Illustration of Minimally Invasive Ponto Surgery technique

Punching Through: A Minimally Invasive Revolution in Bone-Anchored Hearing Devices?

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"Discover how a refined surgical technique is improving patient satisfaction and stability in bone-anchored hearing solutions."

For individuals with hearing loss, bone-anchored hearing devices (BAHDs) offer a life-changing solution. Traditionally, the implantation process involved more invasive surgical techniques. However, a revolutionary method known as Minimally Invasive Ponto Surgery (MIPS) is changing the landscape, promising improved outcomes and enhanced patient experiences.

MIPS, first described in 2011 by Hultcrantz et al., utilizes a small 5mm dermal punch to create space for the Ponto abutment, minimizing soft tissue disruption. This approach contrasts sharply with traditional open surgery, which involves greater tissue removal. The key advantages of MIPS include shorter procedure times, better soft tissue preservation, and the potential for faster recovery.

Recognizing the potential benefits of MIPS, clinicians have been keen to adopt this technique. A recent study published in the Journal of Otolaryngology - Head & Neck Surgery explores the long-term stability and patient satisfaction associated with MIPS, providing valuable insights for those considering BAHDs.

MIPS: A Closer Look at Stability and Satisfaction

Illustration of Minimally Invasive Ponto Surgery technique

The study, conducted by Sardiwalla, Jufas, and Morris, followed 12 adult patients who underwent MIPS between 2016 and 2017. The researchers aimed to assess device stability and gather patient feedback on their surgical experience and overall satisfaction. This was achieved through prospective research clinics, implant site assessments, and patient interviews and surveys.

Key aspects of the study included:

Soft Tissue Status: Evaluated using the Inflammation, Pain, Skin Height (IPS) Scale.
Patient Experiences: Assessed via the Surgical Satisfaction Questionnaire (SSQ-8) modified for MIPS.
Device Stability: Monitored through follow-up examinations and patient reports.

The results indicated minimal soft tissue changes, with low average scores on the IPS Scale. Patient experiences were overwhelmingly positive, with speedy recoveries and no long-term complications reported. Importantly, there were zero device losses in the cohort.

The Future of BAHDs: MIPS as the Preferred Approach

This study provides compelling evidence for the long-term stability and patient satisfaction associated with MIPS. The findings suggest that MIPS is not only a safe and effective technique but also offers significant advantages over traditional open surgery.

Clinicians are encouraged to carefully assess and evaluate new developments in patient treatment. As the study demonstrates, MIPS offers a refined approach to BAHD implantation, potentially leading to better patient outcomes and experiences. This is particularly relevant given the increasing demand for less invasive and more patient-centered surgical solutions.

With its proven stability, high patient satisfaction, and minimal complications, MIPS is poised to become the procedure of choice for percutaneous BAHD placement, marking a significant step forward in the treatment of hearing loss.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1186/s40463-018-0316-5, Alternate LINK

Title: Long Term Follow-Up Demonstrating Stability And Patient Satisfaction Of Minimally Invasive Punch Technique For Percutaneous Bone Anchored Hearing Devices

Subject: Otorhinolaryngology

Journal: Journal of Otolaryngology - Head & Neck Surgery

Publisher: Springer Science and Business Media LLC

Authors: Yaeesh Sardiwalla, Nicholas Jufas, David P. Morris

Published: 2018-11-20

Everything You Need To Know

What is Minimally Invasive Ponto Surgery (MIPS), and how does it work?

Minimally Invasive Ponto Surgery, known as MIPS, is a surgical method used to implant bone-anchored hearing devices. It involves using a small 5mm dermal punch to create space for the Ponto abutment, which reduces soft tissue disruption compared to traditional open surgery. This leads to quicker procedure times, better tissue preservation, and potentially faster recovery for patients.

What were the key methods and goals of the Sardiwalla, Jufas, and Morris study?

The study by Sardiwalla, Jufas, and Morris focused on the long-term stability and patient satisfaction associated with Minimally Invasive Ponto Surgery, or MIPS. Researchers monitored soft tissue status using the Inflammation, Pain, Skin Height Scale, patient experiences through the Surgical Satisfaction Questionnaire modified for MIPS, and device stability via follow-up examinations and patient reports. The absence of device loss suggests a robust integration.

What is the Inflammation, Pain, Skin Height Scale (IPS Scale), and how is it used after MIPS?

The Inflammation, Pain, Skin Height Scale, or IPS Scale, is used to evaluate the soft tissue status around the implant site after undergoing Minimally Invasive Ponto Surgery. Low scores on this scale indicate minimal soft tissue changes, suggesting that the surgical technique is gentle and promotes healthy tissue integration. Monitoring inflammation, pain, and skin height helps assess the success of the procedure and patient comfort. This contributes to the high satisfaction that patients have due to quick healing.

How does Minimally Invasive Ponto Surgery (MIPS) compare to traditional surgical methods for bone-anchored hearing devices?

A key benefit of Minimally Invasive Ponto Surgery, or MIPS, over traditional methods is the reduced soft tissue disruption. MIPS uses a small dermal punch, preserving more tissue and resulting in shorter procedure times and faster recovery. Traditional open surgery involves greater tissue removal, which can lead to longer healing times and potentially more complications. MIPS is geared toward better patient outcomes and satisfaction.

What are the long-term implications of the study's findings on Minimally Invasive Ponto Surgery (MIPS) for the future of bone-anchored hearing solutions?

The study indicates that Minimally Invasive Ponto Surgery, or MIPS, has shown great results with long-term device stability and high patient satisfaction. Patients reported speedy recoveries, no long-term complications, and zero device losses. MIPS represents a significant advancement in bone-anchored hearing device implantation. This suggests a shift toward MIPS as the preferred approach in the field of bone-anchored hearing solutions, potentially becoming the standard for future procedures, which will increase access for more patients.