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. 2020 Mar;277(3):715-725.
doi: 10.1007/s00405-019-05746-5. Epub 2019 Dec 6.

Minimal invasive pocket technique for magnet bone implant hearing aid without fixation

Pierre Dolhen  1 , Samuel Lipski  1 , Rachid Touijar  1 , Juliette Van Bogaert  2
Affiliations

Minimal invasive pocket technique for magnet bone implant hearing aid without fixation

Pierre Dolhen et al. Eur Arch Otorhinolaryngol. 2020 Mar.

Abstract

Introduction: The BAHA (bone-anchored hearing aid) Attract is a magnetic transcutaneous bone conduction device anchored into the temporal bone. The standard surgical technique for BAHA Attract is a multi-tools time-consuming process, which requires a large cutaneous incision. The objective of this study is to describe and test the feasibility of a minimally invasive pocket (MIP) technique for Magnet Bone Implant Hearing Aid (MBIHA) with a modified magnet of BAHA Attract without fixation and without any tissue reduction. We use a 3-cm vertical skin incision and a subperiosteal pocket.

Method: A study of 10 patients with conductive or mixed hearing loss who benefited from a MBIHA using the MIP technique is presented. The pure tone average (PTA) (dB) for air-conduction thresholds and the speech recognition threshold (SRT) (dB) in speech audiometry in quiet are calculated. The Entific Medical Systems (EMS) questionnaire and the postoperative clinical outcomes are realized.

Results: We found a significant improvement of 33.8 dB on average for the PTA and 44.8 dB for the SRT with MBIHA at 3 months, compared with unaided situation. No implant was removed or displaced after 2 years of follow-up. The skin condition remains intact in all the cases.

Conclusion: The minimally subperiosteal pocket surgical technique MIP without fixation and with tissue preservation for the MBIHA is safe, rapid and effective for patients with conductive or mixed hearing loss. It opens new perspectives of development and modify conventional concept in magnetic coupling of bone-conducted device.

Keywords: Bone anchored implant; Bone conduction hearing aid; Minimally invasive surgery; Subperiosteal implantation; Surgical technique; Transcutaneous.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The five major surgical steps according to the MIP technique (off label procedure). a Markage on the skin of the future cutaneous incision and the internal implant site projection. b Realization of a 3 cm cutaneous incision. c Creation of the subperiosteal pocket was carried out with a freer suction elevator (Storz, Germany). d Insertion of the BIM400 internal magnetic implant into the pocket. e Incision was closed in two layers
Fig. 2
Fig. 2
a Distribution of mean 4PTAAC (dB) shown in a box plot for the unaided situation, for BAHA on soundarc and for MBIHA at 3 months. N = 10. b Mean pure-ton average (dB) for each specific frequency (Hz) in the situation without hearing aid and with MBIHA at 3 months. N = 10
Fig. 3
Fig. 3
Distribution of mean SRT (dB) shown in a box plot for the unaided situation, for BAHA on soundarc and for MBIHA after 3 months. N = 10
Fig. 4
Fig. 4
MBIHA use (days per week and hours per day)
Fig. 5
Fig. 5
MBIHA benefit according to situation
Fig. 6
Fig. 6
Esthetic results with MBIHA in three different patients. a 7 days postoperatively. b 14 days postoperatively. c 2 months postoperatively
See this image and copyright information in PMC

References

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