title: Bone-anchored hearing device surgery: Linear incision without soft tissue reduction. A prospective study.
abstract: OBJECTIVE
  The classic surgical procedure for percutaneous bone-anchored hearing devices involves removal of a large area of subcutaneous tissue down to the periosteum. This leads to alopecia and raises the risk of devascularization of the overlying skin with the potential for infection and scarring. The objective of this study was to determine the results of implant placement using a single, linear incision with no underlying soft tissue reduction.
  
  
  METHODS
  A prospective study was conducted in our hospital over a period of 14 months in all consecutive surgeries performed using this technique in adults. Patients were reviewed regularly (week 1, week 3, weeks 4-6 and months 3, 6 and 12) to assess wound healing including evaluation with the Holgers scale.
  
  
  RESULTS
  Corresponding to 34 patients, 34 cases were consecutively enrolled in this study. We found that 15% of the patients had minor skin reactions during the first visit (Holgers grade 1 or 2); this number raised to 20% in week 3, but at week 4 only 1 patient had a reaction score of 1 (which was solved by week 6). None of the cases required revision surgery and all skin reactions were treated topically.
  
  
  CONCLUSIONS
  Our results suggest that the tissue preservation technique is a simple and effective insertion technique with a favourable healing process and cosmesis.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España. Electronic address: xaltuna@osakidetza.net.
authors.forename: Xabier
authors.initials: X
authors.lastname: Altuna
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Navarro
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España.
authors.forename: Idoia
authors.initials: I
authors.lastname: Palicio
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España.
authors.forename: Leire
authors.initials: L
authors.lastname: Álvarez
mesh_terms: D000328:Adult; D000368:Aged; D001844:Bone Conduction; D005260:Female; D006310:Hearing Aids; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods*; D040521:Subcutaneous Tissue; D016896:Treatment Outcome
keywords: Hearing aids; Implantes auditivos; Osseointegration; Osteointegración; Procedimientos quirúrgicos; Surgical procedures