Larsson Anna, Tjellström Anders, Stalfors Joacim
Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Otol Neurotol. 2015 Feb;36(2):336-40. doi: 10.1097/MAO.0000000000000446.
Our knowledge of implant losses for bone-anchored hearing devices (BAHD) is still limited. This study examined the long-term survival rate, the reasons for implant loss, and the need for implant replacement in a large cohort with a long follow-up.
Retrospective study of patients who received a BAHD between January 1977 and December 2011 as identified from records of operations performed. All data were retrieved from patient records.
A total of 571 patients were found in the surgical records. Seven patients were excluded because of incomplete data. The follow-up period was up to 32 years, with a median follow-up of 6.6 years. Implant failures were identified in 46 (8.2%) of the patients. A total of 763 implants were inserted. Of these, 141 (18%) implants were lost: 109 (14%) due to lost osseointegration, 21 (3%) due to trauma, while 11 were electively removed. Twenty-seven patients had 1 implant reinstallation, whereas 5 patients had 2 reinstallations. Nine patients were reinstalled three times and five patients were reinstalled 4 to 6 times. Of 141 implants lost, 78 (55%) were lost in 19 patients with 2 or more implant losses.
CONCLUSION/IMPLICATIONS: Implant failures were identified in 8.2% of the patients with a median follow-up time of 6.6 years. A total of 141 (18%) of 763 implants were lost; the majority of losses took place in patients with multiple implant failures.
我们对骨锚式听力装置(BAHD)植入物丢失情况的了解仍然有限。本研究在一个随访时间长的大型队列中,考察了长期生存率、植入物丢失的原因以及植入物更换的必要性。
对1977年1月至2011年12月期间接受BAHD植入手术的患者进行回顾性研究,所有数据均从患者记录中获取。
手术记录中共找到571例患者。7例因数据不完整被排除。随访时间长达32年,中位随访时间为6.6年。46例(8.2%)患者出现植入物失败。共植入763枚植入物,其中141枚(18%)丢失:109枚(14%)因骨整合失败丢失,21枚(3%)因外伤丢失,11枚为择期取出。27例患者进行了1次植入物重新安装,5例患者进行了2次重新安装。9例患者进行了3次重新安装,5例患者进行了4至6次重新安装。在141枚丢失的植入物中,78枚(55%)在19例有2次或更多次植入物丢失的患者中丢失。
结论/启示:中位随访时间为6.6年的患者中,8.2%出现植入物失败。763枚植入物中共有141枚(18%)丢失;大多数丢失发生在有多次植入物失败的患者中。