Punch and Drill Implantation of Bone Anchored Hearing Device Through a Minimal Skin Punch Incision Versus Implantation With Dermatome and Soft Tissue Reduction

Objective:To compare 2 surgical techniques for implantation of a percutaneous bone anchored hearing device: (1) a minimal skin punch incision without additional skin incision or soft tissue reduction and (2) implantation with an epidermal flap and soft tissues reduction.Study Design:Prospective study.Setting:Tertiary care referral center.Subjects and Methods:Forty patients consecutively implanted (18 males and 22 females). Twenty patients underwent implantation by means of epidermal flap and soft tissues reduction (dermatome group), and 20 patients underwent skin punch resection without soft tissues reduction (punch group). Main outcome measurements: surgical adverse events, surgical time, skin healing, skin tolerance (Holgers classification), and skin appearance and implant failure.Results:The surgical time was shorter with the punch technique (P < .05). The postoperative healing was satisfactory in both groups. All implants were loaded after the healing period. The skin tolerance was good in both groups...