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. 2018 Jul 23;39(7):882–893. doi: 10.1097/MAO.0000000000001852

TABLE 2.

Outcomes

Outcomes
Primary Outcome MIPS (n = 33) Linear Incision (n = 30) P Value
Holgers index >= 2 at any time from surgery to 12 wk 3 (9.1%) 5 (16.7%) 0.37
Holgers index >= 2 at any time from surgery to 12 wk(Sensitivity analysis, highest observed Holgers index score plus one) 3 (9.1%) 5 (16.7%) 0.37
Holgers index >= 2 at any time from surgery to 12 wk(Sensitivity analysis, all implant losses have experienced Holgers index score of 4) 7 (21.2%) 5 (16.7%) 0.65
Secondary Outcomes MIPS (n = 33) Linear Incision (n = 30) P Value
Wound dehiscence at 9 d 16 (48.5%) 22 (73.3%) 0.078
Extrusion rate 4 (12.1%) 1 (3.3%) 0.19
Loss of skin sensibility (mm)a
 9 d 2.70 (6.13) 0.00(0.0; 25.0) (0.52; 4.87) 13.5 (21.0) 4.5(0.0; 100.0) (5.6; 21.3) 0.0050
 3 wk 0.375 (1.04) 0.0(0.0; 5.0) (0.00; 0.75) 8.23 (17.25) 0.0(0.0; 70.0) (1.79; 14.68) 0.013
 12 wk 0.14 (0.52) 0.0(0.0; 2.0) (0; 0.33) 5.79 (13.75) 0.00(0.00; 60.00) (0.56; 11.02) 0.0076
No loss of sensibility (0 mm)
 9 d 24 (72.7%) 13 (43.3%)
 3 wk 27 (84.4%) 18 (60.0%)
 12 wk 27 (93.1%) 19 (65.5%)
 Soft tissue overgrowth 0 (0.0%) 0 (0.0%) 1.00
 Mean skin level at 12 wk 5.02 (1.42) (4.48; 5.56) 5.08 (1.04) (4.68; 5.47) 0.64
Wound healing
 9 d 7 (21.2%) 5 (16.7%) 0.89
 3 wk 22 (68.8%) 20 (71.4%) 0.82
 12 wk 29 (100.0%) 29 (100.0%) 1.00
Pain scoringsa
Pain around implant
 9 d 1.39 (1.87) 0.00(0.00;6.00) (0.73; 2.06) 1.97 (2.61) 1.00(0.00:8.00) (0.99; 2.94) 0.50
 3 wk 0.938 (1.22) 0.0(0.00;4.00) (0.50; 1.38) 1.0 (1.61) 0.0(0.00;6.00) (0.04; 1.60) 0.67
 12 wk 1.38 (2.23) 0.00(0.00;8.00) (0.53; 2.23) 1.17 (2.04) 0.00(0.00;7.00) (0.40; 1.95) 0.54
Radiating pain
 9 d 0.61 (1.66) 0.0(0.00;7.00) (0.02; 1.19) 0.5 (1.57) 0.0(0.00;8.00) (0.0; 1.09) 0.95
 3 wk 0.56 (1.39) 0.0(0.00;5.00) (0.06; 1.06) 0.43 (1.36) 0.0(0.00;5.00) (0.0; 0.94) 0.39
 12 wk 0.76 (1.86) 0.0(0.00;6.00) (0.05; 1.47) 0.76 (1.8) 0.0(0.00;7.00) (0.04; 1.48) 0.77
Presence of headache
 9 d 0.42 (1.39) 0.0(0.00;7.00) (0.0; 0.92) 1.30 (2.39) 0.00(0.00;8.00) (0.41; 2.19) 0.077
 3 wk 0.375 (1.476) 0.0(0.00;6.00) (0.0; 0.91) 0.30 (1.32) 0.0(0.00;7.00) (0.0; 0.79) 0.96
 12 wk 0.79 (2.1) 0.0(0.00;8.00) (0.00; 1.59) 0.24 (0.83) 0.0(0.00;4.00) (0.08; 0.56) 0.59
Skin sagging at 12 wk
 Quadrant 1 4 (13.8%) 4 (14.3%) 1.00
 Quadrant 2 7 (24.1%) 19 (67.9%) 0.0020
 Quadrant 3 1 (3.4%) 1 (3.6%) 1.00
 Quadrant 4 1 (3.4%) 2 (7.1%) 0.97
 Any quadrant 8 (27.6%) 20 (71.4%) 0.0020
Cosmetic resultsb
Observer scorings
 Natural skin position 2.72 (1.10) (2.31; 3.14) 3.48 (1.38) (2.96; 4.01) 0.025
 Extent of baldness 2.24 (0.79) (1.94; 2.54) 3.62 (1.35) (3.11; 4.13) <0.0001
 Scarring 2.41 (0.95) (2.05; 2.77) 4.48 (1.79) (3.80; 5.16) <0.0001
 Skin colour 3.17 (1.23) (2.71; 3.64) 3.86 (1.27) (3.38; 4.35) 0.020
 Indentation 2.34 (1.01) (1.96; 2.73) 4.00 (1.63) (3.38; 4.62 <0.0001
 Overall cosmetic score 8.45 (0.74) (8.17; 8.73) 7.17 (1.20) (6.72; 7.63) <0.0001
Subject scorings
 Without processor (BAHS) 8.42 (1.47) (7.83; 9.02) 8.61 (1.29) (8.11; 9.11) 0.75
 With processor attached 7.41 (2.58) (6.39; 8.43) 7.89 (1.83) (7.18; 8.60) 0.73
Tertiary Outcome MIPS (n = 29) Linear Incision (n = 29)
Pocket size (normal position) (mm) 0.207 (0.292) (0.096; 0.318) 0.172 (0.251) (0.077; 0.268) NP
Pocket size (maximum) (mm) 0.672 (0.418) (0.513; 0.831) 0.698 (0.440) (0.531; 0.866) NP
Sound processor usage (h per wk) 70.5 (37.2) (56.3; 84.6) 90.3 (25.5) (80.3; 100.4) NP

Categorical variables: n (%). Continuous variables: mean (SD) (95% CI).

aMean (SD), median (min; max) (95% CI of the mean).

bCosmetic rating: observer outcomes (not including overall cosmetic score): 1–10. 1 being no difference with the healthy contralateral site, with 10 being the most negative difference with the healthy situation. Overall cosmetic and subject scorings: 1–10: 10 being the best cosmetic result and 1 being the most negative cosmetic result.

NP indicates not planned; MIPS, minimally invasive ponto surgery; BAHS, bone-anchored hearing systems.