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Linear Versus Curved Incision for Transcutaneous Bone Conduction Implants: Comparative Scar Assessment
Leonardo Elías Ordóñez-Ordóñez1,2,3,4, José Agustín Caraballo-Arias5, Hernán Díaz-Badillo1,2
1Department of Otolaryngology, Clínica Universitaria Colombia, Clínicas Colsanitas SA, Keralty, Colombia.
International Archives of Otorhinolaryngology
|August 15, 2026
Summary
Linear incisions in transcutaneous bone conduction implant (BCI) surgery may lead to better patient-reported scar appearance. Alopecia was also less frequent with certain BCI devices, suggesting incision choice impacts cosmetic outcomes.
Area of Science:
- Otolaryngology
- Plastic Surgery
- Medical Devices
Background:
- Bone conduction implants (BCIs) are effective for hearing loss.
- Scar appearance is a key factor in patient satisfaction with BCIs.
Purpose of the Study:
- To compare scar appearance and alopecia between linear and curved scalp incisions in transcutaneous BCI surgery.
Main Methods:
- Observational, cross-sectional study of 84 patients undergoing transcutaneous BCI.
- Scar evaluation using Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS).
- Alopecia defined as hair follicle absence within 2mm of the incision.
Main Results:
- Patients reported better scar appearance with linear incisions (POSAS, p=0.035).
- Alopecia was less frequent with the Bonebridge implant (OR=0.113, p=0.003).
- No significant difference in observer scar assessments (POSAS, VSS).
Conclusions:
- Linear incisions may improve scar appearance in transcutaneous BCI surgery.
- Device type and surgical approach can influence scar characteristics.
- Cosmetic and auditory outcomes should be balanced in surgical planning.
