Department of Otolaryngology, Ochsner Health Louisiana State University Shreveport, Shreveport, Louisiana.
Otol Neurotol. 2021 Aug 1;42(7):1044-1050. doi: 10.1097/MAO.0000000000003157.
Compare outcomes of surgical techniques in percutaneous bone-anchored hearing implant surgery.
Matched retrospective cohort study.
Tertiary referral center.
Electronic review of adult and pediatric patients who underwent bone conduction device surgery by either the Minimally-invasive Ponto Surgery (MIPS) technique or the linear incision with no soft tissue removal (LnSTR) technique or between August 2015 and April 2018 at our facility.
Patients in MIPS group underwent Minimally invasive Ponto Surgery (MIPS) technique, while those in LnSTR group underwent LnSTR technique.
Major outcome was presence/severity of localized skin reaction. Secondary outcomes included cosmetic outcome, revision surgery, minor adverse events, device utilization, and postoperative aided speech recognition thresholds (SRTs) across 250 to 4000 Hertz (Hz).
Fifty patients met inclusion criteria. There was a significantly lower rate of localized cutaneous reactions for the MIPS group (4.5%) compared with LnSTR group (33.3%; p = 0.026). Rate of revision surgery was significantly less for MIPS (13.6%) compared with LnSTR (20.8%; p = 0.008). Occurrence of poor cosmetic outcome was noted significantly less for the MIPS group (9.1%) compared with LnSTR patients (20.8%; p = 0.005). Minor adverse events and aided SRTs were comparable between groups.
MIPS leads to a statistically significant decrease in localized cutaneous reaction compared with LnSTR. Both the LnSTR and MIPS techniques are safe and effective in the treatment of hearing loss, however MIPS may be superior in certain cases by offering improved healing, decreasing needs for wound care, and possibly decreasing need for frequent follow up.
比较经皮骨锚定式听力植入手术中不同手术技术的效果。
配对回顾性队列研究。
三级转诊中心。
回顾性分析 2015 年 8 月至 2018 年 4 月在我院接受骨导设备手术的成年和儿童患者，手术采用微创桥小脑角手术（MIPS）技术或无软组织切除直线切口（LnSTR）技术。
MIPS 组患者采用微创桥小脑角手术（MIPS）技术，LnSTR 组患者采用 LnSTR 技术。
主要观察指标为局部皮肤反应的发生/严重程度。次要观察指标包括美容效果、翻修手术、轻微不良事件、设备使用率和术后 250-4000 赫兹（Hz）助听听阈。
50 例患者符合纳入标准。MIPS 组的局部皮肤反应发生率明显低于 LnSTR 组（4.5% vs 33.3%；p=0.026）。MIPS 组的翻修手术率明显低于 LnSTR 组（13.6% vs 20.8%；p=0.008）。MIPS 组不良美容效果的发生率明显低于 LnSTR 组（9.1% vs 20.8%；p=0.005）。两组的轻微不良事件和助听听阈相似。
与 LnSTR 相比，MIPS 可显著降低局部皮肤反应。LnSTR 和 MIPS 技术在治疗听力损失方面均安全有效，但 MIPS 可能在某些情况下更具优势，因为它可以改善愈合，减少对伤口护理的需求，并可能减少频繁随访的需求。
