A Minimally Invasive Technique for the Implantation of Bone-Anchored Hearing Devices

Abstract

Objective To describe and evaluate a novel technique for the implantation of bone conduction hearing devices as compared with a common, conventional technique. Study Design Case series with chart review. Setting Tertiary referral otology and neurotology practice. Methods Individuals who underwent the implantation of bone-anchored hearing devices between January 1, 2004, and December 31, 2011, were identified. Demographic data, surgical indications, surgical technique used, surgical time, and complications were recorded. Soft tissue complications were graded on the Holgers classification scheme. Group 1 was defined as those undergoing a traditional technique using a dermatome with subcutaneous tissue reduction. Group 2 was defined as those undergoing the described technique for implantation of the coupling hardware with minimal subcutaneous soft tissue reduction. Results Forty patients underwent the procedure, with 11 patients comprising group 1 and 29 patients comprising group 2. Group 2 required a shorter operative time (32.3 vs 56.1 minutes, P < .0001). Of patients in group 1, 2 of 11 developed soft tissue complications, whereas 5 of 29 in group 2 developed soft tissue complications ( P = 1.000). Most soft tissue complications were reversed with conservative wound care. Conclusion Surgery was performed faster with similar postoperative outcomes in individuals undergoing implantation of bone-anchored hearing devices using the described technique that necessitated minimal soft tissue reduction.