LETTER TO THE EDITOR CONCERNING: "HEARING DEVICE COIL PLACEMENT LATERAL TO THE TEMPORALIS: AN ALTERNATIVE TO FLAP THINNING FOR COCHLEAR AND TRANSCUTANEOUS BONE-ANCHORED IMPLANTS".

OpenAlex İngilizce

Dear Editor I read with great interest the recent video report published in Otology & Neurotology titled: “Hearing Device Coil Placement Lateral to the Temporalis: An Alternative to Flap Thinning for Cochlear and Transcutaneous Bone-Anchored Implants” (1). This innovative approach to addressing challenges posed by excessive scalp thickness aligns closely with our own findings and surgical techniques, published previously in the following study: “Temporal Scalp Thickness, Body Mass Index, and Suprafascial Placement of Receiver Coil of the Cochlear Implant” (2). In our study, we demonstrated the relationship between temporal scalp thickness and variables such as body mass index (BMI), age, and gender, and proposed a suprafascial placement technique over the temporal muscle as a solution for patients with thick scalp tissue (≥7 mm), avoiding the need for surgical thinning of vulnerable subcutaneous tissue (2). Our findings revealed that male patients and those with higher BMI levels tend to have significantly thicker scalp tissues, emphasizing the importance of tailored surgical approaches. Similar to Nassiri et al., we aimed to minimize complications such as skin necrosis and device extrusion by reducing the distance between the external processor and internal components through suggested alternative placement techniques. Nassiri et al.’s use of a lateral subcutaneous pocket for hearing device coil placement complements our findings by offering an additional method to optimize outcomes for patients with excessive scalp thickness (1). We are happy to see other surgeons on the other side of the earth suggesting the same solution for too thick soft tissue, and corroborating our results. Our comprehensive evaluation and surgical solution have been noticed and cited by 18 scientific papers till now. We believe that incorporating our study into their discussion could provide a broader perspective on the significance of scalp thickness in surgical planning and its relationship with patient demographics and outcomes. Specifically, our work provides detailed evidence on how BMI and other factors influence scalp thickness and how suprafacial placement technique can mitigate associated risks. Thank you for considering our comments. We commend the authors for their valuable contribution to this field and hope this exchange fosters further advancements in cochlear and bone-anchored implant surgery. Sincerely, Orhan OzturanAlper YenigunRamazan Bahadir KucukErol SenturkSabri Baki ErenFadlullah Aksoy Bezmialem Vakif University Faculty of Medicine Department of Otorhinolaryngology Fatih, Istanbul Turkey [email protected]