title: Bone-anchored hearing aid surgery in older adults: implant loss and skin reactions.
abstract: OBJECTIVE
  We evaluated the clinical outcome measures of fixture loss and skin reactions in older-adult users of percutaneous bone-anchored hearing aids (BAHAs).
  
  
  METHODS
  We performed a retrospective analysis of 224 older adults (at least 60 years of age) who underwent implantation of 248 implants with the simplified Nijmegen surgical technique between January 1995 and May 2007.
  
  
  RESULTS
  During a mean follow-up of 39 months (range, 0 to 144 months), 16 of the 248 implants were lost (6.5%). The causes were failed osseointegration in 9 cases, trauma in 6 cases, and implant loss in irradiated bone in 1 case. There were no losses due to infection. Implant loss was not significantly correlated with age. In 40 implants (16.9%), severe skin reactions of Holgers grade 2 or more were observed. Skin revision surgery was performed around 6 implants (2.4%). None of the patients had an 8.5-mm abutment to overcome severe skin reactions.
  
  
  CONCLUSIONS
  The outcome of BAHA surgery in older adults was favorable. The rate of implant loss was comparable with that in the overall population of BAHA recipients. There were low risks of severe skin reactions or developing thick skin around the implant.
authors.affiliation: Department of Otorhinolaryngology, Donders Center of Neuroscience, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Maarten J F
authors.initials: MJ
authors.lastname: de Wolf
authors.forename: Myrthe K S
authors.initials: MK
authors.lastname: Hol
authors.forename: Emmanuel A M
authors.initials: EA
authors.lastname: Mylanus
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
mesh_terms: D000367:Age Factors; D000368:Aged; D001844:Bone Conduction / Q000502:physiology*; D015331:Cohort Studies; D004868:Equipment Failure; D005260:Female; D006310:Hearing Aids / Q000009:adverse effects*; D034381:Hearing Loss / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D012189:Retrospective Studies; D018570:Risk Assessment; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D053441:Suture Anchors / Q000009:adverse effects*; D016896:Treatment Outcome