{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:15:08Z","timestamp":1784693708036,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Bone conduction implants can be used in the treatment of conductive or mixed hearing loss. The BONEBRIDGE bone conduction implant (BB-BCI) is an active, transcutaneous device. BB-BCI implantation can be performed through either the transmastoid or retrosigmoid approach with their respective limitations. Here, we present a third, novel approach for BB-BCI implantation. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p> Describe the detailed surgical technique of BB-BCI implantation through a middle fossa approach with self-drilling screws and present preliminary audiometric outcome data following this approach. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> A single institution, retrospective chart review was completed for patients implanted with the BB-BCI via the middle fossa approach. Preoperative planning and modelling were performed using 3D Slicer. Audiological testing was performed pre- and post-operatively following standard audiometric techniques. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Forty patients underwent BB-BCI implantation using the middle fossa approach. Modelling techniques allowed for implantation through the use of external landmarks, obviating the need for intraoperative image guidance. The surgical technique was refined over time through experience and adaptation. Mean follow-up was 29\u2009months (range 3\u201371\u2009months) with no surgical complications, favourable cosmesis, and expected audiometric outcomes. An average functional gain of 39.6\u2009dB (\u00b1 14.7 SD) was found. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> The middle fossa technique with self-drilling screws is a safe and effective option for BONEBRIDGE implantation. As a reference for other groups considering this approach, an annotated video has been included as a supplement to the study. <\/jats:p><\/jats:sec>","DOI":"10.1186\/s40463-019-0354-7","type":"journal-article","created":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T13:03:03Z","timestamp":1564405383000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["The middle fossa approach with self-drilling screws: A novel technique for BONEBRIDGE implantation"],"prefix":"10.1177","volume":"48","author":[{"given":"Peng","family":"You","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren H.","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Kassam","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Schulich School of Medicine & Dentistry, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hebb","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorne","family":"Parnes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanif M.","family":"Ladak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada"},{"name":"Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Canada"},{"name":"Department of Electrical & Computer Engineering, Faculty of Engineering, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1309-3838","authenticated-orcid":false,"given":"Sumit Kishore","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada"},{"name":"University Hospital, Room B1-333, London Health Sciences Centre \u2013 University Hospital, 339 Windermere Road, N6A 5A5, London, Ontario, Canada"},{"name":"Department of Electrical & Computer Engineering, Faculty of Engineering, Western University, London, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,1]]},"reference":[{"key":"bibr1-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20164"},{"key":"bibr2-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-014-3403-x"},{"key":"bibr3-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1177\/0003489405114S1201"},{"key":"bibr4-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318291c651"},{"key":"bibr5-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2013.11.010"},{"key":"bibr6-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.2147\/MDER.S39691"},{"key":"bibr7-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001010"},{"key":"bibr8-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814529925"},{"key":"bibr9-s40463-019-0354-7","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12484"},{"key":"bibr10-s40463-019-0354-7","unstructured":"LHSC. LHSC first in North America to perform BONEBRIDGE bone conduction implant: London Health Science Centre Media Release; 2013. Available from: http:\/\/www.lhsc.on.ca\/About_Us\/LHSC\/Publications\/Homepage\/Bonebridge.htm. [cited 2018 Oct 1]"},{"issue":"4","key":"bibr11-s40463-019-0354-7","first-page":"343","volume":"19","author":"Zernotti ME","year":"2014","journal-title":"Int Arch Otorhinolaryngol"},{"key":"bibr12-s40463-019-0354-7","unstructured":"Food and Drug Administration BONEBRIDGE FDA De Novo summary documents 2018 Available from: https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf17\/DEN170009.pdf. [cited 2018 Oct 5]"},{"key":"bibr13-s40463-019-0354-7","unstructured":"MED-EL. BONEBRIDGE Information for Surgeons (with BCI Lifts): VIBRANT MED-EL Hearing Technology GmbH; 2013. p. 14\u201324. 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