European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 2, pp 349–356 | Cite as

Wide diameter bone-anchored hearing system implants: a comparison of long-term follow-up data between tissue reduction and tissue preservation techniques

  • Martin ReznitskyEmail author
  • Kirsten Wielandt
  • Søren Foghsgaard



To present long-term data on the Wide Ponto implant bone-anchored hearing system (BAHS) in regards to implant stability, soft tissue reaction and implant loss for two case series undergone either the tissue reduction- or the tissue preservation surgical technique.


Comparison of two consecutive, prospective case series. Each case series enrolled 24 patients. The case series underwent one-stage implantation of the Wide Ponto implant BAHS using either a linear incision technique with subcutaneous reduction or a linear incision technique without subcutaneous reduction. Implant stability quotient (ISQ) values were measured using resonance frequency analysis and soft tissue reactions were graded according to Holgers’ classification system. Follow-up visits were performed at 10 days, 6 weeks, 6 months, 12 months and annually up to 4 years (tissue preservation) or 5 years (tissue reduction) postoperatively.


The two case series had homogenous patient populations and followed an identical postoperative scheme. The ISQ values increased consistently the first 12 months for both groups (p ≤ 0.001), and were higher in the tissue preservation case series, (p = 0.04, 9 mm abutment). More than 91% of the soft tissue observations were assessed as Holgers’ grade 0 or 1. One implant (2.1%) was lost due to trauma.


In both case series, the Wide Ponto implant showed increasing implant stability during the follow-up period from the time of surgery, irrespective of surgical technique, indicating good osseointegration. Soft tissue reactions were rare and of minor severity. Implant survival was high.


Bone-anchored hearing systems Wide implant Osseointegration Implant stability quotient Soft tissue and skin reaction Tissue reduction/preservation surgery 



The authors would like to thank our colleagues Dr. Martin Nue Møller and Prof. Per Cayé-Thomasen and all the nurses and secretaries in the outpatient clinic at the Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, who participated and contributed with their help during all phases of the study. A sincere thank you to Sofia Jonhede and Sara Svensson from Oticon Medical for assisting in the statistical analysis.


The authors received no funding.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyRigshospitalet, Copenhagen University HospitalCopenhagenDenmark
  2. 2.Department of Ear, Nose, Throat and Maxillofacial SurgeryZealand University HospitalKøgeDenmark

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