14
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Long term follow-up demonstrating stability and patient satisfaction of minimally invasive punch technique for percutaneous bone anchored hearing devices

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          Minimally Invasive Ponto Surgery (MIPS) was recently described to facilitate the placement of percutaneous bone anchored hearing devices. As early adopters of this new procedure, we sought to perform a quality assurance project using our own small prospective cohort to justify this change in practice. We chose to examine device stability and to gauge our patients’ perspective of the surgery and their overall satisfaction with the process.

          Methods

          A total of 12 adult patients who underwent MIPS between 2016 and 2017 with a minimum post-operative follow-up of 12 months were included in this study. A prospective MIPS research clinic was used to follow patients, assess the implant site soft tissue status and gather qualitative information through patient interviews and surveys.

          Results

          The mean (SD) soft tissue status score averages using the IPS Scale were low for inflammation 0.1 (0.1), pain 0.1 (0.1), skin height 0.2 (0.1) and total IPS score 0.4 (0.3) indicating minimal soft tissue changes. Patient experiences with MIPS were overwhelmingly positive in reports through the MIPS modified SSQ-8. All patients reported speedy recoveries and no long-term complications. There were zero device losses.

          Conclusion

          The series presented in this paper represents the first MIPS cohort with long term follow-up to be published to date in North America. Our findings conclude both device stability and patient satisfaction with no loss of fixtures. Consequently, we have adopted MIPS as our procedure of choice for the placement of all percutaneous BAHDs.

          Related collections

          Most cited references13

          • Record: found
          • Abstract: found
          • Article: not found

          Soft tissue reactions around percutaneous implants: a clinical study of soft tissue conditions around skin-penetrating titanium implants for bone-anchored hearing aids.

          Some patients with hearing impairment cannot use conventional hearing aids. One solution for these patients is the use of bone conduction hearing aids; however, this kind of equipment is associated with several problems related to the necessity for a good contact between the transducer and the temporal bone. Direct bone contact would be an ideal solution provided that safe and reaction-free skin penetration and a safe and permanent bone anchorage could be achieved. Brånemark et al have developed a procedure to furnish edentulous patients with fixed bridges using titanium implants. This report is focused on the clinical status of the soft tissue adjacent to the 67 skin-penetrating devices in 60 patients. The patients have been followed between 3 and 96 months on 313 occasions, which represents a total observation time of 1515 months of clinical performance. Only one implant was extracted due to adverse skin reaction, giving a failure rate of 0.07% per month. This is comparable with the failure rate of cardiac pacemakers 0.02-0.04% per month).
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial.

            To evaluate the outcome of Bone-Anchored Hearing Aid surgery without skin thinning, a test group with direct implantation without such thinning was compared with a control group that underwent the traditional procedure.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Minimally Invasive Ponto Surgery Versus the Linear Incision Technique With Soft Tissue Preservation for Bone Conduction Hearing Implants: A Multicenter Randomized Controlled Trial

              Objective: To compare the surgical outcomes of the Minimally Invasive Ponto Surgery (MIPS) technique with those of the linear incision technique with soft-tissue preservation for bone-anchored hearing systems (BAHS). Design: Sponsor-initiated multicenter, open, randomized, controlled clinical trial. Setting: Maastricht University Medical Centre, Ziekenhuisgroep Twente and Medisch Centrum Leeuwarden, all situated in The Netherlands. Participants: Sixty-four adult patients eligible for unilateral BAHS surgery. Interventions Single-stage BAHS surgery with 1:1 randomization to the linear incision technique with soft-tissue preservation (control) or the MIPS (test) group. Primary and Secondary Outcome Measurements: Primary objective: compare the incidence of inflammation (Holgers Index ≥ 2) during 12 weeks’ follow-up after surgery. Secondary objectives: skin dehiscence, pain scores, loss of sensibility around the implant, soft-tissue overgrowth, skin sagging, implant extrusion, cosmetic results, surgical time, wound healing and Implant Stability Quotient measurements. Results: Sixty-three subjects were analyzed in the intention-to-treat population. No significant difference was found for the incidence of inflammation between groups. Loss of skin sensibility, cosmetic outcomes, skin sagging, and surgical time were significantly better in the test group. No statistically significant differences were found for dehiscence, pain, and soft-tissue overgrowth. A nonsignificant difference in extrusion was found for the test group. The Implant Stability Quotient was statistically influenced by the surgical technique, abutment length, and time. Conclusion: No significant differences between the MIPS and the linear incision techniques were observed regarding skin inflammation. MIPS results in a statistically significant reduction in the loss of skin sensibility, less skin sagging, improved cosmetic results, and reduced surgical time. Although nonsignificant, the implant extrusion rate warrants further research.
                Bookmark

                Author and article information

                Contributors
                ysardiwalla@gmail.com
                drnicholasjufas@gmail.com
                dp.morris@dal.ca
                Journal
                J Otolaryngol Head Neck Surg
                J Otolaryngol Head Neck Surg
                Journal of Otolaryngology - Head & Neck Surgery
                BioMed Central (London )
                1916-0208
                1916-0216
                20 November 2018
                20 November 2018
                2018
                : 47
                : 71
                Affiliations
                [1 ]ISNI 0000 0004 1936 8200, GRID grid.55602.34, Faculty of Medicine, Dalhousie University, ; Halifax, NS Canada
                [2 ]ISNI 0000 0004 1936 8200, GRID grid.55602.34, Division of Otolaryngology – Head and Neck Surgery, , Dalhousie University, ; Halifax, NS Canada
                [3 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, Discipline of Surgery, Sydney Medical School, , University of Sydney, ; Sydney, Australia
                [4 ]ISNI 0000 0001 2158 5405, GRID grid.1004.5, Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine and Health Sciences, , Macquarie University, ; Sydney, Australia
                [5 ]ISNI 0000 0004 0407 789X, GRID grid.413292.f, QEII Health Science Center - VG Site Otolaryngology, ; 5820 University Ave - Rm 3037, Halifax, NS B3H 2Y9 Canada
                Author information
                http://orcid.org/0000-0002-9595-2199
                Article
                316
                10.1186/s40463-018-0316-5
                6247525
                30458887
                a5433687-bd10-473b-a7f3-902836088ead
                © The Author(s). 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 July 2018
                : 4 November 2018
                Categories
                Original Research Article
                Custom metadata
                © The Author(s) 2018

                patient safety,otologic surgical procedures,bone conduction,minimally invasive surgical procedures,patient satisfaction,quality improvement

                Comments

                Comment on this article