BAHA Surgery in Singapore

• Adults and children with sufficient skull bone thickness
• Individuals with conductive hearing loss from chronic ear infections, otosclerosis, or middle ear malformations
• Patients with mixed hearing loss who have a conductive component
• People with single-sided deafness (SSD) who have one functioning ear
• Those experiencing chronic ear drainage or infections that may prevent hearing aid use
• Individuals with congenital ear canal stenosis or atresia (absent or narrowed ear canal)
• Patients who have not achieved success with conventional hearing aid trials due to medical or comfort reasons
• Those with bone conduction hearing levels within appropriate ranges

• Active infection at the proposed implant site
• Insufficient skull bone thickness
• Certain autoimmune conditions affecting bone healing
• Uncontrolled diabetes that may impair wound healing
• Previous radiation therapy to the skull affecting the implant area
• Severe cognitive impairment preventing proper device care
• Unrealistic expectations about hearing outcomes
• Active middle ear disease requiring treatment

A comprehensive evaluation by an ENT specialist specialising in otology is essential to determine candidacy. This assessment includes audiological testing, CT imaging to measure bone thickness, and evaluation of overall health status. Individual suitability and outcomes may vary based on anatomy, medical history, and other factors.

Before BAHA surgery, you’ll undergo comprehensive audiological testing to document your hearing levels and determine the potential benefit from the device. A CT scan evaluates skull bone thickness at the planned implant site. Blood tests ensure you’re healthy for surgery. You’ll receive instructions to stop certain medications that affect blood clotting. Hair around the surgical site may need trimming. You may have a trial with a BAHA device on a softband or headband to experience the potential hearing improvement before committing to surgery.

BAHA surgery typically takes 30-90 minutes under local anaesthesia with sedation or general anaesthesia, depending on patient preference and medical factors. The ENT specialist makes a small incision behind the ear and prepares the bone surface. Using specialised drills with cooling irrigation, a precise hole is created for the titanium implant. The implant is carefully inserted and tightened to the appropriate torque.

For percutaneous systems, the skin is thinned around the abutment site if necessary. For transcutaneous systems, the magnetic disk is attached, and the skin is closed over it. The incision is sutured, and a protective dressing is applied. Throughout the procedure, the surgical team monitors the implant stability to ensure proper initial fixation.

After surgery, you’ll recover in the observation area while the anaesthesia wears off. Pain is typically mild and may be managed with oral medications. The surgical site is covered with a protective cap and dressing. You’ll receive detailed wound care instructions and antibiotics if prescribed. Most patients return home the same day. The healing cap remains in place for about one week, and you’ll need to keep the area dry during this initial period. A follow-up appointment is scheduled for dressing removal and wound inspection.

Mild pain and swelling around the implant site typically resolve within days. Temporary numbness near the incision is common and usually improves over weeks. Some patients may experience minor skin irritation around the abutment that can respond to proper hygiene and topical treatments. Initial dizziness or balance changes may occur occasionally but often resolve. Percutaneous systems may develop granulation tissue around the abutment, which can be managed with proper care and treatment.

Implant failure or poor osseointegration may occur, potentially requiring implant replacement. Skin overgrowth around percutaneous abutments may need minor revision surgery. Wound infections, though uncommon with proper care, require prompt antibiotic treatment. Persistent pain at the implant site may indicate underlying issues requiring evaluation.

ENT specialists aim to minimise risks through careful patient selection, surgical technique, and post-operative care protocols. The use of established implant systems with safety data provides additional information. Regular follow-up aims to enable early detection and management of any complications.