Teunissen Emma, Caspers Coosje, Kruyt Ivo, Mylanus Emmanuel, Hol Myrthe
Department of Otorhinolaryngology-Head and Neck Surgery, Donders Center for Neuroscience, Radboud University Medical Center, Radboud University, Nijmegen, the Netherlands.
Otol Neurotol. 2025 Feb 1;46(2):161-169. doi: 10.1097/MAO.0000000000004398.
To compare the 3-year outcomes of the modified minimally invasive Ponto surgery (m-MIPS) to both the original MIPS (o-MIPS) and linear incision technique with soft tissue preservation (LIT-TP) for inserting bone-anchored hearing implants (BAHIs).
Prospective study with three patient groups: m-MIPS, o-MIPS, and LIT-TP.
Tertiary referral center.
In the m-MIPS group, 24 patients with 25 implants were enrolled. The o-MIPS and LIT-TP groups included 25 patients (25 implants) each.
The patients underwent BAHI surgery using m-MIPS, o-MIPS, or LIT-TP.
Implant survival and implant stability were compared between all groups. Soft tissue status, skin sensibility, subjective numbness, and hearing-related quality of life (HRQoL) were compared between m-MIPS and LIT-TP and o-MIPS and LIT-TP, respectively.
Implant survival was comparable between m-MIPS and LIT-TP (96 versus 100%), with o-MIPS showing nonsignificant lower survival (88%). Both MIPS groups exhibited fewer (adverse) skin reactions, better skin sensibility, and less subjective numbness than LIT-TP throughout visits. At 3 years, soft tissue status, sensibility, and numbness were comparable between groups. Device use was consistent among groups (83-86% daily users). All groups demonstrated significant improvement in HRQoL post-surgery based on GBI, GHSI, and APHAB total scores.
Compared with LIT-TP, m-MIPS showed comparable long-term implant survival, fewer (adverse) skin reactions, and earlier sensibility and numbness recovery. M-MIPS resulted in favorable clinical and QoL outcomes with low intra- and postoperative complication rates until 3 years after surgery. It is therefore considered a safe technique for BAHI insertion. Moreover, with a shorter surgery time and the ability to operate under local anesthesia in a controlled outpatient setting, m-MIPS appears to be a more efficient alternative to LIT-TP.
比较改良微创骨桥手术（m-MIPS）与原始骨桥手术（o-MIPS）以及保留软组织的线性切口技术（LIT-TP）在植入骨锚式听力植入物（BAHI）方面的3年效果。
对三个患者组进行前瞻性研究：m-MIPS组、o-MIPS组和LIT-TP组。
三级转诊中心。
m-MIPS组纳入了24例患者，共植入25枚植入物。o-MIPS组和LIT-TP组各包括25例患者（25枚植入物）。
患者接受使用m-MIPS、o-MIPS或LIT-TP的BAHI手术。
比较所有组之间的植入物存活率和植入物稳定性。分别比较m-MIPS与LIT-TP组以及o-MIPS与LIT-TP组之间的软组织状况、皮肤感觉、主观麻木感和听力相关生活质量（HRQoL）。
m-MIPS组与LIT-TP组的植入物存活率相当（分别为96%和100%），o-MIPS组的存活率略低但无显著差异（88%）。在整个随访过程中，与LIT-TP组相比，两个MIPS组的皮肤反应（不良）更少、皮肤感觉更好且主观麻木感更少。3年后，各组之间的软组织状况、感觉和麻木感相当。各组之间的设备使用情况一致（每日使用者占83-86%）。根据GBI、GHSI和APHAB总分，所有组在术后的HRQoL均有显著改善。
与LIT-TP相比，m-MIPS显示出相当的长期植入物存活率、更少的（不良）皮肤反应以及更早的感觉和麻木感恢复。m-MIPS在术后3年内产生了良好的临床和生活质量结果，术中及术后并发症发生率低。因此，它被认为是一种安全的BAHI植入技术。此外，m-MIPS手术时间更短，能够在可控的门诊环境中进行局部麻醉下的手术，似乎是LIT-TP更有效的替代方法。
