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BONEBRIDGE BCI 602 Implant Surgery | MED-EL
MED-EL Professionals
Overview
This video details the surgical procedure for implanting the MED-EL Bonebridge BCI 602, a bone conduction hearing implant. It covers the components of the implant kit, the preparation steps including marking the incision site and creating a periosteal pocket, and the precise creation of a bone bed for the transducer. The video also explains how to position and securely fix the implant using self-drilling screws, and concludes with the wound closure process. The emphasis is on accurate placement and secure fixation for optimal function.
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Chapters
- The BCI 602 implant kit contains the main implant (receiver coil, transducer/BCFMT, and magnet), self-drilling screws (including an emergency screw), and a disposable screwdriver.
- The sizer kit includes tools to accurately measure and prepare the surgical site: a footprint sizer for the coil area and a transducer sizer for the bone bed.
- Medical illustrations are for demonstration and may differ from individual patient anatomy; consult the surgical guide for specifics.
Understanding the components and tools is crucial for the surgeon to perform the implantation correctly and safely.
The BCI 602 implant itself, which comprises of a holding magnet, the receiver coil, and the transducer, known as the BCFMT.
- The optimal implant position is determined using the footprint sizer, typically posterior and superior to the ear canal, angled at about 45 degrees.
- An incision is marked at least 5 mm away from the implant site to reduce the risk of the device extruding through the skin.
- A precise periosteal pocket is created to house the coil section, ensuring it's not too thick (under 7 mm) for proper audio processor function.
Accurate site preparation ensures the implant is well-positioned for optimal sound transmission and minimizes complications like infection or extrusion.
Placing the footprint sizer behind the ear and marking the incision at least 5 mm away from its rim.
- A bone bed is drilled to a depth of 4.5 mm specifically for the BCFMT (transducer).
- The transducer sizer, used with a handle, helps ensure the correct drilling depth and that the bone bed is fully recessed.
- The implant can be gently bent to optimize coil positioning before insertion.
- The BCFMT is placed into the bone bed, and the implant is secured to the skull bone using two self-drilling cortical screws, initially tightened loosely then fully countersunk.
Properly creating the bone bed and securely fixing the implant are critical for the device's stability, function, and long-term success.
Using the transducer sizer with a handle to drill the bone bed, and checking for sufficient depth when the sizer sits fully within the drilled area.
- Before closing, the surgeon palpates the BCFMT to confirm it is securely fixed in place.
- The wound is closed in layers.
- A final wound dressing is applied.
Ensuring the implant is stable and closing the wound properly are the final steps to promote healing and prevent complications.
Palpating the BCFMT to ensure it is fixed properly before closing the wound.
Key takeaways
- The BCI 602 implant requires precise surgical preparation, including accurate site marking and bone bed creation, for optimal performance.
- The use of specialized sizer tools is essential for achieving the correct dimensions and depth during surgery.
- Secure fixation of the BCFMT transducer using self-drilling screws is critical for implant stability.
- The implant's coil section can be adjusted (bent) to achieve optimal positioning under the skin.
- Minimizing incision distance from the implant site and ensuring flap thickness are important for preventing device extrusion and ensuring processor function.
- Post-implantation palpation confirms secure fixation before wound closure.
Key terms
Bonebridge BCI 602BCFMT (Bone Conduction Floating Mass Transducer)Periosteal pocketFootprint sizerTransducer sizerSelf-drilling cortical screwsBone bedDevice extrusion
Test your understanding
- What are the main components of the BCI 602 implant kit?
- Why is it important to mark the incision at least 5 mm away from the desired implant position?
- How is the correct depth for the bone bed ensured during surgery?
- What is the purpose of the periosteal pocket in this procedure?
- How is the BCI 602 implant secured to the skull bone?