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用于骨传导听力植入物的羟基磷灰石涂层皮肤穿透式基台能否与周围皮肤整合？

Can the Hydroxyapatite-Coated Skin-Penetrating Abutment for Bone Conduction Hearing Implants Integrate with the Surrounding Skin?

作者信息

van Hoof Marc, Wigren Stina, Duimel Hans, Savelkoul Paul H M, Flynn Mark, Stokroos Robert Jan

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center , Maastricht , Netherlands.

Cochlear Bone Anchored Solutions AB , Mölnlycke , Sweden.

出版信息

Front Surg. 2015 Sep 14;2:45. doi: 10.3389/fsurg.2015.00045. eCollection 2015.

DOI:10.3389/fsurg.2015.00045
PMID:26442276
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4568398/
Abstract

INTRODUCTION

Percutaneous implants, such as bone conduction hearing implants, suffer from complications that include inflammation of the surrounding skin. A sealed skin-abutment interface can prevent the ingress of bacteria, which should reduce the occurrence of peri-abutment dermatitis. It was hypothesized that a hydroxyapatite (HA)-coated abutment in conjunction with soft tissue preservation surgery should enable integration with the adjacent skin. Previous research has confirmed that integration is never achieved with as-machined titanium abutments. Here, we investigate, in vivo, if skin integration is achievable in patients using a HA-coated abutment.

MATERIALS AND METHODS

One titanium abutment (control) and one HA-coated abutment (case) together with the surrounding skin were surgically retrieved from two patients who had a medical indication for this procedure. Histological sections of the skin were investigated using light microscopy. The abutment was qualitatively analyzed using scanning electron microscopy.

RESULTS

The titanium abutment only had a partial and thin layer of attached amorphous biological material. The HA-coated abutment was almost fully covered by a pronounced thick layer of organized skin, composed of different interconnected structural layers.

CONCLUSION

Proof-of-principle evidence that the HA-coated abutment can achieve integration with the surrounding skin was presented for the first time.

摘要

引言

经皮植入物，如骨传导听力植入物，会出现包括周围皮肤炎症在内的并发症。密封的皮肤-基台界面可以防止细菌侵入，这应该会减少基台周围皮炎的发生。据推测，羟基磷灰石（HA）涂层基台结合软组织保留手术应能与相邻皮肤实现整合。先前的研究已证实，机械加工的钛基台无法实现整合。在此，我们在体内研究使用HA涂层基台的患者是否能够实现皮肤整合。

材料与方法

从两名有此手术医学指征的患者身上手术取出一个钛基台（对照）和一个HA涂层基台（病例）以及周围皮肤。使用光学显微镜对皮肤的组织学切片进行研究。使用扫描电子显微镜对基台进行定性分析。

结果

钛基台仅附着有一层部分且薄的无定形生物材料。HA涂层基台几乎完全被一层明显较厚的由不同相互连接结构层组成的有组织皮肤覆盖。

结论

首次提出了HA涂层基台可与周围皮肤实现整合的原理性证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/6ef0ca874d94/fsurg-02-00045-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/412763136eae/fsurg-02-00045-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/691e1bf36145/fsurg-02-00045-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/aa8a141634d5/fsurg-02-00045-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/6ef0ca874d94/fsurg-02-00045-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/412763136eae/fsurg-02-00045-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/691e1bf36145/fsurg-02-00045-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/aa8a141634d5/fsurg-02-00045-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3249/4568398/6ef0ca874d94/fsurg-02-00045-g004.jpg

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