Background
Increasingly, bone conduction ‘osseointegrated’ titanium implants coupled with implantable magnets are being offered to suitable patients. The established procedure of implantation of these devices involves a semicircular incision behind the ear followed by raising of a flap of soft tissue. Here, we describe a simplified incision that has been used in >30 patients with no associated complications.
Technique
The incision site is marked in a conventional manner (Fig 1). An oblique line to mark the incision is drawn through the centre of the marked circle. After measuring skin thickness, a linear incision is made down to the periosteum and the wound undermined. An implant template is placed (Fig 2). Any bony prominences that have been palpated are used as the implant site. The implant is placed in a conventional manner followed by the bone bed indicator (Fig 3) then the implant magnet (Fig 4). The magnet is secured and the wound closed (Fig 5).
Figure 1.
Marking of the incision site
Figure 2.
Placement of an implant template
Figure 3.
The implant is placed in a conventional manner followed by the bone bed indicator
Figure 4.
Placement of the implant magnet
Figure 5.
The wound is closed
Discussion
The technique described here has three advantages over the conventional technique: (i) improved cosmetic effect (thanks to avoidance of the abnormal hair growth that occurs along the line of the semicircular incision); (ii) easier skin thinning (Fig 6); (iii) shorter operative time.
Figure 6.
Skin thinning