Percutaneous bone-anchored hearing implant surgery: inside or outside the line of incision?

Abstract

The objective of this historical cohort study was to compare soft tissue reactions in adults after bone-anchored hearing implant (BAHI) surgery when the percutaneous implant is placed inside or outside the line of incision. All adult patients who received a percutaneous BAHI between 1 January 2010 and 31 January 2014 in our tertiary referral centre were identified. Patients were selected if operated by two surgeons, who perform the same standardised linear incision technique with one of them placing the implant outside the incision while the other prefers placement inside the line of incision. A total of 202 patients and 211 implants were included in the case analysis. The results showed the registration of a soft tissue reaction Holgers ≥1 in 47 implants (49.0 %) placed outside the incision compared to 70 implants (60.9 %) which were placed inside the line of incision. An adverse soft tissue reaction, Holgers ≥2, was noticed in 17 implants (17.7 %), respectively, 20 implants (17.4 %). No significant differences were found between the two groups for both the presence of soft tissue reactions Holgers ≥1 (p = 0.322) and a Holgers score ≥2 (p = 0.951). During the follow-up three implants were lost (1.4 %) and in 18 of 211 implants one or multiple revisions were performed (8.5 %). In conclusion, this study did not show any differences in the presence of postsurgical (adverse) soft tissue reactions between placement of the percutaneous BAHI inside or outside the line of incision.

A Clinical Evaluation of Minimally Invasive Ponto Surgery With a Modified Drill System for Inserting Bone-Anchored Hearing Implants

“…After periosteum removal, a 2-step drilling sequence was performed whereby the guide hole was created to full depth in one step prior to widening of the hole. Following implant-abutment insertion, the skin was closed with sutures and a 5-mm punch hole was created to enable the abutment to penetrate the skin ( 18 ). In control group 2, o-MIPS has been performed.…”

The use of CO2 laser in skin complications following BAHA implantation: our experience in the eight patients

“…The excess of soft tissue leads to inability to tack the hearing aid to the abutment and with the time the implant can become entirely overgrown with soft tissues. Different surgical procedures have been developed to overcome skin complications, that is, free full-thickness skin graft, pedicled flaps, dermatome technique, linear incision and soft tissue reduction or preservation variant 8. Different methods, mostly topical antibiotics, corticosteroid injections and scar excision have been introduced to deal with this complication.…”