Minimally Invasive Surgery for Osseointegrated Auditory Implants

Abstract

Objectives (1) To describe the benefits of the minimally invasive punch technique without soft tissue reduction (PT) for the placement of percutaneous osseointegrated auditory implants. (2) To compare and contrast techniques and outcomes from PT with the linear technique with soft tissue reduction (LT). Study Design Case series with chart review Setting Performed at a tertiary otology practice at an academic medical center. Subjects and Methods LT was used until 2012 when a switch was made for all patients to PT. Preoperative variables recorded included age, sex, BMI, smoking status, indication, device selected, and abutment length. Outcomes measures included surgical time, skin reaction grading by Holgers score at 1 week and at most recent follow-up, and any other complications. Two-sample t test and χ2 was used to compare. Results A total of 51 patients (34 LT, 17 PT) were identified. Surgical time was found to be significantly shorter for the PT group (LT, 49.2 min; PT, 13.4 min; P < .001). There were no statistically significant differences between LT and PT for mean Holgers at first (LT, 0.24; PT, 0.47; P = .87) or final follow-up (LT, 0.62; PT, 0.41; P = .22). Conclusions The punch technique offers several potential surgical and cosmetic advantages over the linear technique without compromising skin-reactivity outcomes. This study supports a growing trend toward minimally invasive percutaneous auditory implant surgery.