Bone-anchored hearing implant surgery: our experience with linear incision and punch techniques

Giustino, Fabio Di; Vannucchi, Paola; Pecci, Raffaella; Mengucci, Arianna; Santimone, Rossana; Giannoni, Beatrice

doi:10.14639/0392-100x-1694

Cited by 13 publications

(11 citation statements)

References 21 publications

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“…In addition, the reported mean surgical time for MIPS in a multicentre study was 16 mins 17 . The impressive reduction of surgical time of MIPS compared with other surgical procedures makes this technique more suitable for local anaesthesia and more cost effective 22 , 23 . Furthermore, Sardiwalla et al investigated patient satisfaction using a Surgical Satisfaction Questionnaire (SSQ-8) modified for MIPS and found that patient experiences with MIPS were overwhelmingly positive.…”

Section: Discussionmentioning

confidence: 99%

Comparison between linear incision and punch techniques for bone anchored hearing aid surgery

Stefano

Mochi

Murri

et al. 2021

Acta Otorhinolaryngol Ital

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Section: Discussionmentioning

confidence: 99%

Comparison between linear incision and punch techniques for bone anchored hearing aid surgery

Stefano

Mochi

Murri

et al. 2021

Acta Otorhinolaryngol Ital

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“…Also, there was an implant survival rate of >95% at the 20-week follow-up (26). Subsequent studies comparing the MIPS technique to the LITT-P showed similar favorable outcomes, even with longer follow-up, regarding soft tissue reactions (27)(28)(29)(30)(31)(32)(33). Moreover, a shorter surgical time (27)(28)(29)(30)(31)(32)(33), better cosmetic appearance (28,29), and improved sensibility (28) were reported in favor of the MIPS technique compared with the LITT-P approach.…”

Section: Introductionmentioning

confidence: 92%

“…Nowadays, the less invasive linear incision technique with tissue preservation (LITT-P) is advocated based on similar or less (adverse) soft tissue reactions (10)(11)(12)(13)(14)(15)(16) as well as favorable outcomes in surgical time, cosmetics, and numbness (15)(16)(17)(18)(19)(20)(21). Recently, minimally invasive punch-only techniques have been introduced to reduce soft tissue trauma (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). A standardized approach was developed by Oticon Medical AB (Askim, Sweden): the minimally invasive Ponto surgery (MIPS) (26).…”

Section: Introductionmentioning

confidence: 99%

Health Economic Cost Analysis for Percutaneous Bone Conduction Devices: The Minimally Invasive Ponto Surgery Versus Linear Incision Technique with Tissue Preservation

et al. 2023

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Objectives To identify differences in mean cost per patient between the Minimally Invasive Ponto Surgery (MIPS) and the linear incision technique with tissue preservation (LITT-P). Study design Health economic cost analysis. Setting The analysis was performed in a randomized multicenter controlled trial cohort. Patients Adult patients eligible for unilateral bone conduction device surgery. Interventions MIPS versus LITT-P surgery for bone conduction device implantation. Main outcome measures Perioperative and postoperative costs were identified and compared. Results The difference in mean cost per patient between both techniques was €77.83 in favor of the MIPS after 22 months follow-up. The mean costs per patient were lower in the MIPS cohort for surgery (€145.68), outpatient visits (€24.27), systemic antibiotic therapy with amoxicillin/clavulanic acid (€0.30) or clindamycin (€0.40), abutment change (€0.36), and abutment removal (€0.18). The mean costs per patient were higher for implant and abutment set (€18.00), topical treatment with hydrocortison/oxytetracycline/polymyxine B (€0.43), systemic therapy with azithromycin (€0.09) or erythromycin (€1.15), local revision surgery (€1.45), elective explantation (€1.82), and implant extrusion (€70.42). Additional analysis of scenarios in which all patients were operated under general or local anesthesia or with recalculation when using current implant survival rates showed that differences in mean cost per patient were also in favor of the MIPS. Conclusion The difference between the MIPS and the LITT-P in mean cost per patient was €77.83 in favor of the MIPS after 22 months of follow-up. The MIPS is an economically responsible technique and could be promising for the future.

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“…In addition to providing benefits to patients, improvements in clinical efficiency using MIPS have been reported in cost analysis studies ( 32 ). While several studies have reported comparable implant survival rates for MIPS compared to LITT-P ( 27 – 29 , 31 , 33 ), lower implant survival for MIPS has also been reported ( 25 , 26 , 34 ). Possible reasons can be the reduced visibility during the procedure, introducing a potential risk of angulated insertion or interposing soft tissue.…”

Section: Introductionmentioning

confidence: 96%

Ex vivo Evaluation of a New Drill System for Placement of Percutaneous Bone Conduction Devices

et al. 2022

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The procedure for installation of a percutaneous bone-conducting device has undergone significant improvements since its introduction 40 years ago. Today, the linear incision technique with tissue preservation (LITT-P) and the minimally invasive procedure (MIPS) are the most commonly used approaches. In both these techniques, a gradual increase of the osteotomy using a three-step drilling sequence is utilized, as this approach can allow a stepwise deepening and widening of the osteotomy in the mastoid and can prevent bone overheating. A new minimally invasive procedure (MONO) has been developed that allows an osteotomy to be performed and enables complete removal of the bone volume in one single drill step for a 4 mm implant using a novel parabolic twist drill. Here, the feasibility of the MONO procedure was qualitatively and quantitatively evaluated in terms of the dura response to drill trauma in comparison with the outcomes achieved with guide drills used for the LITT-P and MIPS techniques. Fresh frozen temporal bone from a human cadaver was subjected to penetration by three drills beyond the base of the mastoid bone to different depths. The sites were evaluated, and the damage to and possible penetration of the dura were determined. The results showed that for a drill depth exceeding mastoid bone thickness by not more than 1 mm, damage to the dura was limited or nonexistent, whereas for a drill depth exceeding bone thickness by 2 mm, damage increased, or the dura was penetrated. There was a trend toward more damage and penetration for both the round burr and MIPS guide drill compared with the MONO drill bit. From this experimental ex vivo study, it can be concluded that if the dura is encountered, the MONO system is not more inclined to penetrate the dura than the conventional LITT-P and MIPS systems.

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Bone-anchored hearing implant surgery: our experience with linear incision and punch techniques

Abstract: Bone-anchored hearing implant surgery: our experience with linear incision and punch techniques La chirurgia delle protesi acustiche ancorate all'osso: la nostra esperienza con le tecniche con incisione lineare e con punch

Cited by 13 publications

References 21 publications

Comparison between linear incision and punch techniques for bone anchored hearing aid surgery

Comparison between linear incision and punch techniques for bone anchored hearing aid surgery

Health Economic Cost Analysis for Percutaneous Bone Conduction Devices: The Minimally Invasive Ponto Surgery Versus Linear Incision Technique with Tissue Preservation

Ex vivo Evaluation of a New Drill System for Placement of Percutaneous Bone Conduction Devices

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