]