Editing Bone conduction (section)

===Surgical devices: percutaneous and transcutaneous devices===
A transcutaneous bone conduction device transmits sound signals, either electronic or mechanical, through the skin. In other words, there is closed, intact skin between the external audio processor and the internal implant. The processor is held in place over the implant using [[Magnetism|magnetic attraction]]. Transcutaneous devices currently on the market include the BAHA Attract,<ref>{{Cite web |title=Baha Attract |url=https://ais.southampton.ac.uk/baha-attract/ |access-date=2022-03-02 |website=University of Southampton Auditory Implant Service}}</ref> and Osia<ref>{{Cite press release |title=FDA clears Cochlear's innovative new Osia 2 hearing implant system |url=https://www.prnewswire.com/news-releases/fda-clears-cochlears-innovative-new-osia-2-hearing-implant-system-300970910.html |language=en |access-date=2022-03-02 |archive-url=https://web.archive.org/web/20241119204201/https://www.prnewswire.com/news-releases/fda-clears-cochlears-innovative-new-osia-2-hearing-implant-system-300970910.html |archive-date=2024-11-19 |website=www.prnewswire.com}}</ref> from Cochlear and the BONEBRIDGE from MED-EL.<ref name="Ears and Hearing UK 2022-03-02">{{Cite web |title=Bonebridge, Medel |url=https://earsandhearinguk.com/ear/deafness/treatments-surgical/implants/bone-conduction-devices/hearing-implants-bonebridge/ |url-status=live |archive-url=https://web.archive.org/web/20241119204320/https://earsandhearinguk.com/ear/deafness/treatments-surgical/implants/bone-conduction-devices/hearing-implants-bonebridge/ |archive-date=2024-11-19 |access-date=2022-03-02 |website=Ears & Hearing UK |language=en-GB}}</ref>
With a percutaneous device, part of the implant (known as the abutment) protrudes through the skin. The audio processor then snaps onto the abutment, providing a direct connection to the implant.<ref>{{Cite journal |last1=Håkansson |first1=B. |last2=Tjellström |first2=A. |last3=Carlsson |first3=P. |date=April 1990 |title=Percutaneous vs. transcutaneous transducers for hearing by direct bone conduction |journal=Otolaryngology–Head and Neck Surgery|volume=102 |issue=4 |pages=339–344 |doi=10.1177/019459989010200407 |issn=0194-5998 |pmid=2113260|s2cid=25857058 }}</ref> Percutaneous devices include the BAHA Connect from Cochlear<ref>{{cite web | title=Bone Conduction Hearing Aids |publisher=Johns Hopkins Medicine | date=15 December 2022 | url=https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/baha--the-implantable-hearing-device | archive-url=https://web.archive.org/web/20230418165657/https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/baha--the-implantable-hearing-device | archive-date=18 April 2023 | url-status=live}}</ref> and the Ponto from Oticon Medical.<ref>{{Cite web |title=The Oticon Ponto System|url=https://berkshearing.com/oticon-ponto-system |access-date=2022-03-02 |website=berkshearing.com}}</ref>
Percutaneous devices have been associated with skin complications, ranging from slight redness to the formation of [[granulation tissue]] and recurring infection. The most serious complications might require further surgery or abutment removal and subsequent reimplantation.<ref>{{Cite web |title=Percutaneous Versus Transcutaneous Bone Conduction Implant System: A Feasibility Study on a Cadaver Head |url=https://www.researchgate.net/publication/23233979 |access-date=2022-03-02 |website=ResearchGate |language=en}}</ref> One study into skin problems with percutaneous implants revealed a complication rate of up to 84%.<ref>{{Cite journal |last1=Mohamad |first1=Shwan |last2=Khan |first2=Imran |last3=Hey |first3=S. Y. |last4=Hussain |first4=S. S. Musheer |date=March 2016 |title=A systematic review on skin complications of bone-anchored hearing aids in relation to surgical techniques |journal=European Archives of Oto-rhino-laryngology|volume=273 |issue=3 |pages=559–565 |doi=10.1007/s00405-014-3436-1 |issn=1434-4726 |pmid=25503356|s2cid=10886157 }}</ref> In another study a meta-analysis of complications with osseointegrated hearing aids showed that revision surgery is required in up to 34.5% of cases.<ref>{{Cite journal |last1=Kiringoda |first1=Ruwan |last2=Lustig |first2=Lawrence R. |date=July 2013 |title=A meta-analysis of the complications associated with osseointegrated hearing aids |journal=Otology & Neurotology|volume=34 |issue=5 |pages=790–794 |doi=10.1097/MAO.0b013e318291c651 |issn=1537-4505 |pmid=23739555|s2cid=10274270 }}</ref> Transcutaneous devices were later designed to avoid or reduce recurring skin complications.<ref name="Ellsperman, Susan E. 2021-05-18" />