Bone-anchored Hearing Implant Surgery: Our Experience with Linear Incision and Punch Techniques

Overview

Journal Acta Otorhinolaryngol Ital

Specialty Otorhinolaryngology

Date 2018 Jul 10

PMID 29984803

Citations 6

Authors

F DI Giustino

P Vannucchi

R Pecci

A Mengucci

R Santimone

B Giannoni

Affiliations

Soon will be listed here.

Abstract

In recent years, bone-anchored hearing implants (BAHIs) have found wider application in the treatment of conductive and mixed hearing loss. Several surgical techniques have been developed to reduce complications, enhance healing and improve audiological and aesthetic results. We report our experience on the use of three BAHI surgery techniques: Group 1, linear incision with thinning of the subcutaneous tissue; Group 2, linear incision without thinning of the subcutaneous tissue; Group 3, punch technique (Minimally Invasive Ponto Surgery, MIPS). We retrospectively analysed patients undergoing BAHI surgery; results were evaluated on the basis of any intra-operative complication, duration of surgery and occurrence of adverse effects at the implantation site over 1 year of follow-up. We collected a total of 30 implantations (12 for Group 1, 8 for Group 2, 10 for Group 3) with an intra-operative complication rate of 25%, 0% and 10%, respectively. The average surgical time was 62.08 minutes, 34.37 minutes and 18.7 minutes respectively. During follow-up, we reported the occurrence of adverse effects in 10.63% of observations in Group 1, 3.12% in Group 2 and 2.5% in Group 3. This study confirms the low rate of intra and postoperative complications during BAHI surgery and documents the simplicity of execution of the novel MIPS technique, with a significant reduction in surgical time compared to the other two techniques, and positive effects in terms of health care costs.

Citing Articles

Bone-Anchored Hearing Aid Effects on Vestibular Function: A Preliminary Report.

Pollastri F, Giannoni B, Marcelli V, Spadavecchia G, Pecci R Audiol Res. 2024; 14(2):386-400.

PMID: 38666904 PMC: 11047723. DOI: 10.3390/audiolres14020033.

Bone-Anchored Hearing Implants: Surgical and Audiological Comparison of Different Surgical Techniques.

Torun Topcu M, Mutlu B, Celik S, Celikgun B, Mutlu A, Kalcioglu M Int Arch Otorhinolaryngol. 2022; 26(4):e649-e656.

PMID: 36405458 PMC: 9668411. DOI: 10.1055/s-0042-1742765.

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

Strijbos R, Straatman L, Stokroos R, Johansson M Front Surg. 2022; 9:858117.

PMID: 35388366 PMC: 8977416. DOI: 10.3389/fsurg.2022.858117.

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

De Stefano S, Mochi P, Murri A, Cuda D Acta Otorhinolaryngol Ital. 2021; 41(5):474-480.

PMID: 34734584 PMC: 8569658. DOI: 10.14639/0392-100X-N1048.

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

Strijbos R, Straatman L, Calon T, Johansson M, de Bruijn A, van den Berge H Front Neurol. 2021; 12:632987.

PMID: 33716934 PMC: 7945693. DOI: 10.3389/fneur.2021.632987.

References

Goldman R, Georgolios A, Shaia W . The punch method for bone-anchored hearing aid placement. Otolaryngol Head Neck Surg. 2013; 148(5):878-80. DOI: 10.1177/0194599813476666. View

den Besten C, Bosman A, Nelissen R, Mylanus E, Hol M . Controlled Clinical Trial on Bone-anchored Hearing Implants and a Surgical Technique With Soft-tissue Preservation. Otol Neurotol. 2016; 37(5):504-12. DOI: 10.1097/MAO.0000000000000994. View

Altuna X, Navarro J, Palicio I, Alvarez L . Bone-anchored hearing device surgery: Linear incision without soft tissue reduction. A prospective study. Acta Otorrinolaringol Esp. 2015; 66(5):258-63. DOI: 10.1016/j.otorri.2014.09.007. View

Reyes R, Tjellstrom A, Granstrom G . Evaluation of implant losses and skin reactions around extraoral bone-anchored implants: A 0- to 8-year follow-up. Otolaryngol Head Neck Surg. 2000; 122(2):272-6. DOI: 10.1016/S0194-5998(00)70255-5. View

Tjellstrom A, Lindstrom J, HALLEN O, Albrektsson T, Branemark P . Osseointegrated titanium implants in the temporal bone. A clinical study on bone-anchored hearing aids. Am J Otol. 1981; 2(4):304-10. View

Briggs R, van Hasselt A, Luntz M, Goycoolea M, Wigren S, Weber P . Clinical performance of a new magnetic bone conduction hearing implant system: results from a prospective, multicenter, clinical investigation. Otol Neurotol. 2015; 36(5):834-41. DOI: 10.1097/MAO.0000000000000712. View

Clamp P, Briggs R . The Cochlear Baha 4 Attract System - design concepts, surgical technique and early clinical results. Expert Rev Med Devices. 2014; 12(3):223-30. DOI: 10.1586/17434440.2015.990375. View

Gordon S, Coelho D . Minimally Invasive Surgery for Osseointegrated Auditory Implants: A Comparison of Linear versus Punch Techniques. Otolaryngol Head Neck Surg. 2015; 152(6):1089-93. DOI: 10.1177/0194599815571532. View

Caruso A, Giannuzzi A, Sozzi V, Sanna M . Bone anchored hearing implants without skin thinning: the Gruppo Otologico surgical and audiological experience. Eur Arch Otorhinolaryngol. 2016; 274(2):695-700. DOI: 10.1007/s00405-016-4305-x. View

10.

Martinez P, Lopez F, Gomez J . Cutaneous complications in osseointegrated implants: comparison between classic and tissue preservation techniques. Acta Otorrinolaringol Esp. 2014; 66(3):148-53. DOI: 10.1016/j.otorri.2014.07.003. View

11.

Dun C, Faber H, de Wolf M, Mylanus E, Cremers C, Hol M . Assessment of more than 1,000 implanted percutaneous bone conduction devices: skin reactions and implant survival. Otol Neurotol. 2012; 33(2):192-8. DOI: 10.1097/MAO.0b013e318241c0bf. View

12.

Johansson M, Stokroos R, Banga R, Hol M, Mylanus E, Savage Jones H . Short-term results from seventy-six patients receiving a bone-anchored hearing implant installed with a novel minimally invasive surgery technique. Clin Otolaryngol. 2016; 42(5):1043-1048. DOI: 10.1111/coa.12803. View

13.

Holgers K, Tjellstrom A, Bjursten L, Erlandsson B . Soft tissue reactions around percutaneous implants: a clinical study of soft tissue conditions around skin-penetrating titanium implants for bone-anchored hearing aids. Am J Otol. 1988; 9(1):56-9. View

14.

Hultcrantz M . Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial. Otol Neurotol. 2011; 32(7):1134-9. DOI: 10.1097/MAO.0b013e31822a1c47. View

15.

Bovo R . Simplified technique without skin flap for the bone-anchored hearing aid (BAHA) implant. Acta Otorhinolaryngol Ital. 2009; 28(5):252-5. PMC: 2689533. View

16.

Wilson D, Kim H . A minimally invasive technique for the implantation of bone-anchored hearing devices. Otolaryngol Head Neck Surg. 2013; 149(3):473-7. DOI: 10.1177/0194599813492946. View

17.

de Wolf M, Hol M, Huygen P, Mylanus E, Cremers C . Clinical outcome of the simplified surgical technique for BAHA implantation. Otol Neurotol. 2008; 29(8):1100-8. DOI: 10.1097/MAO.0b013e31818599b8. View

18.

Tjellstrom A, Granstrom G . Long-term follow-up with the bone-anchored hearing aid: a review of the first 100 patients between 1977 and 1985. Ear Nose Throat J. 1994; 73(2):112-4. View

19.

Husseman J, Szudek J, Monksfield P, Power D, OLeary S, Briggs R . Simplified bone-anchored hearing aid insertion using a linear incision without soft tissue reduction. J Laryngol Otol. 2013; 127 Suppl 2:S33-8. DOI: 10.1017/S0022215113000741. View

20.

Calon T, van Hoof M, van den Berge H, de Bruijn A, van Tongeren J, Hof J . Minimally Invasive Ponto Surgery compared to the linear incision technique without soft tissue reduction for bone conduction hearing implants: study protocol for a randomized controlled trial. Trials. 2016; 17(1):540. PMC: 5103483. DOI: 10.1186/s13063-016-1662-0. View