Bone-anchored hearing devices: indications, outcomes, and the linear surgical technique

Bone conduction hearing systems utilize a surgically implanted osseointegrated fixture to create a method for direct transmission of vibration to the skull and cochlea via a bone conduction sound processor. They are indicated for use in persons over the age of 5 with conductive and/or mixed hearing loss and single-sided deafness. Bone anchored hearing devices are considered when use of a conventional air conduction hearing aid is not possible or effective. The operative technique includes two components—subcutaneous tissue reduction to create thin, immobile skin around the abutment, and bone work for fixture placement performed in such a way to maximize the opportunity for osseointegration. The indications, linear incision surgical technique, special considerations in pediatrics, postoperative care, complications and expected outcomes are presented.