title: Minimal access surgery for implantable bone conduction systems: early experience with the "Sheffield" incision.
abstract: BACKGROUND
  To compare the results of the "Sheffield" incision technique for implantable temporal bone conduction systems against the previous inferiorly based flap technique.
  
  
  METHODS
  Bone-Anchored Hearing Aid surgery performed over a 2-year period using the new incision (32 patients) was monitored prospectively. A short "lazy S" incision, within the hairline was used followed by soft tissue reduction and implantation. Age range was 6 to 76 years. Average follow-up was 6 months. The results in this group were compared with those of a similar group (20 patients) where the inferiorly based flap was used.
  
  
  RESULTS
  The "Sheffield" incision produced more aesthetically pleasing flaps, and patient satisfaction was high. There were no major complications like flap necrosis or fixture loss (against 25% flap necrosis in the flap technique). One patient had a wound hematoma and subsequent wound dehiscence, which needed clearing and closure under anesthetic. Minor complications included granulations in 4 (13%) at the lower edges of the incision (55% in the flap technique), skin redness in 3 (9%) of Holgers Grade 2, and small wound dehiscence in 3 (3%), all of which settled conservatively.
  
  
  CONCLUSIONS
  The results of the "Sheffield" incision compare well with other similar case series and with our own results from using the alternative inferior flap technique. In addition, it offers simplicity, speed, and aesthetically pleasing results with minimal postoperative management.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Royal Hallamshire Hospital, Sheffield, UK. jaydip.ray@sth.nhs.uk
authors.forename: Jaydip
authors.initials: J
authors.lastname: Ray
authors.forename: Julia
authors.initials: J
authors.lastname: Addams-Williams
authors.forename: Alice
authors.initials: A
authors.lastname: Baldwin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001844:Bone Conduction; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006310:Hearing Aids; D034381:Hearing Loss / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D013524:Surgical Flaps; D053441:Suture Anchors; D016896:Treatment Outcome