title: Early loading after single-stage bone-anchored implantation in adults.
abstract: OBJECTIVE
  Classically, processor loading after single-stage bone-anchored implantation (BAI) surgery follows a 3-month osseointegration period. The purpose of this study was to examine audiometric outcomes and postoperative complications in adult patients undergoing single-stage BAI with processor loading at less than 6 weeks postoperatively.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Otology clinic in a tertiary care academic center.
  
  
  METHODS
  A retrospective review was performed of all adult patients (>18 years) undergoing BAI from 2007 to 2010. Sixty-four patients met inclusion criteria. Fifty-five patients had unilateral hearing loss, including single-sided deafness, conductive hearing loss, or mixed hearing loss. Nine patients had bilateral hearing loss. Patients were divided into groups based on time to processor loading (>12 weeks, <12 weeks, <6 weeks). All patients were loaded with the external processor at less than 6 weeks when possible. Preoperative and postoperative audiometric evaluations were performed.
  
  
  RESULTS
  There were no cases of osseointegration failure. All groups showed significant improvement in audiometric testing using their BAI (P < .005), and there were no significant differences between patients loaded at less than 12 weeks and those loaded at less than 6 weeks (P > .05). Major skin complications were seen in 9% of subjects and minor complications in 30%.
  
  
  CONCLUSIONS
  Single-stage BAI implantation with early processor loading is safe and effective in adults. All groups demonstrated significant audiometric benefit that was not affected in patients loaded early. Major and minor skin-site complications frequently delayed processor loading, but there were no cases of osseointegration failure in any group.
authors.affiliation: University of Miami Ear Institute, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Zeitler
authors.forename: Hillary A
authors.initials: HA
authors.lastname: Snapp
authors.forename: Simon
authors.initials: S
authors.lastname: Angeli
authors.forename: Bjorn S
authors.initials: BS
authors.lastname: Herman
authors.forename: Ann W
authors.initials: AW
authors.lastname: Plum
authors.forename: Fred F
authors.initials: FF
authors.lastname: Telischi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D019929:Cochlear Implantation / Q000379:methods*; D005260:Female; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications; D016348:Osseointegration; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D053441:Suture Anchors; D013997:Time Factors; D055815:Young Adult