A five-year follow-up on the osseointegration of bone-anchored hearing device implantation without tissue reduction

To evaluate the outcome of the non-skin thinning technique as compared with the thinning technique 5 years after surgical implantation of bone-anchored hearing "devices."

A single-center, 5-year retrospective follow-up study was designed to evaluate the novel surgical technique without skin thinning as compared to conventional techniques. Eligible patients were consecutively operated on 5 years earlier in a test group without thinning and in two control groups with thinning. In the first control group, a flap technique was used, whereas in the second control group a dermatome technique was used and age-matched patients were selected.

Thirty-six patients were operated on with a single-step surgery under local anesthesia. In the test group (non-skin thinning technique), 12 patients were operated on with a linear incision using an 8.5-mm abutment. In the control groups (flap and dermatome techniques, 12 patients in each group), the standard protocol with skin thinning was used with a 5.5-mm abutment.

Throughout the 5-year span under review, the non-skin thinning test group exhibited good preservation of tissue with decreased skin reactions and no adverse events. The time required for surgery without skin thinning was reduced to approximately 10 to 15 minutes and the cosmetic outcome after 5 years was improved. Numbness and peri-implant infections were minimal in the surrounding skin area for patients who underwent surgery without thinning.

This 5-year follow-up study demonstrates that percutaneous osseointegrated implantation without skin thinning is safe and has a better outcome than implantation with skin thinning.