A Systematic Review on Complications of Tissue Preservation Surgical Techniques in Percutaneous Bone Conduction Hearing Devices

Verheij, Emmy; Bezdjian, Aren; Grolman, Wilko; Thomeer, Hans G. X. M.

doi:10.1097/mao.0000000000001091

Cited by 51 publications

(58 citation statements)

References 36 publications

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“…Traditionally, the skin surrounding the abutment was thinned, but van de Berg et al noted lower complication rates after BCHI surgery with a less invasive approach [20]. Since then, an even less invasive, single-stage procedure, where the soft tissue surrounding the abutment is left intact [22–25], has become one of the most common techniques used for BCHI surgery. Advantages of this tissue-preserving approach include: less surgical procedure time, reduced numbness or pain and better cosmetic results [22, 24, 25].…”

Section: Introductionmentioning

confidence: 99%

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

Calon

Hoof

Berge

et al. 2016

Trials

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BackgroundOver the last years, less invasive surgical techniques with soft tissue preservation for bone conduction hearing implants (BCHI) have been introduced such as the linear incision technique combined with a punch. Results using this technique seem favorable in terms of rate of peri-abutment dermatitis (PAD), esthetics, and preservation of skin sensibility. Recently, a new standardized surgical technique for BCHI placement, the Minimally Invasive Ponto Surgery (MIPS) technique has been developed by Oticon Medical AB (Askim, Sweden). This technique aims to standardize surgery by using a novel surgical instrumentation kit and minimize soft tissue trauma.MethodsA multicenter randomized controlled trial is designed to compare the MIPS technique to the linear incision technique with soft tissue preservation. The primary investigation center is Maastricht University Medical Center. Sixty-two participants will be included with a 2-year follow-up period. Parameters are introduced to quantify factors such as loss of skin sensibility, dehiscence of the skin next to the abutment, skin overgrowth, and cosmetic results. A new type of sampling method is incorporated to aid in the estimation of complications. To gain further understanding of PAD, swabs and skin biopsies are collected during follow-up visits for evaluation of the bacterial profile and inflammatory cytokine expression.The primary objective of the study is to compare the incidence of PAD during the first 3 months after BCHI placement. Secondary objectives include the assessment of parameters related to surgery, wound healing, pain, loss of sensibility of the skin around the implant, implant extrusion rate, implant stability measurements, dehiscence of the skin next to the abutment, and esthetic appeal. Tertiary objectives include assessment of other factors related to PAD and a health economic evaluation.DiscussionThis is the first trial to compare the recently developed MIPS technique to the linear incision technique with soft tissue preservation for BCHI surgery. Newly introduced parameters and sampling method will aid in the prediction of results and complications after BCHI placement.Trial registrationRegistered at the CCMO register in the Netherlands on 24 November 2014: NL50072.068.14. Retrospectively registered on 21 April 2015 at ClinicalTrials.gov: NCT02438618. This trial is sponsored by Oticon Medical AB.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1662-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

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

Calon

Hoof

Berge

et al. 2016

Trials

View full text Add to dashboard Cite

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“…Since wider-diameter implants have higher survival rates enabling higher abutment lengths, tendency is to preserve this subcutaneous tissue. Studies show a better clinical outcome compared to the removal of subcutaneous tissue and is easier and faster [22–24, 35]. …”

Section: Discussionmentioning

confidence: 99%

Auricular prostheses attached to osseointegrated implants: multidisciplinary work-up and clinical evaluation

Vijverberg

Verhamme

Pol

et al. 2019

Eur Arch Otorhinolaryngol

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PurposeNot long after the introduction of osseointegrated implants outside the oral cavity, auricular prostheses are retrained on osseointegrated implants. New insights have been gained with the next-generation percutaneous osseointegrated titanium implants for bone conduction hearing since its introduction in 2010. As a result, the same technology was introduced in the Vistafix® system (VXI implant) to retain auricular prostheses. The aim of this study is to evaluate the surgical procedure, clinical outcome, and satisfaction of the patient of osseointegration-retained auricular prosthesis using VXI implants.Materials and methods11 patients who received an auricular prosthesis using VXI implants between December 2012 and November 2017 were evaluated retrospectively. The patient’s medical files were reviewed to assess clinical complications and the necessity for revision surgery. The subjective outcome was measured using the Glasgow benefit inventory (GBI).ResultsIn total, 31 implants were placed in 11 patients. None of these implants were lost nor revision surgery needed. An adverse skin reaction was observed in 13.0% of the implants and in 27.2% of the patients, adequately treated with an antibiotic ointment. The average follow-up time was 2 years and 7 months. The GBI displayed a positive score in every patient.ConclusionsThe VXI implants used are a safe and reliable treatment option for retaining auricular prostheses in patients with an absent auricle. Patients were satisfied with their auricular prosthesis and showed benefit in quality of life. Studies with larger numbers and preferably a prospective character are needed to draw statistically significant conclusions.

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“…These complications can lead to explantation. Skin‐related complications can often be prevented by improved surgical techniques with tissue preservation and good hygiene instructions . Otolaryngologist can also opt for a longer abutment to resolve skin‐related complications .…”

Section: Discussionmentioning

confidence: 99%

Strategies for removing a worn‐out Bone‐Anchored Hearing Aid abutment screw

Schwarz

Bianchi

Bezdjian

et al. 2017

Clinical Otolaryngology

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A Systematic Review on Complications of Tissue Preservation Surgical Techniques in Percutaneous Bone Conduction Hearing Devices

Abstract: Tissue preservation surgical techniques for percutaneous BCDs have limited postoperative skin complication rates. Moreover, these techniques are suggested to have at least similar complications rates compared with skin-thinning techniques.

Cited by 51 publications

References 36 publications

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

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

Auricular prostheses attached to osseointegrated implants: multidisciplinary work-up and clinical evaluation

Strategies for removing a worn‐out Bone‐Anchored Hearing Aid abutment screw

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