Surgical implantation of the Sophono transcutaneous bone conduction system

Bone conduction implantable devices are an effective means of rehabilitation for ipsilateral conductive hearing loss and in a contralateral routing of signal (CROS) configuration for single-sided deafness. Percutaneous systems provide excellent sound quality but suffer from the complications of recurrent infection, skin overgrowth, and cosmetic concerns. The Sophono transcutaneous bone conduction system uses an internal retention magnet to hold an external force plate and sound processor to the scalp, allowing for transcutaneous bone conduction and stimulation of the cochlea. Implantation consists of a simple incision, drilling a shallow recess for the bilobed magnet in the cranium, and securing of the implant with standard plating screws. Surgical considerations such as placement, flush positioning to the bone, and maintaining or augmenting overlying tissue thickness are important to ensuring postactivation wearability. Fitting considerations such as time to fitting, magnet strength determination, and graduated wearing schedules are also critical to patient outcomes.