The winter and holiday season is usually full of fun, family and friends. Today, we’re sharing tips collected from our community to make sure Bone Anchored Hearing System (BAHS) users get the most joy out of winter. From dealing with the noise of large group gatherings to unique winter hats, gear and gifts for family members with hearing loss, here’s what our community had to share.
In her post, “Holiday Madness, Seven Tips to Better Communication” Arlene Romoff shares a great reminder: “Realize that large social groups, especially around a large dining room table, are one of the most difficult environments for a person with a hearing loss.” Penny Feltham took to Twitter to share a great idea about reducing those unnecessary clunks that add to the noise.
Today, Oticon Medical Audiologist Laura Carr hosted the Audiology Online Webinar “Overcoming Distance and Noise: Strategies for Successfully Utilizing FM with the Ponto System.” Laura discussed FM compatibility with the Ponto Pro and Ponto Plus sound processor families—including how the Oticon Medical Streamer enables FM for Ponto Plus processors. She also talked about connecting to other devices. Her presentation answered many foundational questions around FM systems.
Here’s a recap of the information in Laura’s presentation and other resources for FM information and how-tos. If you would like to watch the full recording of Laura’s presentation, you can find it here.
First, why is FM important?
Many who deal with hearing loss work to overcome three key obstacles: noise, distance and reverberation. Here’s how FM helps with each:
Every new product we create starts with our premise of people first, and the latest addition to the Ponto family is no different. The newest line of sound processors include the Ponto Plus and the Ponto Plus Power.
The devices were created with three goals in mind:
1. Bring more power to bone anchored hearing device users.
2. Produce a device that provides protection from feedback.
3. Give bone anchored users, for the first time, access to wireless possibilities that hearing aid users have enjoyed over the last few years.
In the video below, Alan Raffauf, VP of marketing at Oticon Medical, talks about why these three goals are so important.
Click here to learn more about the Ponto Plus. You can also sign up to get offers and updates delivered directly to your inbox here.
Daniel H. Coelho, MD, FACS specializes in Otologic & Neurotologic Surgery. He is assistant professor of Otolaryngology, Physiology and Biophysics, and he’s the director at the Cochlear Implant Center at Virginia Commonwealth University School of Medicine in Richmond, Virginia. Following his training in Otolaryngology, Dr. Daniel Coelho completed a two-year fellowship in skull-base surgery. He began practicing minimally invasive linear surgery 5 years ago, and was an early developer of the punch method about two years ago.
“On day one of medical school we learned that you have to respect the tissue.”
Progressive surgeons like Dr. Coelho spend a great deal of their time studying outcomes and working together to improve surgical procedures. Yet, very few patients are aware of the surgical implant techniques used for bone anchored hearing devices. Many only know of the traditional skin-graft technique, which causes a visible scar and frequently results in skin overgrowth and post-surgical irritation. Today, we’re sharing information about a new technique that Dr. Coelho uses. It’s a minimally invasive technique to optimize tissue preservation.
The procedure takes about 10 minutes and is typically done under local anesthesia. As most users have experienced, patients can expect a bit of soreness for a few days afterward. But, with little pain and no narcotics, patients can go back to work or normal routines the day after the procedure. This is all because the whole process is designed with tissue preservation in mind.
Tissue preservation is important for several reasons. It contributes to a very short amount of recovery time, and there’s little -to-no scaring and no hair removal. The bottom line is that the tissue preservation is minimally invasive, which improves overall results.
The fact that the procedure is minimally invasive is the most important aspect of a surgical procedure. “The more trauma there is, the more inflammation and scarring. While scarring isn’t ideal cosmetically, it also means less predictable tissue – the implant and the abutment are foreign objects that the tissue can work to reject,” Dr. Coelho explained.
Tissue preservation is incredibly important in function—it’s one of the most important aspects of the surgery. And it’s all possible since the introduction of longer abutments. “The Ponto is an excellent product and a major advancement was the development of the longer abutment. With a longer abutment, it’s no longer necessary to thin out the tissue to prevent the processor from touching the skin. If you’re going to be doing tissue thinning and suturing, those are traumatic to the skin and soft tissue and may result in an increased inflammation. Inflammation can lead to scarring, tissue overgrowth, loss of sound quality and eventually to non-use.” As as an added benefit, less tissue inflammation also yields excellent cosmetic outcomes.
In the 70-80’s, an abutment was 5 mm or less. “The only way to get the processors to function without rubbing against the skin (and compromising sound quality) was by undermining the skin” Dr. Coelho recalls. “Once the new, longer abutment came out, and the sound quality was shown to be equal, it showed that any additional skin manipulation was not necessary.” Oticon Medical was a leader in introducing the longer abutments, giving surgeons increased flexibility to adapt to individual variations in skin thickness and accommodating new clinical developments in surgical techniques, including tissue preservation.
The improved technology enables medical providers to focus on other factors like continuously iterating surgery to be as minimally invasive as possible. “Patients are happy with the functionality and the great cosmetic outcomes— it’s truly as minimally invasive as you can get.”
Melissa Tumblin, founder of Ear Community asked Dr. Coelho, “What are the common concerns about skin irritation? What do you recommend other than the cortisone cream and general cleanly maintenance?”
“First of all, hygiene shouldn’t be blamed for everything. Some people just have a more robust reaction to that foreign object—just like people have allergies worse than others.” Dr. Coelho explains that some people even clean too frequently, which can irritate the area even more.
Dr. Coelho has had no skin overgrowth, as of 2-year follow-ups, with his own patients that received their implant via the punch technique. When he does treat overgrowth, it’s in patients who had the traditional technique. For overgrowth, Dr. Coelho uses clobetasol cream, a topical steroid to help reduce the number of surgical revisions. But, he points out that there is a longer term solution. “Surgical revisions only buy time, they do not actually fix the underlying problem. But, the longer abutments theoretically do. Because it’s such a simple procedure to switch, people who were getting the steroid shots are now making the change. The abutment change procedure is done in the office and takes seconds—some insurance companies are covering the abutment switch.” Patients can also immediately go back to wearing their processor unlike some of the corrective treatments.
Overall, more surgeons are slowly, yet surely, implementing the minimally invasive procedure. Dr. Coelho predicts that within 5 years it will be the standard. “Surgeons learn from colleagues, conferences, journals and the industry as well. People expect to see a divide between industry and medical providers, but many technological advances are made by industry organizations or through a collaboration with clinical professionals – this open line of communication benefits everyone.”
Help us spread the word about tissue preservation by sharing this post. If you have questions about Ponto, bone anchored devices or implant surgery, let us know in the comments below or on Facebook or Twitter.