Minimal access surgery for implantable bone conduction systems: early experience with the "Sheffield" incision.

INTRODUCTION

To compare the results of the "Sheffield" incision technique for implantable temporal bone conduction systems against the previous inferiorly based flap technique.

MATERIALS AND METHODS

Bone-Anchored Hearing Aid surgery performed over a 2-year period using the new incision (32 patients) was monitored prospectively. A short "lazy S" incision, within the hairline was used followed by soft tissue reduction and implantation. Age range was 6 to 76 years. Average follow-up was 6 months. The results in this group were compared with those of a similar group (20 patients) where the inferiorly based flap was used.

RESULTS

The "Sheffield" incision produced more aesthetically pleasing flaps, and patient satisfaction was high. There were no major complications like flap necrosis or fixture loss (against 25% flap necrosis in the flap technique). One patient had a wound hematoma and subsequent wound dehiscence, which needed clearing and closure under anesthetic. Minor complications included granulations in 4 (13%) at the lower edges of the incision (55% in the flap technique), skin redness in 3 (9%) of Holgers Grade 2, and small wound dehiscence in 3 (3%), all of which settled conservatively.

DISCUSSION

The results of the "Sheffield" incision compare well with other similar case series and with our own results from using the alternative inferior flap technique. In addition, it offers simplicity, speed, and aesthetically pleasing results with minimal postoperative management.