NW Ear Institute, PC, Portland, Oregon.
Department of Surgery, University of California-San Diego School of Medicine, San Diego, California.
Otol Neurotol. 2019 Jul;40(6):e631-e635. doi: 10.1097/MAO.0000000000002291.
To describe and assess intraoperative and postoperative outcomes in the insertion of osseointegrated auditory implants with a newly designed surgical instrumentation set through a punch type technique.
Retrospective case series.
Patients who underwent bone anchored auditory implant surgery using the Minimally Invasive Ponto Surgery (Oticon Medical, Somerset, NJ) surgical set through a punch technique at nine neurotology tertiary referral based practices were identified. Demographic data, skin thickness at implant site, implant used, duration of surgery, adverse intraoperative events, and postoperative outcomes were recorded.
Seventy-five patients comprised the study cohort (32 males, 43 females). Most patients (57. 3%) were aged 51 to 75 years while 30.7% of the cohort comprised those aged 18 to 50 years and 12% were over 75 years. All but two patients received 4 mm fixtured implants and 68% received the Oticon Medical BioHelix implant. Two patients received 3 mm fixture implants and 32% received the Oticon Medical Wide Ponto implant. Mean surgical time was 12.2 minutes (6-45 min, standard deviation of 6.88 min). In three instances, surgery was converted to a linear incision to control brisk bleeding. Skin condition was Holgers 0 to 1 in 91.8%, while 5.5% had Holgers 2, and 2.7% had Holgers 3 at the first postoperative visit. At second postoperative visit, 94.3% had Holgers 0 to 1, 4.3% had Holgers 2, and 1.4% had Holgers 3. All instances of adverse skin reactions were treated with topical or systemic antibiotics and/or local debridement. There were no instances of implant loss. One patient had his implant traumatically displaced to a 45-degree angle necessitating implant replacement at a second site.
Punch technique placement of osseointegrated auditory implants using the Minimally Invasive Ponto Surgery surgical set represents a safe technique that further simplifies a progressively minimally invasive surgery.
通过经皮打孔技术，描述并评估使用新型手术器械套装植入骨整合听觉植入物的术中及术后结果。
回顾性病例系列。
在 9 个神经耳科三级转诊中心，通过经皮打孔技术，使用微创耳桥手术（Oticon Medical，Somerset，NJ）手术套件对接受骨锚定听觉植入手术的患者进行了识别。记录了人口统计学数据、植入部位的皮肤厚度、植入物使用情况、手术时间、术中不良事件和术后结果。
75 例患者构成了研究队列（32 例男性，43 例女性）。大多数患者（57.3%）年龄在 51 至 75 岁之间，30.7%的患者年龄在 18 至 50 岁之间，12%的患者年龄在 75 岁以上。除了两名患者外，所有患者均植入了 4mm 固定植入物，68%的患者植入了 Oticon Medical BioHelix 植入物，2 名患者植入了 3mm 固定植入物，32%的患者植入了 Oticon Medical Wide Ponto 植入物。平均手术时间为 12.2 分钟（6-45 分钟，标准差为 6.88 分钟）。有 3 例患者手术转为直线切口以控制明显出血。91.8%的患者皮肤状况为 Holgers 0 至 1，5.5%为 Holgers 2，2.7%为 Holgers 3，术后首次就诊时。术后第二次就诊时，94.3%的患者为 Holgers 0 至 1，4.3%的患者为 Holgers 2，1.4%的患者为 Holgers 3。所有不良皮肤反应均采用局部或全身抗生素和/或局部清创治疗。没有植入物丢失的病例。有 1 例患者的植入物因外伤而以 45 度角移位，需要在第二部位更换植入物。
使用微创耳桥手术套件的经皮打孔技术植入骨整合听觉植入物是一种安全的技术，进一步简化了日益微创的手术。
