title: Percutaneous bone-anchored hearing implant surgery: dermatome versus linear incision technique.
abstract: The objective of this historical cohort study is to identify if there are differences in soft tissue reactions and skin thickening between implantation of the percutaneous bone-anchored hearing implant (BAHI) using the dermatome or linear incision technique. All adult patients who received a BAHI between August 2005 and January 2013 were selected. One surgeon performed all procedures and only the dermatome and linear incision technique were used. A total of 132 patients/implants were included and significantly more patients with risk factors were seen in the linear incision cohort. A soft tissue reaction Holgers ≥1 was present in 18 patients (40.9 %) in the dermatome compared to 36 patients (40.9 %) in the linear incision group. A Holgers ≥2 was noticed in 9 (20.5 %) and 19 (21.6 %) patients, respectively. Skin thickening was described in 14 (31.8 %) and 11 patients (12.5 %) in, respectively, the dermatome and linear incision cohort, which was a significant difference (p = 0.001). Nevertheless, therapeutic interventions were effective. In conclusion, there was no significant difference in (adverse) soft tissue reactions; however, skin thickening was more present in the dermatome technique. In addition, significantly more patients with risk factors were allocated to the linear incision technique. Based on these results, the linear incision is advocated as preferred technique.
authors.affiliation: Department of Otorhinolaryngology, Radboud University Medical Centre, Post 377, PO box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Ruben M
authors.initials: RM
authors.lastname: Strijbos
authors.affiliation: Department of Otorhinolaryngology, Deventer Hospital, Deventer, The Netherlands.
authors.forename: Steven J H
authors.initials: SJH
authors.lastname: Bom
authors.affiliation: Department of Otorhinolaryngology, Deventer Hospital, Deventer, The Netherlands.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zwerver
authors.affiliation: Department of Otorhinolaryngology, Radboud University Medical Centre, Post 377, PO box 9101, 6500 HB, Nijmegen, The Netherlands. Myrthe.Hol@radboudumc.nl.
authors.forename: Myrthe K S
authors.identifier: http://orcid.org/0000-0002-9708-935X
authors.initials: MKS
authors.lastname: Hol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003638:Deafness / Q000601:surgery; D003872:Dermatitis / Q000209:etiology; D005260:Female; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000601:surgery; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps / Q000473:pathology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D053441:Suture Anchors; D055815:Young Adult
keywords: Baha; Bone-anchored hearing implant; Dermatome technique; Linear incision; Soft tissue reactions; Surgical technique