Modified Baha Punch Technique: Least Invasive, Shortest Time and No Suturing.

To describe a new Baha surgical procedure (Modified Punch Technique) with a smaller punch hole, a minimal incision and the use of the hydroxyapatite-coated abutment (BIA400). Retrospective chart review. Patients were implanted between 2012 and 2013 at King Abdulaziz University Hospital (Kingdom of Saudi Arabia). Eligible for initial or replacement bone-anchored hearing system; includes six patients (four adults, two children). Baha surgery using the Punch Method is described. The mean surgical time was 12.33 min (range 6-30), without the single outlier, it was 8.8 min. Bleeding was significant but easily controlled in two patients only. Depending on the postauricular subcutaneous thickness, the sizes of abutment used were 6, 8, 10 or 12 mm. None of the patients experienced severe pain. The postoperative follow-up period was 7 months for one patient, 5 months for three patients, and 3 months for two patients. First report of combined Modified Punch Technique with the BIA400 abutment is minimally invasive, reduces surgical time and results in faster healing and reduced likelihood of postoperative numbness.