title: Implant losses for the bone-anchored hearing devices are more frequent in some patients.
abstract: BACKGROUND
  Our knowledge of implant losses for bone-anchored hearing devices (BAHD) is still limited. This study examined the long-term survival rate, the reasons for implant loss, and the need for implant replacement in a large cohort with a long follow-up.
  
  
  METHODS
  Retrospective study of patients who received a BAHD between January 1977 and December 2011 as identified from records of operations performed. All data were retrieved from patient records.
  
  
  RESULTS
  A total of 571 patients were found in the surgical records. Seven patients were excluded because of incomplete data. The follow-up period was up to 32 years, with a median follow-up of 6.6 years. Implant failures were identified in 46 (8.2%) of the patients. A total of 763 implants were inserted. Of these, 141 (18%) implants were lost: 109 (14%) due to lost osseointegration, 21 (3%) due to trauma, while 11 were electively removed. Twenty-seven patients had 1 implant reinstallation, whereas 5 patients had 2 reinstallations. Nine patients were reinstalled three times and five patients were reinstalled 4 to 6 times. Of 141 implants lost, 78 (55%) were lost in 19 patients with 2 or more implant losses.
  
  
  CONCLUSIONS
  Implant failures were identified in 8.2% of the patients with a median follow-up time of 6.6 years. A total of 141 (18%) of 763 implants were lost; the majority of losses took place in patients with multiple implant failures.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Larsson
authors.forename: Anders
authors.initials: A
authors.lastname: Tjellström
authors.forename: Joacim
authors.initials: J
authors.lastname: Stalfors
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology; D006310:Hearing Aids; D034381:Hearing Loss / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D012189:Retrospective Studies; D053441:Suture Anchors; D055815:Young Adult