Percutaneous bone-anchored hearing implant surgery: dermatome versus linear incision technique

Abstract

The objective of this historical cohort study is to identify if there are differences in soft tissue reactions and skin thickening between implantation of the percutaneous bone-anchored hearing implant (BAHI) using the dermatome or linear incision technique. All adult patients who received a BAHI between August 2005 and January 2013 were selected. One surgeon performed all procedures and only the dermatome and linear incision technique were used. A total of 132 patients/implants were included and significantly more patients with risk factors were seen in the linear incision cohort. A soft tissue reaction Holgers ≥1 was present in 18 patients (40.9 %) in the dermatome compared to 36 patients (40.9 %) in the linear incision group. A Holgers ≥2 was noticed in 9 (20.5 %) and 19 (21.6 %) patients, respectively. Skin thickening was described in 14 (31.8 %) and 11 patients (12.5 %) in, respectively, the dermatome and linear incision cohort, which was a significant difference (p = 0.001). Nevertheless, therapeutic interventions were effective. In conclusion, there was no significant difference in (adverse) soft tissue reactions; however, skin thickening was more present in the dermatome technique. In addition, significantly more patients with risk factors were allocated to the linear incision technique. Based on these results, the linear incision is advocated as preferred technique.

Clinical Outcomes of Soft Tissue Preservation Surgery With Hydroxyapatite-Coated Abutments Compared to Traditional Percutaneous Bone Conduction Hearing Implant Surgery—A Pragmatic Multi-Center Randomized Controlled Trial

“…Also, the weight of the different types of complications which are included in the primary outcome measure should be further investigated. The duration of follow-up is expected to capture the incidence of common complications, such as moderate to severe periabutment dermatitis, encountered by subjects (50,51). No adjustments for multiple testing were carried out, but general effects observed were consistent in their direction over time.…”

Long-Term Outcomes of the Minimally Invasive Ponto Surgery vs. Linear Incision Technique With Soft Tissue Preservation for Installation of Percutaneous Bone Conduction Devices

“…Different surgical techniques were introduced, including the free retro-auricular full-thickness skin graft, pedicled grafts, the dermatome technique, and finally leading up to the universally adopted linear incision technique with tissue reduction (LITT-R) ( 12 , 13 ). Of these surgical techniques, the LITT-R gained popularity because it leads to fewer complications and is a straightforward procedure ( 13 – 15 ). A different approach to achieve reduced soft tissue reaction is the usage of transcutaneous BCDs.…”