Mudry A
ENT & HNS, Avenue de la Gare 6, CH-1003 Lausanne, Switzerland.
Rev Laryngol Otol Rhinol (Bord). 2009;130(4-5):281-4.
Since the introduction of the BAHA (bone-anchored hearing aid), two main different surgical procedures have been used to insert the implant: the skin flap technique and the linear incision technique.
The aim of this retrospective study is to compare the short terms results (3 months after the implantation, the usual period of skin healing) of the skin healing process in the surgical field and around the BAHA implant of these two different techniques.
113 implantations were done from January 2004 to mid May 2008. Between January 2004 to December 2006, 62 were inserted with the skin flap technique and between January 2007 to mid May 2008, followed by 51 with the linear incision technique. All cases were done by the same surgeon.
Four implanted BAHA with the skin flap technique necessitated a revision of the operating field because skin necrosis around the implant and only 1 with the linear incision technique. For the other cases and outside the normal range of fixed controls, the cases with the skin flap technique necessitated 25 unforeseen visits by 21 patients for cleaning and removal of crusts, in contrast to 2 visits by 2 patients for the cases with the linear incision technique.
This study clearly demonstrates that the linear incision technique has statistically lower risks of skin problems than the skin flap technique in the first three months post-implantation.
自骨锚式助听器(BAHA)问世以来,主要采用两种不同的外科手术方法植入该植入物:皮瓣技术和线性切口技术。
本回顾性研究的目的是比较这两种不同技术在手术区域及BAHA植入物周围皮肤愈合过程的短期结果(植入后3个月,即皮肤通常的愈合期)。
2004年1月至2008年5月中旬共进行了113例植入手术。2004年1月至2006年12月期间,采用皮瓣技术植入62例;2007年1月至2008年5月中旬,采用线性切口技术植入51例。所有病例均由同一位外科医生完成。
采用皮瓣技术植入的BAHA中有4例因植入物周围皮肤坏死需要对手术区域进行翻修,而采用线性切口技术的仅1例。对于其他病例以及超出正常固定对照范围的情况,采用皮瓣技术的病例有21名患者需要进行25次意外就诊以清理和清除结痂,相比之下,采用线性切口技术的病例有2名患者进行了2次就诊。
本研究清楚地表明,在植入后的前三个月,线性切口技术在统计学上比皮瓣技术出现皮肤问题的风险更低。