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

Stefano, Sabrina De; Mochi, Paolo; Murri, Alessandra; Cuda, Domenico

doi:10.14639/0392-100x-n1048

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…The occurrence of any postoperative complication was more commonly reported in the linear incision group (66%) than in the minimally invasive group (49%) but when comparing specific subcategories such as pain, scarring, and numbness no reliable differences were detected. However, Holgers scores indicate that there are fewer and less severe skin complications after minimally invasive procedures, which is in line with previously reported findings in the literature ( 4 , 17 , 18 , 25 ). The reported Holgers scores were in accordance with those previously published by Amaral et al, 2020 ( 16 ) but slightly higher than those reported in the systematic review by Lagerkvist et al, 2020 ( 5 ) which is possibly explained by the unique study setting.…”

Section: Discussionsupporting

confidence: 91%

Minimally invasive surgery as a new clinical standard for bone anchored hearing implants—real-world data from 10 years of follow-up and 228 surgeries

Cruz

Danieli

Håkansson³

et al. 2023

Front. Surg.

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PurposeTo explore the clinical practice development of different surgical techniques when installing bone-anchored hearing implants and their associated trends in outcomes.DesignRetrospective study of 228 bone-anchored hearing implants in 200 patients, performed over a 10-year period between 2012 and 2022 in a referral hospital.MethodReal-world data of demography, etiology, surgical setup, complications, and audiological outcomes were collected. Eligibility criteria from clinical practice were applied.ResultsThe minimally invasive technique is associated with shorter surgery duration, 20 vs. 44 min as compared to a linear incision technique. The minimally invasive technique was also associated with a lower occurrence of complications when compared to linear incision techniques (intraoperative; 1.8% vs. 4.9%, postoperative; 49% vs. 66%). Most differences were seen in complications relating to skin and wound healing.ConclusionAdoption of a minimally invasive surgical technique for the installations of bone-anchored hearing implants can reduce surgical complexity without compromising safety aspects or clinical benefits.

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Section: Discussionsupporting

confidence: 91%

Minimally invasive surgery as a new clinical standard for bone anchored hearing implants—real-world data from 10 years of follow-up and 228 surgeries

Cruz

Danieli

Håkansson³

et al. 2023

Front. Surg.

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“…MIPS represents a promising minimally invasive, punch-only, surgical technique for BCD implantation. Comparable or improved soft tissue outcomes in combination with better results registered in surgical time, cosmetics, skin sensibility and in the field of cost analysis compared with the outcomes of traditional techniques can corroborate this statement ( 25 – 29 , 32 , 33 , 37 ). These encouraging features make this technique relevant to improve and to further streamline the procedure to install a BCD.…”

Section: Discussionmentioning

confidence: 78%

“…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%

“…The results of the MIPS technique are encouraging, and several recent studies have compared the clinical outcome of MIPS with that of the commonly used LITT-P ( 25 – 29 ). While both techniques show favorable soft tissue outcomes compared with the outcomes of previous tissue reduction approaches, MIPS is also associated with improvements in terms of surgery time, cosmetics and preservation of skin sensibility ( 25 – 31 ).…”

Section: Introductionmentioning

confidence: 99%

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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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“…Minimally invasive Ponto surgery is an even less traumatic surgical method in which a 5-mm punch is used to remove tissue only where the implant and abutment are placed. It causes less postoperative pain and numbness, and less soft tissue reaction, and is a rather fast procedure (3,4).…”

Section: Introductionmentioning

confidence: 99%

Very Early Loading of a Bone-Anchored Hearing System Is Safe

Møller,

Foghsgaard,

Hougaard

2024

Otol Neurotol

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Objective To investigate the feasibility of early sound processor loading with two separate bone-anchored hearing aid implants 1 to 2 weeks after implantation. Secondary endpoints included registration of any postoperative complications, skin reactions, and any adverse events. Study Design Prospective, nonrandomized, noncontrolled, multicenter clinical trial. Setting Tertiary referral center. Patients Sixty adult patients, eligible for bone-anchored hearing aid surgery, were enrolled. Intervention Implantation of the bone-anchored hearing aid implants were done using minimally invasive surgery with tissue preservation. Main Outcome Measure Implant stability quotient (ISQ) values were recorded using resonance frequency analysis. Follow-ups were scheduled 5 to 12 days, 4 to 8 weeks, 6 months, and 12 months postoperatively. Differences between the lowest ISQ values (ISQ low) over time were analyzed by paired-samples t test with a significance level of 0.05. Skin and soft tissue reactions were assessed according to Holger's classification. Results Loading time of the Ponto Wide implant was 11.6 ± 1.4 days (SD) in average (median, 12 d; range, 7–19 d). Loading of the Ponto BHX implant was done 9.7 ± 3.5 days (SD) postoperatively (median, 9 d; range, 5–19 d). The implant stability increased significantly during the 12-month study period with both implants. One Ponto BHX implant was lost. Skin and soft tissue reactions were few in both groups. Across all planned follow-up visits, no skin and soft tissue reactions were observed in 86% (Ponto BHX implant) and 85% (Ponto Wide implant). Conclusion Very early loading of sound processors after percutaneous bone-anchored hearing system surgery is safe already 1 to 2 weeks postoperatively.

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

Cited by 6 publications

References 25 publications

Minimally invasive surgery as a new clinical standard for bone anchored hearing implants—real-world data from 10 years of follow-up and 228 surgeries

Minimally invasive surgery as a new clinical standard for bone anchored hearing implants—real-world data from 10 years of follow-up and 228 surgeries

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

Very Early Loading of a Bone-Anchored Hearing System Is Safe

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