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. 2025 Jun 1;46(5):e190-e197.
doi: 10.1097/MAO.0000000000004484. Epub 2025 Feb 24.

Outcomes of a New Minimally Invasive Single-Drill Procedure for Installing Percutaneous Bone-Anchored Hearing Implants in Adult Patients

[Article in Portuguese, English]
Miguel Angelo Hyppolito  1 , Ana Cláudia Mirândola Barbosa Reis  2 , Letícia Cândido de Oliveira  3 , Karine Eying da Silva  3 , Denny Marcos Garcia  1 , Fabiana Danieli-Hyppolito
Affiliations

Outcomes of a New Minimally Invasive Single-Drill Procedure for Installing Percutaneous Bone-Anchored Hearing Implants in Adult Patients

[Article in Portuguese, English]
Miguel Angelo Hyppolito et al. Otol Neurotol. .

Abstract
in English, Portuguese

Objective: To investigate the surgical and audiological outcomes in adult bone-anchored hearing system (BAHS) users who underwent implantation using a minimally invasive, single-drill procedure (MONO procedure).

Study design: Retrospective cohort design.

Setting: University hospital.

Patients: Adult subjects (≥18 yr), with conductive and mixed hearing loss, or single-sided deafness (SSD), who underwent BAHS surgery using MONO from 2021 to 2023.

Intervention: BAHS implantation.

Main outcome measures: Surgical and postoperative complications were investigated during the entire follow-up period. Preoperative unaided air- and bone-conduction thresholds, pure-tone average (PTA), air-bone gap (ABG), and monosyllabic word recognition scores (unaided- and softband-aided) were compared with the postoperative BAHS aided PTA, remaining ABG, functional gain, and monosyllabic word recognition scores.

Results: Forty-four subjects aged between 20 and 70 (52 ± 15) years met the inclusion criteria. One subject (2.3%) required two punch incisions due to implant instability during surgery. Two subjects (4.6%) experienced adverse skin reactions. Pain (6.9%) and moisture (6.9%) at implant site were also reported. No other complications were reported over a mean follow-up time of 12.2 ± 5.7 months. The mean BAHS aided score was significantly greater than the mean unaided- and softband-aided scores. All subjects showed functional improvements after surgery (25-31 dB), and the average effective gain was 1.3 dB.

Conclusion: The MONO procedure was shown to be a viable option for routine BAHS surgery in adults. The auditory performance of the subjects improved postoperatively, and complications were minimal and easily resolved. Further studies are required to investigate the long-term outcomes of MONO in this population.

Level of evidence: 4-Retrospective review.

Objective: To investigate the surgical and audiological outcomes in adult bone-anchored hearing system (BAHS) users who underwent implantation using a minimally invasive, single-drill procedure (MONO procedure).

Study design: Retrospective cohort design.

Setting: University hospital.

Patients: Adult subjects (≥18 yr), with conductive and mixed hearing loss, or single-sided deafness (SSD), who underwent BAHS surgery using MONO from 2021 to 2023.

Intervention: BAHS implantation.

Main outcome measures: Surgical and postoperative complications were investigated during the entire follow-up period. Preoperative unaided air- and bone-conduction thresholds, pure-tone average (PTA), air-bone gap (ABG), and monosyllabic word recognition scores (unaided- and softband-aided) were compared with the postoperative BAHS aided PTA, remaining ABG, functional gain, and monosyllabic word recognition scores.

Results: Forty-four subjects aged between 20 and 70 (52 ± 15) years met the inclusion criteria. One subject (2.3%) required two punch incisions due to implant instability during surgery. Two subjects (4.6%) experienced adverse skin reactions. Pain (6.9%) and moisture (6.9%) at implant site were also reported. No other complications were reported over a mean follow-up time of 12.2 ± 5.7 months. The mean BAHS aided score was significantly greater than the mean unaided- and softband-aided scores. All subjects showed functional improvements after surgery (25–31 dB), and the average effective gain was 1.3 dB.

Conclusion: The MONO procedure was shown to be a viable option for routine BAHS surgery in adults. The auditory performance of the subjects improved postoperatively, and complications were minimal and easily resolved. Further studies are required to investigate the long-term outcomes of MONO in this population.

Level of evidence: 4—Retrospective review.

Keywords: Bone drilling; Bone-anchored hearing aid; Bone-conduction hearing; Hearing loss; Minimally invasive surgery.

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Conflict of interest statement

F.D. worked at Oticon Medical. The remaining authors disclose no conflicts of interest.

References

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