title: Percutaneous bone-anchored hearing implant surgery without soft-tissue reduction: up to 42 months of follow-up.
abstract: OBJECTIVE
  To report the results of bone-anchored hearing implant (BAHI) surgery without soft-tissue reduction (WoSR); in our case, a series of 30 patients with a follow-up period of up to 42 months.
  
  
  METHODS
  The study group included 30 patients between ages 17 and 79 years, where BAHI was indicated, during a 42-month period, between February 2010 and July 2013. Initially, only patients with medical comorbidities that could compromise wound healing were offered the procedure but, subsequently, all our patients are now offered this technique.
  
  
  METHODS
  Unlike in traditional techniques where all dermal and subcutaneous tissue and muscle are removed to enable the thinned skin to sit directly on the periosteum, here, in our series, using the WoSR technique, the soft tissue was preserved and only longer abutments (8.5, 9, and 12 mm) were used.
  
  
  METHODS
  Good early postoperative wound healing, absence of flap necrosis, absence of numbness around the surgical site, and trouble-free follow-up period, with 25 patients encountering no complications.
  
  
  RESULTS
  Of the 30 patients, 25 have had no postoperative problems and five had mild inflammation, of which three patients developed intractable pain and underwent soft-tissue reduction.
  
  
  CONCLUSIONS
  The technique WoSR for BAHI surgery seems to be a safe technique with consistently good results, decreasing operating time and patient morbidity and avoiding some of the complications seen in traditional techniques using soft-tissue reduction.
authors: *Torbay Hospital, Devon; and †Institute of Naval Medicine, Gosport, England, United Kingdom.
authors: Shyam
authors: S
authors: Singam
authors: Richard
authors: R
authors: Williams
authors: Clair
authors: C
authors: Saxby
authors: Finn P
authors: FP
authors: Houlihan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001844:Bone Conduction; D005260:Female; D005500:Follow-Up Studies; D006310:Hearing Aids; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D053441:Suture Anchors; D016896:Treatment Outcome; D055815:Young Adult