Federspil P A, Koch A, Schneider M H, Zaoui K
Univ.-Hals-Nasen-Ohren-Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland,
HNO. 2014 Jul;62(7):490-7. doi: 10.1007/s00106-014-2882-9.
By virtue of direct bone conduction, percutaneous bone-anchored hearing implants offer a high level of wearing comfort, as well as audiologically superior signal transmission due to less dampening. Over the years, titanium implants have been optimized and the surgical technique developed into a minimally invasive intervention without soft tissue reduction. This study aims to investigate the success rates of the various percutaneous implant systems.
This retrospective study includes 191 patients who received a total of 283 percutaneous titanium implants for bone conduction hearing systems during the period from 01.01.1989 until 31.12.2013. Patient age ranged from 2 to 81 years (mean 36 years). The mean follow-up duration was 5.2 years.
The overall osseointegration success rate was 92.6% and ranged from 90.5 to 100% for the various implant systems (p = 0.6). For children and adolescents, the success rate was 86.8%, compared to 95.2% in adults (p = 0.023). Classical soft tissue reduction was received by 185 patients, mainly via the dermatome technique. The linear incision technique was used in 3.8% of cases and the technique without soft tissue reduction in 3.7% of cases. Revision surgery for soft tissue problems was performed in 4.2% of cases.
Success rates in adults were significantly higher than those in children and adolescents. Although success rates improved with the development of new systems, this did not reach statistical significance. Minimally invasive surgery without soft tissue reduction is considered state of the art.
经皮骨锚式听力植入物借助直接骨传导，佩戴舒适度高，且因阻尼较小，在听觉信号传输方面具有优势。多年来，钛植入物不断优化，手术技术发展为一种无需减少软组织的微创干预。本研究旨在调查各种经皮植入系统的成功率。
这项回顾性研究纳入了191例患者，他们在1989年1月1日至2013年12月31日期间共接受了283枚用于骨传导听力系统的经皮钛植入物。患者年龄从2岁至81岁不等（平均36岁）。平均随访时间为5.2年。
总体骨整合成功率为92.6%，各种植入系统的成功率在90.5%至100%之间（p = 0.6）。儿童和青少年的成功率为86.8%，而成人的成功率为95.2%（p = 0.023）。185例患者接受了经典的软组织减少手术，主要通过植皮技术。3.8%的病例采用了线性切口技术，3.7%的病例采用了无软组织减少技术。4.2%的病例因软组织问题进行了翻修手术。
成人的成功率显著高于儿童和青少年。尽管随着新系统的发展成功率有所提高，但未达到统计学意义。无需减少软组织的微创手术被认为是目前的先进技术。
