MI-SI-R: A Mini-Invasive, Drill-Free, Anchor-Free Subperiosteal Reverse Technique for Active Bone Conduction...

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Neurosurgery

Background:

• Bone conduction devices are crucial for hearing restoration in specific patient groups.
• Traditional implantation methods can involve invasive drilling and anchoring.
• The development of minimally invasive techniques is essential for improving patient outcomes and device usability.

Purpose of the Study:

• To assess the feasibility, safety, and preliminary audiological results of the mini-invasive subperiosteal reverse (MI-SI-R) technique.
• To evaluate a novel screw-free and drill-free approach for active piezoelectric bone conduction device implantation.
• To explore the potential benefits of the reverse implant orientation for external processor placement.

Main Methods:

• A retrospective, single-center feasibility study was conducted on 14 patients (15 procedures).
• The MI-SI-R technique involved a small incision and an endoscopically created subperiosteal pocket without bone drilling or anchoring.
• Audiological outcomes (PTA, SRT, overclosure) and complications were assessed over a mean follow-up of 19.6 months.

Main Results:

• Significant improvements in Pure-Tone Average (PTA) by 55.1 dB and Speech Recognition Threshold (SRT) by 20.2 dB were observed at 3 months in mixed hearing loss patients.
• A mean overclosure of 19.2 dB HL was noted, indicating effective bone conduction transmission.
• One minor complication (magnet extrusion) occurred, successfully managed with device replacement; no implant migration was observed.

Conclusions:

• The MI-SI-R technique is a safe, feasible, and mini-invasive option for active bone conduction implantation.
• This drill-free, anchor-free approach preserves periosteum and offers encouraging short-term audiological outcomes.
• Further multicenter studies are needed to confirm long-term efficacy and explore pediatric applications.