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

Area of Science:

• Otolaryngology
• Surgical Techniques
• Audiology

Background:

• Bone anchored hearing systems (BAHS) are crucial for hearing rehabilitation.
• Surgical approaches for BAHS implantation include linear incision with tissue preservation (LT) and minimally invasive ponto surgery (MIPS).
• Optimizing surgical techniques is essential for patient outcomes and cost-effectiveness.

Purpose of the Study:

• To compare the surgical outcomes of MIPS and LT for BAHS implantation.
• To evaluate differences in surgical time, soft tissue reactions, implant survival, and intraoperative complications between MIPS and LT.
• To determine the suitability of MIPS for local anesthesia and its cost-effectiveness.

Main Methods:

• A retrospective review of 48 BAHS patients (2014-2019) was conducted.
• Patients were divided into two groups: 13 undergoing LT and 35 undergoing MIPS.
• Surgical time, complications, implant loss, and skin reactions were assessed post-operatively. Statistical analysis used the Mann-Whitney U test.

Main Results:

• MIPS demonstrated a significantly shorter mean surgical time (15 minutes) compared to LT (36 minutes).
• Implant survival was 100% in both groups, with no intraoperative complications reported.
• Adverse skin reactions occurred in 7.7% of the LT group versus 0% in the MIPS group at the first follow-up.

Conclusions:

• MIPS is associated with shorter surgical times, making it more suitable for local anesthesia and potentially more cost-effective.
• Both MIPS and LT yield excellent implant survival rates.
• Both surgical techniques demonstrate favorable outcomes regarding skin reactions based on Holgers score.