The Upside-down Approach With a Lazy-S Incision for Osia Implantation: How I Do It

Background: – Improved surgical techniques for OSIA-bone conduction implant placement are needed to enhance comfort, sound localization, and cosmetic outcomes, especially for patients transitioning from Bone-Anchored Hearing Systems (BAHA). Methods: – A case study at a tertiary center used a novel “upside-down” OSIA 300 implantation with a “lazy-S” incision. The actuator and coil were repositioned closer to the ear canal to improve performance, while the incision reduced skin tension and enhanced cosmesis. Outcomes assessed included surgical complications, patient comfort, and sound localization. Results: – The modified technique achieved implantation without intraoperative or postoperative complications. Patients reported greater comfort, improved sound localization, and favorable cosmetic results. Conclusions: – The “upside-down” OSIA 300 approach with a “lazy-S” incision simplifies surgery and enhances comfort, localization, and cosmetic outcomes, offering benefits for patients converting from BAHA systems.