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新型激光烧蚀钛种植体系统在儿童群体中用于骨锚定听力系统的临床评估,以及共振频率分析与种植体存活率的关系。

Clinical Evaluation of a Novel Laser-Ablated Titanium Implant System for Bone Anchored Hearing Systems in a Pediatric Population and the Relationship of Resonance Frequency Analysis With Implant Survival.

机构信息

Birmingham Children's Hospital, Steelhouse Ln, Birmingham, UK.

Oticon Medical AB, Askim.

出版信息

Otol Neurotol. 2022 Feb 1;43(2):219-226. doi: 10.1097/MAO.0000000000003435.

Abstract

OBJECTIVE

To evaluate the clinical outcomes of pediatric patients implanted a novel 4.5 mm wide laser ablated titanium bone anchored implant system and to evaluate the implant stability over the first 12-month period.

STUDY DESIGN

A prospective, single-subject, repeated measure, cohort study. Participants served as their own controls.

SETTING

Community and tertiary referral hospital pediatric assessment center.

PATIENTS

A total of 115 consecutive pediatric patients aged 4 to 15 years were implanted with 176 laser ablated titanium bone anchored implants from January 2016 to January 2019.

MAIN OUTCOME MEASURE

Clinical outcomes, implant failure rates, and post implantation implant stability quotient (ISQ) scores were studied over the first 12-month period. Data were analyzed for statistical significance through mixed effect modeling, with the significance level p = 0.01.

RESULTS

A median 12-month survival of 96.6% was observed. Six implants (3.5%) were lost in total, one of these (0.6%) was lost due to trauma. Adverse skin reactions (Holgers grade 2-4) were observed in 4.4% of all postoperative visits, occurring in 22 individuals (19.1%). Neither the ISQ high (ISQH) nor ISQ low (ISQL) values increased significantly between the stage 1 and 2 surgeries. In contrast, the ISQ results, irrespective of abutment size, demonstrated an increasing trend from 49.1 to 57 over the 12 months review period. A statistically significant change was only demonstrated from the 3 months follow up onwards.

CONCLUSION

The use of 4.5 mm wide laser-ablated titanium bone anchored hearing implants resulted in superior survival rates and excellent clinical outcomes compared with previous implant systems.

摘要

目的

评估植入新型 4.5mm 宽激光消融钛骨锚固植入物系统的儿科患者的临床结果,并评估植入物在最初 12 个月期间的稳定性。

研究设计

前瞻性、单受试者、重复测量、队列研究。参与者作为自己的对照。

设置

社区和三级转诊医院儿科评估中心。

患者

2016 年 1 月至 2019 年 1 月期间,共有 115 例年龄 4 至 15 岁的连续儿科患者植入了 176 个激光消融钛骨锚固植入物。

主要观察指标

在最初的 12 个月期间,研究了临床结果、植入物失败率和植入后植入物稳定性商数(ISQ)评分。通过混合效应模型分析数据,统计学意义水平 p=0.01。

结果

观察到 12 个月的中位生存率为 96.6%。总共有 6 个植入物(3.5%)丢失,其中 1 个(0.6%)因创伤丢失。在所有术后就诊中,有 4.4%观察到不良皮肤反应(Holgers 分级 2-4),发生在 22 人(19.1%)中。ISQ 高(ISQH)和 ISQ 低(ISQL)值在第 1 阶段和第 2 阶段手术之间均未显著增加。相比之下,无论植入物尺寸如何,ISQ 值在 12 个月的随访期间从 49.1 增加到 57,呈上升趋势。仅从 3 个月的随访开始才显示出统计学上的显著变化。

结论

与以前的植入物系统相比,使用 4.5mm 宽激光消融钛骨锚固植入物可获得更高的存活率和出色的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ae6/8746879/3864c2462174/mao-43-219-g001.jpg

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