Osseointegrated implants in children: experience from our first 100 patients.
This study was undertaken on 100 children aged 16 years or under intended for installation of osseointegrated implants. Of these, 76 had implants installed for bone-anchored hearing aids or prostheses. The main indication for implant installation was a bilateral ear malformation. Surgery was generally performed as a two-stage procedure with a healing time of 3 to 4 months in between. Available bone thickness was on average 2.5 mm, and lack of bone necessitated bone augmentation in 12 patients. Thirty-nine percent of implants were installed in contact with the dura, sigmoid sinus, or an air cell. Implant failures were 5.8% of 170 inserted fixtures. Adverse skin reactions appeared in 9.1% of patients over a 21-year follow-up period. Revision surgery was undertaken in 22% of patients because of appositional growth of the temporal bone. Of the 24 children considered but not found suitable for osseointegration surgery, plastic surgery was considered a better option, or growth of the temporal bone was awaited. It is concluded that the rate of implant failure is lower in children; the frequency of skin reactions is the same as in adults, but revision surgery is more common in young patients because of new bone formation. Our clinical experience supported by the data presented in this article suggests that the concept could be used with good functional and aesthetic results in children.
Granström
G
G
Department of Otolaryngology, Head and Neck Surgery, Göteborg University, Sweden. gosta.granstrom@orlss.gu.se
Bergström
K
K
Odersjö
M
M
Tjellström
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004423:Ear / Q000002:abnormalities* / Q000601:surgery*; D004431:Ear, External / Q000002:abnormalities / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006310:Hearing Aids; D006801:Humans; D008297:Male; D016348:Osseointegration / Q000502:physiology*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016896:Treatment Outcome