title: Cutaneous complications in osseointegrated implants: comparison between classic and tissue preservation techniques.
abstract: OBJECTIVE
  The standard surgical technique for osseointegrated hearing aids involves removing a large area of subcutaneous tissue down to the periosteum. Recently, the industry has designed a new range of abutment lengths for less invasive surgery with soft tissue preservation. This study compared and evaluated the complications in the standard and the tissue preservation techniques.
  
  
  METHODS
  This was a prospective study including 29 adult patients that underwent single-stage osseointegrated hearing aids insertion between February 2009 and February 2013. We performed the standard technique in 14 patients, and the tissue preservation technique in 15. Soft tissue complications were graded according to the Holgers classification.
  
  
  RESULTS
  No patient required removal of implant or revision surgery. Although the Holgers grade was always worse in the standard technique (reaction score of 3 or higher was 28% versus 7% at a month), the complication rate was not statistically significant between the 2 groups at any postoperative time a week (p=0.233), a month (p=0.470) and a year (p=0.401).
  
  
  CONCLUSIONS
  In our experience the tissue preservation technique, without soft tissue reduction, is the procedure of choice for bone anchored implant surgery. The preservation technique is easier, faster and possible with local anaesthesia and has similar postoperative outcomes.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España. Electronic address: p5martinezg@gmail.com.
authors.forename: Patricia
authors.initials: P
authors.lastname: Martínez
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: López
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Justo Ramón
authors.initials: JR
authors.lastname: Gómez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019929:Cochlear Implantation / Q000009:adverse effects* / Q000379:methods; D003054:Cochlear Implants / Q000009:adverse effects*; D003238:Connective Tissue / Q000601:surgery; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods*; D016348:Osseointegration; D011446:Prospective Studies; D012871:Skin Diseases / Q000209:etiology* / Q000473:pathology; D013524:Surgical Flaps; D013536:Suture Techniques
keywords: Complicaciones cutáneas; Cutaneous complications; Implante oseointegrado; Osseointegrated hearing aids; Preservación de tejido; Surgical procedures; Tissue preservation; Técnica quirúrgica