title: Simplified bone-anchored hearing aid insertion using a linear incision without soft tissue reduction.
abstract: BACKGROUND
  Numerous techniques have been described to manage the skin and other soft tissues during bone-anchored hearing aid insertion. Previously, generally accepted techniques have sometimes led to distressing alopecia and soft tissue defects. Now, some surgeons are rejecting the originally described split skin flap in favour of a less invasive approach.
  
  
  OBJECTIVE
  To investigate bone-anchored hearing aid placement utilising a single, linear incision with either no or minimal underlying soft tissue reduction.
  
  
  METHODS
  Thirty-four adults were prospectively enrolled to undergo single-stage bone-anchored hearing aid placement with this modified technique. A small, linear incision was used at the standard position and carried down through the periosteum. Standard technique was then followed with placement of an extended length abutment. Patients were reviewed regularly to assess wound healing, including evaluation with Holgers' scale.
  
  
  RESULTS
  Only 14.7 per cent of patients had a reaction score of 2 or higher. Most complications were limited to minor skin reactions that settled with silver nitrate cautery and/or antibiotics. None required revision surgery for tissue overgrowth, and there were no implant failures.
  
  
  CONCLUSIONS
  Our results suggest this to be a simple and effective insertion technique with favourable cosmesis and patient satisfaction.
authors: Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
authors: J
authors: J
authors: Husseman
authors: J
authors: J
authors: Szudek
authors: P
authors: P
authors: Monksfield
authors: D
authors: D
authors: Power
authors: S
authors: S
authors: O'Leary
authors: R
authors: R
authors: Briggs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006310:Hearing Aids; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016348:Osseointegration; D017060:Patient Satisfaction; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods*; D053441:Suture Anchors; D016896:Treatment Outcome; D014945:Wound Healing