Tag Archives: surgery

The Ponto 3 SuperPower is a hopeful solution to hearing loss for James Wolff

James Wolff is 71-years-old and has experienced hearing loss for years. In the past, he wore bilateral hearing aids, however, because of drainage in his left ear, he often had to remove the hearing aid which left him with poor hearing on his left side. His daughter, Kimberlee Griffey who has worked at Oticon Medical for 7 years, recounts bringing her bone anchored hearing equipment to Christmas every year for her father to try.

“I’d bring a demo, a softband, and a Streamer to Christmas,  just wanting to test him, but he would say he didn’t need it. Then last Christmas he finally said ‘I think I’m ready for the procedure’.” – Kimberlee Griffey

James had surgery to get his abutment placed in June 2017 with Dr. James Benecke at Missouri Baptist Hospital in St. Louis, Missouri. Dr. Benecke has been working with bone anchored hearing systems (BAHS) for 14 years. He says that for many patients with conductive or mixed hearing loss who cannot have their hearing corrected surgically and cannot use hearing aids because of ear canal and drainage issues, a BAHS is a great option.

When considering a BAHS for his patients, Dr. Benecke investigates and explains all available options. He recommends that his patients talk with other patients who wear different devices, checks insurance options and has patients trial the BAHS on a softband. If an audiometric evaluation is unclear as to whether a person might be a good candidate for the Ponto, he works with Oticon Medical representatives to help with identifying potential candidates when an evaluation might be unclear.

“I always give patients their options and have them chat with people who have tried different systems. Overall, my patient population does better with bone anchored hearing systems as opposed to a CROS hearing aid.” – Dr. Benecke

For James’s procedure, Dr. Benecke performed the Minimally Invasive Ponto Surgery (MIPS). MIPS is a procedure that takes 10-15 minutes and is normally carried out under local anesthetic. He mentions that when someone says the word surgery, most patients have pre-conceived thoughts about what is involved.

“No one wants to have surgery, but if there is an opportunity to improve an aspect of someone’s health by doing a procedure that someone is well informed about and has good outcomes, then people need to know about it so they can make the best-informed decision.” – Dr. Benecke

“When people first think of surgery they think long recovery time—a long time in the operating room. I tell people that with the MIPS procedure it’s less than an hour, outpatient procedure. My dad had no pain whatsoever. It was life-changing for him. My advice is not to wait because you don’t know what you’re missing.” – Kimberlee Griffey

This past September, James was activated with his Ponto 3 SuperPower and the results have been life-changing.

“Before he described sounds as muffled.  Now it is loud and clear.  His volume of speech has significantly decreased because now he can monitor his own speech, where he was not able to do this before. He drives a lot and he’s able to put the microphone on his grandkids and he can hear them in the back seat. He also loves using his Streamer to connect to his phone, TV, and laptop. It has opened a whole new world and I am so very grateful that he is able to get the best of life in his golden years.” – Kimberlee Griffey

As awareness continues to grow around bone anchored hearing and the MIPS procedure, Dr. Benecke says he will continue to advocate for bone anchored hearing because ‘the results speak for themselves’.

“The first thing my dad said after he was fit with his Ponto was ‘why didn’t you tell me about this earlier?’” – Kimberlee Griffey


Interested in learning more about the Ponto 3 SuperPower? Click below and we can help connect with you with an audiologist in your area.
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Meet Dr. Lawrence Lustig, Chair of the Department of Otolaryngology—Head and Neck Surgery at the Columbia University College of Physicians

This post is part of a clinic feature series, where we highlight doctors and clinics who offer the Oticon Medical Bone Anchored Hearing System, the Ponto.

Dr. Lawrence Lustig, MD,  is one of the nation’s leading experts in hearing loss

Dr. Lawrence Lustig, Otolaryngologist-in-chief at New York-Presbyterian Hospital/Columbia University Medical Center

Dr. Lustig is the chair of the Department of Otolaryngology—Head and Neck Surgery at the Columbia University College of Physicians and Surgeons and otolaryngologist-in-chief at New York-Presbyterian Hospital/Columbia University Medical Center. Today, Dr. Lustig’s mission at New York City at Columbia University Medical Center & New York Presbyterian Hospital is to build a practice of the very best otolaryngology clinicians and research scientists.

He treats the full spectrum of ear disorders in adults and children, as well as skull base disease. His specialties include skull base surgery, Bone Anchored Hearing Systems (BAHS), cochlear implants, the genetics of hearing loss, cochlear gene therapy, surgery for chronic otitis media, balance disorders, and hair cell physiology.

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Introducing the First Ever Bone Anchored Hearing System Soft Healing Cap

Oticon Medical is pleased to announce the launch of the first soft healing cap on the market.

Soft_healing_cap_3The healing cap is intended to be attached to the Ponto abutment during the soft tissue healing period after a bone anchored implant surgery to hold the dressing in place and act as protective mechanical barrier.

The new soft healing cap is made of a specially selected thermoplastic elastomer material, designed to provide a dampening effect and stay in place if subject to impact. This flexibility allows the healing cap to absorb side forces when exposed to impact, rather than transferring that impact to the abutment, which can happen with a hard healing cap.

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Q&A with Christina D’Allesandro: Her Seven-Year-Old’s Journey from Softband to Ponto Implant

Remember Anthony Smith, also known as Blue Ear? The seven-year-old who inspired Marvel Comics to create a new Superhero with a listening device just received a super upgrade.

Anthony After Surgery

Success and popsicles!

Recently, Anthony had surgery to go from temporary to temporal, having an abutment placed that would allow him to move from a Ponto on a softband to using the Ponto on a titanium implant that sits in the bone behind the ear.

After a long wait, Anthony had stage 2 surgery for his Ponto abutment on May 5, 2015.

“We waited 14 months to try again and we were all so happy to get the go ahead. Working with our provider we decided a two stage surgery would give Ants the best results,” Christina explained.


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Finding A Hopeful Future: Life After An Acoustic Neuroma with the Ponto Plus

Think back to the last time you felt alone.

Maybe you had just moved to a new city where you didn’t know anyone. Maybe you experienced an unexpected breakup. Or, maybe you just felt unappreciated. The thing is, with any of those ‘alone’ moments, the moment passes. You make friends. You meet someone new. Somebody compliments you.

For Rebecca Davenport, that moment never passed.

“My world was so quiet. You’re isolated. You don’t know what’s going on in your environment.”

Rebecca, a mother of four and PhD candidate, was diagnosed with an Acoustic Neuroma in August 2013, a tumor of the Eighth Cranial Nerve responsible for hearing. Rebecca met with physicians in Portland and after weighing the pros and cons, they deemed it necessary for her to have two surgeries.

As with most surgeries, there were no guarantees. From the routine to the most complex, there is always some degree of risk involved. In Rebecca’s case the risk was high.

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College Student Cuts Through Years of Noise with Ponto Plus

Kevin Hotaling is a sophomore at Stonehill College who got his Ponto Plus on October 13, 2014. When we saw Kevin’s video, we just had to meet him. We knew you’d feel the same.

So, here’s Kevin to tell you a bit of his story:

I originally found out about Ponto through one of my mother’s coworkers. She didn’t have the Ponto, but she had a very similar bone anchored hearing aid procedure done, and she’s had results that were nothing short of stellar. I was nervous originally. Although surgery was nothing new to me, the idea of someone drilling into my skull was very unsettling. In addition to that, I hadn’t heard of any people my age who had ever gotten the procedure done. I had only ever heard of adults and small children owning the system, never a teenager. I was given the opportunity to test the device using a headband, and immediately, I noticed a massive difference in my hearing quality.

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Hangout On Air: Dr. Sheryl Lewin Discusses Microtia Ear Surgery & Bone Anchored Hearing Devices

Dr. Sheryl Lewin is a Craniofacial trained Board Certified Plastic Surgeon who has dedicated her career to ear reconstruction, specializing in Microtia ear surgery using the Medpor technique. Her artistic approach and innovative surgical techniques have helped minimize scarring and create more natural appearing ears.

On May 28 at 6pm PST, we hosted a Google+ Hangout On Air with Dr. Lewin about her work. Dr. Lewin discussed simultaneous Microtia ear reconstruction surgery with bone anchored hearing device implants. She also shared more about what the Medpor technique is, a case and took your questions.

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Scientific Meetings: The Future of Bone Anchored Solutions


The 117th American Academy of Otolaryngology (AAO) Meeting took place in September and the 29th Politzer Society took place in November. Ravi Sockalingam, PhD and Director of Clinical Research at Oticon Medical took part in the meetings, which both included several sessions on bone anchored hearing systems. Here’s Ravi’s account of the meetings and information shared and themes of each. 

Meeting Highlights
Some of the meeting sessions touched on surgical techniques– one particular session focused on loading timeframe. Loading is the time when we put the sound processor on the abutment. Patients will have surgery, and then we wait until the skin heals before we put the sound processor onto the abutment. The FDA indications say three months before loading. Many doctors feel it is safe to put the sound processor on at six to eight weeks post-op. There is now more evidence indicating that even a three-week loading does not increase the risk of an implant extrusion or adverse skin reactions. Dr. Jack Wazen at Silverstein Institute in Sarasota reported no differences in outcomes between loading at three weeks and loading at six weeks. The outcomes at 3 weeks loading were reported to be good with no revision surgery or implant extrusion, and the skin reactions were either nonexistent or very minimal.

Three week loading is a discussion for adults with normal bone quality. Surgery for children was also discussed. There is some development on the pediatric side about whether the surgery should be done in a single-stage or two stages. Typically, surgery in children is performed in two stages because they have softer bone.

Surgeons would want to put the implant in first, wait for three months, and then put on the abutment. Then they would wait for another three months or so to be fit with the sound processor. There are centers here in the United States that do the surgeries in one stage. They place the implant and the abutment at the same time, just as they do in adults, and wait for three months before they load the sound processor. It depends on the quality of the bone before the surgeon decides whether it is going to be single stage or two stages. The rule of thumb is, if a child is over 12 years old, the surgery is not staged, provided the quality of the bone is good. If the child is under 12 years of age, then surgery is staged.

Surgical Techniques
For a long time the surgical technique employed was one that involved thinning of the skin and removing tissue around the implant site. Later, a linear incision technique, whereby a small straight line incision is made, was adopted by many surgeons in Europe and in the US. More recently, more and more surgeons are using a linear incision technique with minimal or no tissue removal. These surgeons are reporting better skin outcomes with this technique.

There are also, surgeons, particularly in the US, who have been using what we call a punch technique. They make a very small, circular 5 mm punch and put the implant and abutment in. Among the surgeons who perform the “punch” technique are Dr. Wayne Shaia from Richmond, Virginia and Dr. Daniel Coelho from Virginia Commonwealth University, also in Richmond. I always joke that Richmond is the punch capital of the world now. They are reporting good outcomes with this technique.

The linear incision technique with minimal or no tissue reduction, and the “punch’ technique aim to preserve as much soft tissue as possible. Often times these techniques are collectively referred to as “Tissue Preservation technique”. Long term data indicate that this technique results in quicker healing, better cosmetics, fewer postoperative complications, and shorter surgery time. 

Product Design
The modern design of our implant itself lends itself to tissue preservation surgery very well. We have a smooth titanium surface on the abutment that adheres to the skin and supports it very well. You may have to use the longer abutment if you are using the tissue preservation technique because you are not removing any tissue. You will typically use at least a 9 mm abutment. In some cases, surgeons use a 12 mm abutment. There is an ENT professor at the Karolinska Institute in Stockholm, Sweden who has been following patients for five years using the non-skin reduction technique and a longer abutment. She has been reporting very good outcomes, even up to five years.

The next hot topic is a transcutaneous solution. In a transcutaneous solution the battery and other components are on the outside. You have to use the power to transmit the signal. Implanted inside are magnets and a receiver. The receiver will transmit the vibrations to the bone. “You are still going to lose some energy across the skin. It will never be better than the bone conduction vibrator that you would use to measure bone conduction thresholds, because that oscillator is in tight contact against the head. For children who are under the age of five and cannot have the surgery, we put a processor on a soft band. You try to make it as tight as possible. If it is too tight, there will be an indention in the skin, and that can be painful after a while. That is what transcutaneous solutions do. Cosmetically, it is appealing, but you are not going to have the same amount of output and gain that you would from a percutaneous system.

Bone Anchored Solutions
Bone Anchored Solutions are getting more public awareness. We are reaching out to consumers directly through social media. We also have patient advocacy weekends and retreats, picnics, and so forth. The consumers are becoming more knowledgeable about bone anchored hearing systems, and they are educating other potential consumers.

Patients are empowering themselves with the information they find online, and in some cases they’re even educating their professionals. I work closely with some of the surgeons and they say some of the patients show up saying, “I need a Ponto. Do you do that? What is the price? When can you do it?” They are not coming for an evaluation or opinion from the doctor. More and more of that is happening, especially with the baby boomers, who are better educated, particularly those living in urban areas. This is, in fact, a topic that is being discussed in current conferences.

Do you have a question for Ravi? Let us know in the comments section below.

Lasting Support: Breck Pipes Supports Son with Ponto Tattoo

Breck Pipes decided to get a tattoo with a purpose. When his 7 year old son, Winslow, recently got his Ponto Pro Power, Breck made a deal to get one of his own.

Breck wanted to connect with Winslow and help to overcome his anxiety about having the surgery for something permanent. Now, Winslow won’t be the only one answering when someone asks, “What’s that thing?”

As Ann Pipes, Breck’s wife and Winslow’s mom put it, “Those two are constantly scheming and making plans!”

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How do you support children with hearing loss? Whether it’s giving a baby doll a Ponto or permanently “wearing” your own device like Breck, we’d love to see it on Facebook, Twitter or in the comments section below, or send us a message sharing your story.

Minimally Invasive Procedure Increases Tissue Preservation for Better Patient Outcomes

Daniel H. Coelho, MD, FACSDaniel 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.

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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.