Category Archives: Surgery

Isla Feels More Confident Than Ever with New Ponto 5 SuperPowers

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Katelyn Harkins tells us how getting fit bilaterally with Ponto 5™ SuperPower processors have helped her eight-year-old daughter Isla blossom socially.

Isla was born with bilateral microtia/atresia. She was adopted from China at 20 months old and had no access to sound prior to coming home. She received Ponto bone anchored hearing processors on a softband as loaners from Oticon Medical the month she turned two and loved them immediately. She even insisted on wearing them to nap!

We are privileged enough to have access to excellent hearing solutions from Oticon Medical, which give Isla a near normal audiogram. We are also lucky to have a school for the Deaf nearby, which gives Isla access to education provided in both spoken English and American Sign Language (ASL).

We were very excited to hear OM was coming out with a Ponto 5 SuperPower! Isla’s hearing loss is severe enough that the extra headroom of the SuperPower allows for access to as much sound as possible, and equally little feedback. Isla was thrilled that the upgrade gave her onboard controls for volume and mute.

Isla’s upgrade included getting bilaterally implanted*. In researching implantation, I understood minimally invasive Ponto surgery (MIPS) was minimally invasive compared to the old “long cut” or “pocket” methods: one hole punched in the skin, one hole drilled and filled with a tiny screw. I brought my research to the Children’s Hospital of Philadelphia (CHOP) ENT and Isla was his first MIPS surgery. He expressed that he loved the process and was very impressed with the how easily it went. In this video, (Isla was still waiting six months to “snap on” her processors because her skull bones are thin).

The Ponto 5 SPs are amazing!  My daughter has loved her devices from the beginning, and we always made them fun by having a bunch of different colored softbands to choose from each morning. She has absolutely blossomed in public and more crowded situations with the upgrade to P5 SPs. She’s more willing to get out there and play or join a group of kids she doesn’t know. Absolutely worth it!

* Ponto surgery is contraindicated for patients under 5 years of age. The subject here is shown wearing two ponto 5 superpowers on a softband but has undergone the surgery stated by the parent. Outcomes and healing times wary patient to patient. Please consult your caregiver.

Wearers explain why you shouldn’t fear minimally invasive Ponto surgery

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We frequently receive inquiries from people who know that they would benefit from a bone anchored hearing system (BAHS) but are holding off because they’re nervous about undergoing implantation surgery. While we can (and do) explain all the reasons our minimally invasive Ponto surgery (MIPS) is a low-risk, quick, and relatively painless procedure, nothing we can say will ever be quite as convincing as hearing from others who have experienced MIPS and its benefits firsthand or through their children. In this week’s post, we’re sharing feedback gathered from multiple Ponto BAHS wearers that we hope will alleviate any reticence that might be preventing you from moving forward in your journey to better hearing.

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“I had my abutment implanted 20 years ago with just local anesthetic and chatted with the assistant during the procedure; it was not painful.”— Beth P.

“It will be okay. My procedure was done 7 years ago, same day surgery, and all went well. I was given a large snap on protective disc/cover and that helped. By large, I mean it was about an inch in diameter. I used Neosporin cream, not greasy ointment, that had lidocaine in it. I would apply a small amount to the skin around the abutment and that helped with the tenderness. The surgery seems daunting, but it really is very safe. I had tenderness for a few days. My surgery was in December and then in February the device was added. I’m thankful every single day that I was able to have the surgery. It is life changing. I spent 50 years being so hard of hearing that once I got my Ponto, I sat and cried with joy.” — Lori H.

“I had my surgery with just a local anesthetic, was awake the whole time. It was fascinating as the doc explained it as she went along.” — Annette C.

“I had my MIPS in the morning, had brunch with my husband, and then napped that afternoon. Was more worried than was warranted!!! I had scheduled the next day off work, but it was not necessary! I teach figure skating. Best of luck! Happy hearing coming up!” — Karen L.

“If you’re talking about the Ponto abutment procedure, it was easy! I opted for no anesthesia or sedation. Just a local. It was painless. And not scary at all.” – Kathrin S.

“Had the procedure. No problems at all. Tiny discomfort the day of surgery. Got to start wearing the hearing aid after about 4-6 weeks. Went fabulously. No worries. You’ll do great! And you won’t regret it.” — Aaron B.

“Clear sound is in store for you… probably 4-8 weeks post-surgery. The abutment implant surgery was easy-peasy! There may be some mild tenderness or soreness. Use an antibiotic ointment! Keep area clean. If hat or cap wearing is part of your routine, take one with you so surgeon can place abutment below hat. Occasionally sleeping may be challenging if you are a side sleeper, changing pillows or pillow plumbing will help. These are minor inconveniences or adjustments for hearing capability! Bluetooth® streaming is wonderful for phone, TV, and other situations.” — Rita R.

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Are you ready to take the next step? We can help you find a clinic close to home where you can get all the answers you need regarding Ponto bone anchored hearing systems, MIPS, and more. You can also always contact Oticon Medical directly at 888.277.8014 or at [email protected].

Ponto Surgery During the Pandemic

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Since the onset of the novel coronavirus, people considering minimally invasive Ponto surgery (MIPS) have had to ask themselves: should I hold off treating my hearing loss? The answer is that your decision – and that of the audiology professional who would perform it – will be unique to your specific circumstances. However, should you decide to proceed, rest assured that hospitals and medical facilities around the United States have implemented the strictest precautions for keeping you safe.

The MIPS procedure is an elective surgery, so the main factor affecting whether yours will go ahead as planned will be the COVID-19 restrictions currently in place where your procedure would occur. While many states are experiencing a second wave as of this writing, not every town or city within those states has been equally affected nor is every state implementing the same level of restrictions on elective surgeries. So your first step is to check the current limitations governing the region in which you plan to have the MIPS procedure.

Assuming your location would permit your procedure to take place, your next step would be to discuss options like where your surgery will take place with your hearing health professional. Your surgeon will review your overall medical history and health risks along with your personal hearing issues, and then based on this information and your expressed comfort level recommend that you have the procedure as an inpatient or outpatient. The good news is that minimally invasive Ponto surgery can and has been performed successfully in either environment, as it is a quick procedure (compared to other surgeries) and usually doesn’t require a lengthy onsite recovery, especially if it is performed under local anesthetic.

COVID-19 safety precautions at clinics and hospitals

Medical institutions around the United States have learned much from the first go-round dealing with the coronavirus and instituting the strictest safety precautions to protect patients. If you are preparing for MIPS, here is a quick rundown of what you will likely experience as your clinic or hospital takes steps to protect you, other patients, and their staff.

  1. COVID-19 tests and screens. You will be screened and likely take a COVID-19 test (possibly more than once) during pre-surgical and day-of surgical visits. You will also have your temperature taken and answer questions about whether you have a cough, muscle aches, loss of taste or smell, or other common symptoms of the virus. You might be told to self-quarantine at home (typically 14 days) before your procedure to reduce your risk of exposure.
  2. Surgical team precautions. Anyone involved in your care before, during, and after MIPS will be going through regular, multiple tests and screenings to protect you. They will also be wearing personal protective equipment (PPE) that includes medical-grade face masks, face shields, gowns, and gloves. Research has shown that PPE use reduces the risk of infecting patients significantly.
  3. Hospital precautions. Medical facilities around the country have been and continue to take extra precautions to thoroughly clean and sanitize, especially in areas where operations take place. If a hospital also treats COVID-19 patients, they restrict that care to separate areas. This normally includes dedicating staff to only care for those patients and even requiring those patients and their visitors (if any are allowed) to use separate entrances and waiting rooms.
  4. Clinic precautions. As for clinics dedicated to hearing healthcare, they are regularly screening any patients that come onsite for fever and other indications of coronavirus, as well as implementing enhanced cleaning and sanitization protocols, mandating patients and staff remain six feet apart whenever possible, requiring staff to take tests if they suspect exposure, and to quarantine if they have a positive test or have reason to suspect they were exposed to coronavirus. PPE has been distributed to clinics for use during surgical and other direct procedures. Many clinics have also taken advantage of telehealth advancements to reduce the number of in-person visitors to their clinics significantly.

The decision is yours – and your surgeon’s

Ultimately, every medical decision must be made on an individual basis. A procedure that is nearly 100 percent without risk for one patient might not be safe for another. Pre-existing conditions must be taken into consideration, along with age and overall health.

That said, should you and your hearing care professional determine MIPS would be safe for you to undergo now, we are confident you will be satisfied with the results. The procedure itself is simple and usually completed in under twenty minutes. Your surgeon will place a small titanium implant in the bone behind your ear. Many patients only require local anesthesia, and there is no need for stitches. Typically, post-operative recovery requires no more than a day or two off work or out of school. And the results speak for themselves – 98 percent of users report improved quality of life after minimally invasive Ponto surgery.[1]

If you are ready to learn more about MIPS and life with Ponto, we can help you find a clinic near you.

[1] Lagerkvist, H, et al., Ten years’ experience with the Ponto bone anchored hearing system – a systematic literature review. Clin Otolaryngol, 2020.

Why You Should Consider Implantation if You Use a Softband – Part 2

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A difference you can hear

While studies and statistics provide clear indications that MIPS implantation improves hearing results, it always helps to hear from actual wearers who went through the procedure. We appreciate adult wearer Jody Bennett and parent of a wearer Dayla Hurley for allowing us to share their personal experiences in their own words.

Jody Bennett on switching from Ponto BAHS softband to implant

Having experienced very few surgical procedures in my life, I was at first a bit nervous and anxious, to say the least, about having the MIPS done. I had nothing to worry about! It was an easy procedure and a wonderful outcome!

I lost my hearing on my right side nine years prior due to SSHL (sudden sensorineural hearing loss). I had no idea a bone anchored hearing system (BAHS) even existed. I had tried CROS hearing aids, a ‘regular’ hearing aid, and was so frustrated I could not hear what was going on in my right side easily. After searching around on the internet and finding a Facebook group with people who had the same or similar problems, I found the Oticon Medical system and knew right away that’s what could help me.

I was immediately told by an ENT I was a good candidate for the Oticon Medical Ponto and put on the surgical list for surgery in two weeks. I was nervous but so excited I would be able to “hear” again!

The procedure was so positive. I had the surgery to implant the abutment as outpatient surgery. Everyone involved was pleasant and so helpful. I was in and out in just a few hours. No pain, just a tiny bit of a headache, which was probably due to the anesthesia. I took it easy the rest of the day and went back to work the next day. To date, I’ve not had any problems at all with the surgery site.

I think the most difficult part of the whole thing was finding the right pillow to accommodate sleeping on the side my abutment is on, which is the side I prefer the most. I found the perfect pillow and hey, no problem!

I had to wait three months before the processor was fitted to the abutment (my ENT and audiologist’s rules). I actually was able to get a softband and wear my Ponto during that time, which was great (although hearing via the softband and hearing via the abutment is such a difference!).

I have had my Ponto 4 since August 2019 attached to the abutment and I love it! I can hear what’s going on from my right side now. I can hear people whisper (when it’s a quiet setting). I can watch TV with my Oticon TV streamer, and it is amazing! I can answer phone calls using the processor! I can listen to music and watch movies on my iPad with it!

I tell anyone and everyone who is interested in my experience. And my friends and family say that I have perked back up to my ‘old’ self! I am more confident and feel less stressed. It’s amazing what having your hearing back can do for you!

Mom Dayla Hurley upgraded her son from softband to BAHS implant

We adopted Brody almost six years ago. Now that his journey to hearing is complete, I want to share our experience. Brody’s steps to MIPS and bilateral Ponto 4s were not conventional and he even had some complications. But with all that said, we would not change one thing! We are so grateful! Having the abutments has been the best thing for him. They healed so easily without extra fuss.

Our son has not been a standard situation and had a few detours along the way. After an eight-month process, he finally snapped on two Ponto 4s yesterday. He is so giddy! You could see the improvement in his audiograms over wearing the device on a softband. For us, there is no doubt that getting the implant  was the way to go. His speech has become so clear since having the implant  12 weeks ago. He started asking about noises in the car, the dryer running, and lyrics to songs he never heard before.

Just today Brody said as soon as he snapped on his Ponto 4s, “Hey, Mom, did you know that every morning the birds are singing?” I said, “Yes, Brody, did you just hear that?” He said, “Yep, I just found out that they sing every morning. I heard them yesterday and today and since I’ve had my new Pontos.”  So sweet. And innocent. He did not know everything he was missing.  We listen to music daily and Brody is often singing. We could always recognize the song he was singing by the tune, but the words were never understandable.  Since having his Ponto 4s, he is asking about the lyrics in songs on the radio saying, “Ha! I never heard that before.”  And, he is singing the correct words! We are thrilled.

Click through the link to find out everything you need to know about upgrading your Ponto device!

 

 

 

Why You Should Consider Implantation if You Use a Softband – Part 1

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We are pleased to be able to offer options for people with hearing loss to benefit from our Ponto™ processors at all ages and with differing health conditions. Our processor can be worn on a hard headband, attached to a hat, or on a softband – the latter of which is particular popular with our juvenile wearers. However, the Ponto was developed as part of a complete bone anchored hearing system, meaning wearers will experience peak performance when it is attached via an abutment directly to their skull. And while children under five aren’t candidates for the implant surgery due to their developing skulls, we encourage all adults and parents of kids over five whose physical conditions don’t preclude the surgery to seriously consider implantation. Here’s why.

The MIPS procedure

The surgical method Oticon Medical uses is called MIPS (minimally invasive Ponto surgery). This procedure involves having a small titanium implant carefully inserted into the bone behind your ear. The operation can be performed under local anesthetic, and in most cases, it takes no more than a day or two to recover. Many older children and most adults can undergo MIPS successfully, unless they have a condition that affects skin or bone thickness. A consultation with a surgeon can help you determine whether you or your child is a qualified candidate.

It’s typical for people to have concerns about surgery of any kind, including the comparatively minor MIPS procedure. For example, you might have concerns about your post-surgical appearance. The good news is that MIPS was designed to create the smallest incision possible. The surgeon makes a circular incision that matches the abutment exactly using instruments specifically designed for the procedure. This leaves the skin around the incision intact, with no skin tissue or hair follicles removed from around the abutment – hence no bald spots. MIPS also removes the need for suturing, which eliminates scarring and fosters quicker healing.

Another concern might be the surgery itself – especially the use of general anesthesia, which always carries some level of risk. MIPS only takes about 15 minutes and is normally carried out under local anesthetic. And as for recovery, since the process preserves soft tissue the blood supply, micro-circulation, and nerves are left as intact as possible, thereby shortening the healing period. Most patients can return to work or school within a couple of days.

Why choose bone anchored surgery over softband?

Affixing the Ponto processor to a softband provides young children with early access to speech and sounds so they can explore and interact with the hearing world with greater ease. It also gives them a great foundation for speech development. It is a suitable solution for children with conductive or mixed hearing loss, or single-sided deafness. It can also be used by adults with these conditions who cannot benefit from conventional hearing aids or who have temporary ear problems, such as blockages or infections.

Because the adjustable softband is simply worn around the head, some wearers prefer it to having to go through any form of surgery. And it certainly works — when you attach the Ponto sound processor, it sends sound waves through the bone to the inner ear, giving the wearer access to our renowned, high quality Ponto sound. Wearing a Ponto on a softband is a valuable method of hearing rehabilitation for children too young for implantation and for adults receiving a preoperative assessment.

However, studies confirm that implantation of a bone anchored hearing device – also known as a percutaneous solution – provides the ultimate hearing improvement over wearing a processor on a softband. Hearing sensitivity through the skin with a softband, as compared to a skin-penetrating abutment, provides between eight and 20 decibels (dB) reduction in the frequency range from one to four kHz. In plain English, wearers hear better when their processor is worn on an abutment than when it is worn on a softband.

One concern is that when vibrations have to pass through the skin without an abutment, the static pressure between the softband and the skin must be high to provide the best transmission possible. The ideal requirement often causes discomfort and can result in problems in the skin and subcutaneous tissues between the processor and the bone, especially if used long-term. It can also trigger tension headaches.

Other challenges include attenuation and feedback. Attenuation refers to a reduction in sound amplification, which can affect speech understanding. Feedback, or the return of a portion of an outbound signal to the same device creating a distorted effect, occurs when sound radiates from the processor back to the microphone.

Other complaints about softbands include cosmetic appeal, and slippage that causes the processor to move out of its ideal placement. If these and the aforementioned discomforts persist, the user is less likely to wear their processor all day long, reducing the efficacy of the device. After all, you can only fully benefit from the better hearing provided by the processor if it is worn steadily – and this is particularly important for children who are still acquiring language.

In our next post on this subject, we’ll share two user experiences about upgrading from wearing processors on softbands to having MIPS and hearing with an implant.