Surgeons from North America, Europe, Israel, and Turkey recently gathered in Copenhagen for Oticon Medical’s Scientific Meeting on tissue preservation surgery.
The three-day conference at Oticon Medical’s international headquarters brought together prominent clinicians, researchers, and thought leaders in otology/neurology and audiology to share experiences and exchange knowledge about tissue preservation in bone anchored hearing implant surgery.
|Attendees of the 2013 Oticon Medical Scientific Meeting. (Click to enlarge.)|
The presentations included:
Peter Roland, MD, professor and chair of the Department of Otolaryngology-Head and Neck Surgery at UT Southwestern Medical Center, presented a report on Single-Stage Osseointegrated Hearing Implant Surgery in Children. In his presentation, he compared skin complications after one-stage and two-stage surgery in 65 children and reported that the percentage of skin complications did not change.
Johan Wolfaardt, BDS MDent, director of the Institute of Reconstructive Sciences in Medicine and Professor in the Faculty of Medicine and Dentistry, University of Alberta, Canada, explored skin response after bone conduction implantation. Wolfaardt discussed the need to increase awareness and understanding of the management of skin inflammation in the long term. He called for the establishment of a network where surgeons could come together to explore better ways to describe and define skin reactions that are more accurate than those available in the currently used Holger’s scale.
Cor Cremers, MD, PhD, professor emeritus of ENT-Otology at Radbound University in Nijmegen, The Netherlands, discussed the long-term history and clinical outcomes for the linear incision technique. Cremers presented data on the incidence of soft tissue reactions, implant failures, revision surgery, and implant stability in more than 1,000 patients including children. His colleague, Arjan Bosman, PhD, gave an overview of the experience of Nijmegen, where the first bone anchored implants were performed in the early 1990s, and the evolution of the technology and its application to a variety of indications and hearing losses.
Avi Goldfarb, MD, of the Edith Wolfson Medical Center, Holon, Israel, discussed the benefits of surgery without tissue reduction for bone anchored hearing solutions. In his study, this relatively new approach to bone anchored implant surgery has been shown to be beneficial in terms of reducing peri-implant infections, numbness around the implant, and surgery time.
Shyam Singam, FRCSI, associate specialist ENT surgeon, Torbay Hospital, Devon, UK, discussed a method of bone anchored surgery without soft tissue reduction. Originally offered in a clinical trial to patients with comorbidities that could interfere with surgery and wound healing, the treatment is now offered by Torbay Hospital to all patients who are candidates for bone anchored solutions.
Daniel Coelho, MD, FACS, of the Virginia Commonwealth University School of Medicine, Richmond, talked about “respect for tissue” and shared his work with the Punch Technique, a minimally invasive, tissue sparing technique for percutaneous bone anchored implants. In following up his patients for a period of up to 2 years, he noticed no adverse skin reactions, no need for the use of topical medication or steroids, no implant extrusion, and no delay in the fitting of the sound processor.
Soren Foghsgaard, MD, of Rigshospitalet/Gentofte Department of Otolaryngology – Head & Neck Surgery, presented findings of a 12-month prospective study of the Ponto Wide Implant. The study showed that use of a wider (4.5 mm) implant improves stability of the implant in bone. Dr Foghsgaard explained that the improved stability suggests that it may be possible to load the bone anchored processor sooner than the postoperative timeframe now used.
The conference also included an information session on Ponto implant and abutment design led by Patrik Westerkull, MSc Eng Ph, senior research consultant to Oticon Medical.
There were also a series of roundtable discussions, where there was general agreement that linear incision without skin thinning and tissue reduction has produced the best results in the short follow-up time, including enhanced cosmetics, shorter healing time, and decreased postoperative complications. However, the general consensus was that it was too early to draw conclusions on this new surgical method and long-term studies on more patients are clearly warranted.
SOURCE: Oticon Medical