Leone Andrea Caruso, Castilho Arthur Menino, Danieli Fabiana, Calil Daniela Bortoloti, Almeida Katia de
Postgraduate Program in Human Communication Health, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
Department of Otorhinolaryngology, Head and Neck Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Int Arch Otorhinolaryngol. 2025 Jan 27;29(1):1-7. doi: 10.1055/s-0044-1788910. eCollection 2025 Jan.
Minimally invasive Ponto surgery (MIPS) enables the installation of percutaneous bone-anchored hearing implants (BAHIs) with a drill guide through a hole punch incision. Despite being well established for adults, there is a lack of studies in the literature regarding its use in pediatric patients. The aim of the present study was to investigate the hearing performance and soft-tissue outcomes of the use of MIPS under local anesthesia in children with unilateral craniofacial malformation (UCM). The study used a retrospective cohort design. Nine subjects with UCM, aged between 6.5 and 17.1 (median = 12) years, who underwent the MIPS procedure under local anesthesia were included. Surgical procedure, intra, and postoperative complications were investigated. Speech recognition thresholds in quiet (SRTQ) and in noise (SRTN), daily use, satisfaction, and perceptual listening effort of the subjects were assessed after 4 months of postoperative follow-up. It was possible to perform MIPS under local anesthesia in 8 of 9 subjects, with no intraoperative complications. One subject (11.11%) showed adverse skin reactions during a mean follow-up period of 11.4 months with MIPS. Speech recognition thresholds in quiet, SRTN, and subjective listening effort scores significantly decreased with the use of BAHI. The subjects were overall satisfied with the device and using it 8.2 hours/day, on average. Under local anesthesia, MIPS showed to be a viable option for BAHI installation in children with UCM. The hearing performance of the subjects improved, and they were globally satisfied with the device. Soft-tissue complications were minimal, and our results are comparable to those reported in the literature for adults.
微创乳突手术（MIPS）可通过打孔切口，借助钻孔导向器植入经皮骨锚式听力植入物（BAHI）。尽管该手术在成人中已广泛应用，但关于其在儿科患者中的应用，文献中缺乏相关研究。
本研究的目的是调查在局部麻醉下，对单侧颅面畸形（UCM）儿童使用MIPS的听力表现和软组织结果。
本研究采用回顾性队列设计。纳入了9名年龄在6.5至17.1岁（中位数 = 12岁）之间、接受局部麻醉下MIPS手术的UCM患者。对手术过程、术中及术后并发症进行了调查。术后4个月随访后，评估了受试者的安静环境下言语识别阈值（SRTQ）、噪声环境下言语识别阈值（SRTN）、日常使用情况、满意度和感知聆听努力程度。
9名受试者中有8名能够在局部麻醉下进行MIPS手术，且无术中并发症。1名受试者（11.11%）在MIPS术后平均11.4个月的随访期内出现了皮肤不良反应。使用BAHI后，安静环境下言语识别阈值、SRTN和主观聆听努力得分均显著降低。受试者总体对该设备满意，平均每天使用8.2小时。
在局部麻醉下，MIPS对于UCM儿童植入BAHI是一种可行的选择。受试者的听力表现得到改善，他们对该设备总体满意。软组织并发症极少，我们的结果与文献中报道的成人结果相当。
