title: Osseointegrated implants in the management of childhood ear abnormalities: with particular emphasis on complications.
abstract: Little has been published about the difficulties encountered during the insertion of osseointegrated implants for the attachment of bone anchored hearing aids (BAHA) and auricular prostheses in children. This study examines this issue in the first 51 children implanted at our centre. During surgery, the most common problem encountered was the presence of thin bone resulting in incomplete insertion of fixtures. Five fixtures had failed to integrate and six fixtures were lost in the long-term, however, only five children required revision surgery. The reason why few patients require revision was due to the judicious insertion of 'sleeper' fixtures. At follow-up, seven children required counselling for psychological problems. It is apparent from this study that osseointegrated implants in children are associated with difficulties, re-emphasizing that a paediatric osseointegration programme requires significant investment, and should only be undertaken by institutions that are committed to its success.
authors.affiliation: Department of Otolaryngology, University Hospital Birmingham and the Birmingham Children's Hospital, UK.
authors.forename: Hisham
authors.initials: H
authors.lastname: Zeitoun
authors.forename: Ranit
authors.initials: R
authors.lastname: De
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Thompson
authors.forename: David W
authors.initials: DW
authors.lastname: Proops
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003638:Deafness / Q000534:rehabilitation; D004432:Ear, Middle / Q000002:abnormalities*; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000534:rehabilitation; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies