Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada.
Otol Neurotol. 2023 Aug 1;44(7):e504-e511. doi: 10.1097/MAO.0000000000003922. Epub 2023 Jun 15.
To evaluate and compare perioperative outcomes of percutaneous bone-anchored hearing implant (BAHI) surgery in syndromic and nonsyndromic pediatric patients.
Retrospective cohort study.
McGill University Health Centre in Montreal, Quebec, Canada.
Forty-one pediatric patients (22 syndromic, 19 nonsyndromic) who underwent percutaneous BAHI surgery between March 2008 and April 2021.
Percutaneous BAHI surgery.
Patient demographics (age at surgery, gender, implant laterality), operative information (American Society of Anesthesia [ASA] score, anesthesia type, surgical technique, implant/abutment characteristics), and postoperative outcomes (implant stability, soft tissue integrity, surgical revisions, implant failure).
The most frequent syndromes among implanted patients were Treacher Collins (27.3%), Goldenhar (13.6%), Trisomy 21 (13.6%), and Nager (9.1%). Syndromic patients were more frequently given higher ASA scores: 2 ( p = 0.003) and 3 ( p = 0.014). All cases of implant extrusion were in syndromic patients: two posttraumatic and two failures to osseointegrate. Nine (40.9%) syndromic patients experienced a Holgers Grade 4 skin reaction at one of their postoperative follow-up visits as compared to 0% of nonsyndromic patients ( p < 0.001). Implant stability was similar between cohorts at all postoperative time-points, except for significantly greater nonsyndromic implant stability quotient scores at 16 weeks ( p = 0.027) and 31+ weeks ( p = 0.016).
Percutaneous BAHI surgery is a successful rehabilitation option in syndromic patients. However, it presents a relatively higher incidence of implant extrusion and severe postoperative skin reactions as compared to nonsyndromic patients. In light of these findings, syndromic patients may be great candidates for novel transcutaneous bone conduction implants.
评估和比较综合征和非综合征儿科患者经皮骨锚定听力植入（BAHI）手术的围手术期结果。
回顾性队列研究。
加拿大魁北克省蒙特利尔麦吉尔大学健康中心。
41 名接受经皮 BAHI 手术的儿科患者（22 名综合征，19 名非综合征），手术时间为 2008 年 3 月至 2021 年 4 月。
经皮 BAHI 手术。
患者人口统计学资料（手术时年龄、性别、植入物侧别）、手术信息（美国麻醉医师协会[ASA]评分、麻醉类型、手术技术、植入物/衔接器特征）和术后结果（植入物稳定性、软组织完整性、手术修正、植入物失败）。
植入患者中最常见的综合征包括特雷彻·柯林斯综合征（27.3%）、金哈综合征（13.6%）、21 三体综合征（13.6%）和纳格尔综合征（9.1%）。综合征患者的 ASA 评分更高：2 分（p=0.003）和 3 分（p=0.014）。所有植入物脱出病例均发生在综合征患者中：两例创伤后，两例未骨整合。9 名（40.9%）综合征患者在一次术后随访中出现霍格 4 级皮肤反应，而非综合征患者无一例（p<0.001）。除了在 16 周（p=0.027）和 31+周（p=0.016）时非综合征患者的植入物稳定性指数评分显著更高外，两组在所有术后时间点的植入物稳定性相似。
经皮 BAHI 手术是综合征患者成功的康复选择。然而，与非综合征患者相比，它具有相对更高的植入物脱出和严重的术后皮肤反应发生率。鉴于这些发现，综合征患者可能是新型经皮骨导植入物的理想候选者。
