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Published on: December 20, 2024
Ultrasound-Guided Placement of Percutaneous Abutments for Bone Conduction Hearing Devices
Joseph T Breen1, Marc-Elie Nader2, Paul W Gidley2
1Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida.
Objective:
To introduce a minimally invasive and image-guided technique for staged placement of a percutaneous abutment after osseointegrated implantation.
Patients:
Adults undergoing temporal bone resection at two academic medical centers.
Interventions:
Ultrasound-guided percutaneous installation of a bone conduction hearing device abutment. All patients had lateral temporal bone resection with osseointegrated implantation. Abutment placement followed as a planned staged procedure 3 to 6 months later depending on the use of radiotherapy.
Main Outcome Measures:
Ability to use a bone conduction hearing device and occurrence of skin reactions or wound complications.
Results:
Twelve patients successfully underwent abutment installation through a 5 mm skin biopsy punch incision, nine of which had minimal to no skin reaction surrounding the abutment. Two patients developed Holgers grade 1 skin reaction (redness with slight swelling). One patient experienced an osseointegration failure 152 days after abutment placement.
Conclusions:
Ultrasound is a widely available imaging modality that can be used to precisely localize subcutaneous osseointegrated implants, allowing for minimally invasive percutaneous placement of an abutment under local or general anesthesia.
