Osseointegrated Hearing Implant Surgery: Outcomes Using a Minimal Soft Tissue Removal Technique

Objectives. (1) To report on the results and complications arising from using a minimal tissue removal procedure for the placement of an osseointegrated hearing implant. (2) To comment on the advantages and disadvantages for this technique compared to current standard techniques. Study Design. Case series with chart review; 2008-2010. Setting. Tertiary care facility. Subjects and Methods. All consecutive patients undergoing osseointegrated hearing implant surgery with a minimal tissue removal technique were reviewed. Technique: A small incision (1.5 cm) with little to no soft tissue (fat only) removal with good skin to periosteum fixation after placement of implant and abutment. Results. Thirty-one adults were assessed (aged 18-86, range of follow-up 3-45 months). No patients experienced hair loss, significant numbness, cosmetic defects, or intraoperative or audiologic complications. Eight patients required some combination of antibiotic ointment, steroid ointment, and/or oral antibiotic for mild erythema around the abutment, and 3 patients required soft tissue revision. Five children under the age of 18 were also assessed. One of these patients required soft tissue revision in the operating room and 1 required removal of the implant. Conclusions. We have demonstrated comparable outcomes to other surgical techniques with less cosmetic and other associated complaints. This study indicates that a less invasive approach for the surgical implantation of the osseointegrated auditory implant may have merit.