title: Bone-anchored hearing aids and chronic pain: a long-term complication and a cause for elective implant removal.
abstract: OBJECTIVE
  To report a case series of elective removal of bone-anchored hearing aid implants, and reasons for removal.
  
  
  METHODS
  Retrospective review of a prospectively collected database.
  
  
  METHODS
  Two tertiary referral centres in the Manchester area: Manchester Royal Infirmary and Salford Royal University Hospital.
  
  
  METHODS
  A series of 499 adults and children who had undergone a total of 602 implant insertions (1984-2008).
  
  
  METHODS
  Implant removal rates, and reasons.
  
  
  RESULTS
  Twenty-seven of the 602 implants (4.5 per cent) required removal. Of these, 12 were due to pain (2.0 per cent), seven to persistent infection (1.2 per cent), three to failure of osseointegration (0.5 per cent), three to trauma (0.5 per cent) and two to other reasons (0.4 per cent).
  
  
  CONCLUSIONS
  Chronic implant site pain represents the main reason why implants are removed electively, and affects 2 per cent of all implants. This complication has important medico-legal implications and should be discussed when obtaining informed consent for implantation.
authors.affiliation: Department of Otolaryngology, University Hospital of South Manchester, UK. bdsiau@gmail.com
authors.forename: D
authors.initials: D
authors.lastname: Siau
authors.forename: H
authors.initials: H
authors.lastname: Nik
authors.forename: J C
authors.initials: JC
authors.lastname: Hobson
authors.forename: A J
authors.initials: AJ
authors.lastname: Roper
authors.forename: M P
authors.initials: MP
authors.lastname: Rothera
authors.forename: K M J
authors.initials: KM
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001844:Bone Conduction; D002648:Child; D002675:Child, Preschool; D059350:Chronic Pain / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D020878:Device Removal / Q000706:statistics & numerical data*; D005260:Female; D006310:Hearing Aids / Q000009:adverse effects*; D034381:Hearing Loss / Q000601:surgery*; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D019736:Prostheses and Implants / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D053441:Suture Anchors / Q000009:adverse effects; D014025:Titanium / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium