Implantation of a transcutaneous, bone-anchored, piezoelectric bone conduction hearing aid on the squama temporalis.

Bone-anchored hearing implants, such as the Osia® system (Cochlear Deutschland GmbH, Hanover, Germany), are used to rehabilitate conductive hearing loss, mixed hearing loss, and single-sided deafness. The surgical technique presented anchors the OSI300 supraauricularly and subperiosteally over the squama temporalis, thereby avoiding the creation of an implant bed in the mastoid and reducing cosmetic contour deformity. Cranial-parietotemporal placement allows bypassing absent or previously operated bone mastoid structures. Postoperatively, the implant was proved to be stable and inconspicuous, with a significant improvement in hearing outcomes. In selected cases, this technique represents a functional and esthetic alternative to standard implant placement, particularly in patients with a history of multiple temporal bone surgeries.