Titanium fixtures for bone-conduction devices and the influence of type 2 diabetes mellitus.
OBJECTIVE
The aim of this study is to evaluate whether diabetes mellitus (DM) is a risk factor for titanium fixture loss in bone-conduction devices (BCDs) because of osseointegration failure.


METHODS
Retrospective case study.


METHODS
Tertiary referral center.


METHODS
All patients who received a BCD at Nijmegen between January 1, 1988, and December 31, 2007, were analyzed. The analyses were performed on 833 patients (993 implants) and a subpopulation of patients aged 40 years or older consisting of 641 patients (739 implants).


METHODS
Patients received a questionnaire asking about the presence of DM at the time of implantation. Data concerning implant loss were retrieved from medical records and the Nijmegen BCD database.


RESULTS
The total survival rate of the BCD implant in this population was 90.6%. The prevalence of DM was 9.3%. In the subpopulation of patients aged 40 years or older, the non-DM group lost 5.1% of their implants versus 14% of Type 2 DM patients, a statistically significantly difference (p = 0.003). Spontaneous loss, loss due to a Grade 4 Holgers skin reaction, and trauma accounted for 2.2% versus 4.7% (p = 0.13), 0.5% versus 2.3% (p = 0.1), and 0.6% versus 4.7% (p = 0.007), respectively, of implant losses in non-DM versus Type 2 DM patients.


CONCLUSIONS
The prevalence of DM among the Nijmegen BCD population is higher than the general Dutch prevalence. A statistically significantly higher implant loss was observed during the study period for Type 2 DM patients than non-DM BCD wearers.
Department of Otorhinolaryngology, Donders Centre of Neuroscience, Radboud University Medical Centre Nijmegen, The Netherlands.
Laura
L
Horstink
Hubert T
HT
Faber
Maarten J F
MJ
de Wolf
Catharina A J
CA
Dun
Cor W R J
CW
Cremers
Myrthe K S
MK
Hol
D000368:Aged; D001844:Bone Conduction; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006310:Hearing Aids; D006312:Hearing Loss, Bilateral / Q000628:therapy; D006314:Hearing Loss, Conductive / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010146:Pain / Q000209:etiology; D012871:Skin Diseases / Q000150:complications; D016019:Survival Analysis; D014025:Titanium
D014025:Titanium