Risks and benefits of the modified skin incision for Cochlear™ Osia2 System Implantations (Semicircular over-the-neck incision SCOTNI)

<b>Introduction:</b> The natural progression in the development of surgical approaches for bone conduction implant systems, such as the Cochlear™ Osia<sup></sup>2, involves exploring alternative solutions aimed at ensuring patient safety, improving surgical outcomes, and simplifying procedural techniques.<b>Aim:</b> The aim of this study is to present an alternative surgical access technique for the implantation of the Osia2 system - SCOTNI, along with the benefits and risks associated with the procedure.<b>Materials and methods:</b> The analysis included 14 patients treated using the SCOTNI incision technique between July 2023 and February 2024. The study details the steps of the procedure employing this technique, intraoperative and postoperative outcomes, and characteristics of the patient group.<b>Results:</b> The implantation using the SCOTNI incision technique is associated with a short incision line and convenient exposure of the implantation site. This method allows for intraoperative bone polishing and repositioning of the OSI200 implant. However, in cases of excessive compression by postoperative dressings, there might be a need for system explantation.<b>Conclusions:</b> The SCOTNI technique enables the management of various complications that may arise during surgery while maintaining the full functionality of the system and aesthetic outcomes. Therefore, this technique represents a valuable option, providing better adaptation to individual patient needs without compromising device effectiveness.