Bone-anchored hearing device surgery: Linear incision without soft tissue reduction. A prospective study

Introduction and objectives: The classic surgical procedure for percutaneous bone-anchored hearing devices involves removal of a large area of subcutaneous tissue down to the periosteum. This leads to alopecia and raises the risk of devascularization of the overlying skin with thepotential for infection and scarring. The objective of this study was to determine the results of implant placement using a single, linear incision with no underlying soft tissue reduction. Material and method: A prospective study was conducted in our hospital over a period of 14months in all consecutive surgeries performed using this technique in adults. Patients werereviewed regularly (week 1, week 3, weeks 4-6 and months 3, 6 and 12) to assess wound healingincluding evaluation with the Holgers scale. Results: Corresponding to 34 patients, 34 cases were consecutively enrolled in this study. We found that 15% of the patients had minor skin reactions during the first visit (Holgers grade 1 or 2); this number raised to 20% in week 3, but at week 4 only 1 patient had a reaction score of 1(which was solved by week 6). None of the cases required revision surgery and all skin reactionswere treated topically. Conclusions: Our results suggest that the tissue preservation technique is a simple and effective insertion technique with a favourable healing process and cosmesis. (C) 2014 Elsevier Espana, S.L.U. and Sociedad Espanola de Otorrinolaringologia y Patologia Cervico-Facial. All rights reserved.