Tissue Preservation Techniques for Bone-Anchored Hearing Aid Surgery

Area of Science:

• Otolaryngology
• Neurosurgery
• Biomedical Engineering

Background:

• Bone-anchored hearing implants (BAHIs) are crucial for treating hearing loss.
• Surgical techniques for BAHI placement impact patient outcomes.
• Minimally invasive Ponto Surgery (MIPS) and linear incision with no soft tissue removal (LnSTR) are two such techniques.

Purpose of the Study:

• To compare the outcomes of the Minimally-invasive Ponto Surgery (MIPS) technique versus the linear incision with no soft tissue removal (LnSTR) technique in percutaneous bone-anchored hearing implant surgery.
• To evaluate differences in localized skin reactions, revision surgery rates, cosmetic outcomes, and audiological results between the two surgical approaches.

Main Methods:

• A matched retrospective cohort study was conducted at a tertiary referral center.
• Electronic records of adult and pediatric patients who underwent BAHI surgery between August 2015 and April 2018 were reviewed.
• Patients were divided into MIPS and LnSTR groups, with outcomes analyzed.

Main Results:

• The MIPS group demonstrated significantly lower rates of localized cutaneous reactions (4.5% vs. 33.3%, p=0.026).
• Revision surgery rates were significantly lower in the MIPS group (13.6% vs. 20.8%, p=0.008).
• MIPS also showed significantly better cosmetic outcomes (9.1% vs. 20.8%, p=0.005), while minor adverse events and speech recognition thresholds were comparable.

Conclusions:

• Minimally-invasive Ponto Surgery (MIPS) leads to a statistically significant decrease in localized cutaneous reactions compared to the LnSTR technique.
• Both techniques are safe and effective for hearing loss treatment.
• MIPS may be superior due to improved healing, reduced wound care, and potentially fewer follow-up visits.