Learning Objectives: Transcutaneous bone conduction implants produce less soft tissue complications. Interim results show high patient satisfaction. Percutaneous devices can be converted to transcutaneous devices.

Introduction: Many soft tissue problems in bone anchored hearing solutions are related to their percutaneous nature. Tissue preservation and non skin penetration techniques help address these issues.

Methods: Prospective longitudinal study of 80 consecutive BAHA Attract patients (Sept 2013 and Feb 2016.) Data included indications, audiology, incision, surgery, skin thickness, fixture and postoperative follow up (including audiological , soft tissue, magnet types and usage).

Results: Total 80 patients implanted. Age range 4 – 86yrs. Male : Female ratio 47:33. Fifty six were adults and 24 paediatric. Indications were Conductive deafness (56%), Mixed hearing loss (16%) and Single Sided Sensorineural loss (28%). 22% were conversions from percutaneous devices. 10% cases were performed under local anaesthesia only. The incision in all cases was inferiorly facing “C”. Average surgical time 40 min. All had 4 mm fixtures. Average skin thickness at midpoint was 6.2 mm for adults and 4 mm for children. Minimal post operative nursing care was required as the wound healed neatly by 1 week without hair loss and minimal surrounding numbness. No wound complications reported. Four (5%) reported pain after a month but settled conservatively. Two (2.6%) reported surrounding oedema after prolonged continuous use. One reported skin tenderness. Majority loaded with processors at 6 weeks. Commonest magnet strength 4 (range 2 to 5). 89% reported good to excellent device retention. Majority were fitted with the BAHA 4 or BAHA 5 processors. Few had BP110. All patients reported good to very good sound quality with average use of 6hrs /day.

Conclusion: The interim experience with the transcutaneous BAHA Attract system is positive with negligible post operative care requirement.