Percutaneous bone-anchored hearing implant surgery: linear incision technique with tissue preservation versus linear incision technique with tissue reduction

Abstract

LITT-P has a significantly higher rate of skin thickening and LITT-R has a significantly higher proportion of adverse soft tissue reactions. Nevertheless, combined with the advantages of LITT-P described in other studies, this can be advocated as the preferred technique.

Surgical outcomes with the tissue preservation technique in bone‐anchored hearing implants: The Birmingham experience of ninety‐seven cases

“…This likely explains increased failure rate compared to the much shorter follow-up in other studies. [7][8][9][10] Adverse soft tissue reactions recorded in this study (3.9% over the whole follow-up period) were low and compared favourably to those recorded in other studies published, between 2.4%-28%. 3,[7][8][9][10] It is likely that the longer follow-up period reduced the percentage of adverse Holgers' scores recorded in this study, as the majority of adverse Holgers' scores were recorded at one week post-operation.…”

“…Fixture failure rates reported in other studies have been similarly low [7][8][9] and a recently published case series with a similar number of participants showed a 3% fixture failure rate. 10 Only 1/7 failures in this series was an early failure (before 4 years).…”

“…Adverse soft tissue reactions in linear incision with tissue preservation have generally also been low (0%-7%); however, some studies have reported rates much higher, between 16% and 28%. [4][5][6][7] The aim of this study is to provide data on the long-term outcomes of a large cohort of patients operated on using linear incision with tissue preservation.…”

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

“…Van Der Stee et al detected wound dehiscence in 28 implants that had been placed using LT with tissue reduction and 33.7% soft tissue reactions in the same group of patients. In contrast, 27.6% of soft tissue reactions in the LT with tissue preservation group were registered without any wound dehiscence 13 . Furthermore, Badran et al reported that patient satisfaction with skin appearance after tissue removal was not significantly better compared to the cosmetic impact of common hearing aids 14 , 15 .…”

Do patients report quality of life improvements after fitting of their unilateral bone conducting hearing implant?

“…4,[13][14][15] There has also been a move towards less invasive soft tissue techniques and use of the minimally invasive Ponto surgery technique. [16][17][18][19][20][21][22][23] Many of the previous QoL studies were performed with older devices and using more invasive soft tissue surgical techniques. 24 Whilst it is clear that bone conducting hearing implants demonstrate a qualitative benefit, there remains a paucity of literature comparing pre-and post-operative QoL benefits.…”