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1.
Otol Neurotol ; 45(5): e435-e442, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38728559

RESUMO

OBJECTIVE: This study evaluates the clinical outcomes of 807 percutaneous wide-diameter bone-anchored hearing implants (BAHIs) in 701 patients. In addition, it compares patient groups and examines bone conduction device (BCD) usage. STUDY DESIGN: Retrospective cohort study. Mean follow-up period of 3.8 years. SETTING: Tertiary referral center. PATIENTS: All patients implanted with a percutaneous wide-diameter BAHI until December 2020 were included. Patients were divided into age groups, "loading-time" groups, and, if applicable, specific subgroups thought to be at risk for complications postsurgery, e.g., intellectual disability and comorbidities. MAIN OUTCOME MEASURES: Soft tissue reaction, implant survival, revision surgery, and BCD usage. RESULTS: In 9.1% of the 5,188 observations of 807 implants, an adverse soft tissue reaction was reported according to the Holgers' scale. Significantly more (adverse) soft tissue reactions were observed in children and intellectually disabled (ID) patients (p < 0.05). Comorbidity subgroups showed no significant differences in soft tissue reactions. Implant loss percentage, including explantations, was 6.2%. Implant survival was significantly worse in patients with ID (14.1%; p = 0.021). Pediatric age, early loading, or comorbidities did not significantly influence implant survival. At least 592 implants (73.4%) were used for bone conduction hearing, of which 65.4% were used daily. CONCLUSION: Both children and ID patients are more prone to (adverse) soft tissue reactions, ID patients only have a higher risk of implant loss. The rate of implant loss in children seemed to be reduced compared to previous studies and thus more comparable to adults since using wide-diameter implants.


Assuntos
Condução Óssea , Prótese Ancorada no Osso , Auxiliares de Audição , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Criança , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Idoso , Pré-Escolar , Resultado do Tratamento , Reoperação/estatística & dados numéricos , Seguimentos , Idoso de 80 Anos ou mais , Âncoras de Sutura , Complicações Pós-Operatórias/epidemiologia
5.
Eur Arch Otorhinolaryngol ; 276(4): 1017-1027, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30847547

RESUMO

PURPOSE: Not long after the introduction of osseointegrated implants outside the oral cavity, auricular prostheses are retrained on osseointegrated implants. New insights have been gained with the next-generation percutaneous osseointegrated titanium implants for bone conduction hearing since its introduction in 2010. As a result, the same technology was introduced in the Vistafix® system (VXI implant) to retain auricular prostheses. The aim of this study is to evaluate the surgical procedure, clinical outcome, and satisfaction of the patient of osseointegration-retained auricular prosthesis using VXI implants. MATERIALS AND METHODS: 11 patients who received an auricular prosthesis using VXI implants between December 2012 and November 2017 were evaluated retrospectively. The patient's medical files were reviewed to assess clinical complications and the necessity for revision surgery. The subjective outcome was measured using the Glasgow benefit inventory (GBI). RESULTS: In total, 31 implants were placed in 11 patients. None of these implants were lost nor revision surgery needed. An adverse skin reaction was observed in 13.0% of the implants and in 27.2% of the patients, adequately treated with an antibiotic ointment. The average follow-up time was 2 years and 7 months. The GBI displayed a positive score in every patient. CONCLUSIONS: The VXI implants used are a safe and reliable treatment option for retaining auricular prostheses in patients with an absent auricle. Patients were satisfied with their auricular prosthesis and showed benefit in quality of life. Studies with larger numbers and preferably a prospective character are needed to draw statistically significant conclusions.


Assuntos
Microtia Congênita/cirurgia , Pavilhão Auricular , Deformidades Adquiridas da Orelha/cirurgia , Osseointegração , Complicações Pós-Operatórias , Próteses e Implantes , Implantação de Prótese , Qualidade de Vida , Adulto , Idoso , Condução Óssea , Prótese Ancorada no Osso , Microtia Congênita/epidemiologia , Pavilhão Auricular/patologia , Pavilhão Auricular/cirurgia , Deformidades Adquiridas da Orelha/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Estudos Prospectivos , Desenho de Prótese , Implantação de Prótese/efeitos adversos , Implantação de Prótese/instrumentação , Implantação de Prótese/métodos , Reoperação/métodos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Titânio
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