title: Long-term results of 185 consecutive osseointegrated hearing device implantations: a comparison among children, adults, and elderly.
abstract: OBJECTIVE
  To determine the occurrence and type of perioperative and postoperative complications in patients implanted with an osseointegrated hearing device (OHD) (also known as BAHA/BAHS) and compare results in children, adults, and elderly and for different surgical techniques.
  
  
  METHODS
  Retrospective case file review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Patients implanted with an OHD between 2004 and 2012, with more than 6 months of follow-up.
  
  
  METHODS
  OHD implantation.
  
  
  METHODS
  Implant loss, adverse skin reactions (Holgers' score, ≥2), skin overgrowth, and discomfort resulting in abutment and/or implant removal.
  
  
  RESULTS
  One hundred eighty-five implantations in 176 patients were reviewed. Overall, 3.8% of the implants were lost spontaneously after a mean of 2.5 years. Implant loss in children was 18% versus 2.5% in adults and 3.8% in elderly. Adverse skin reactions occurred in 14% of observations overall; in 10% in children compared with 16% in adults and 9% in elderly. Partial or total skin overgrowth was seen in 4% and 6% of the observations in children and adults, respectively, whereas none of the elderly experienced this problem. The abutment was removed because of discomfort and/or no benefit in 10% overall, in 13% of adults, and in 6% of the elderly; none of the children opted for removal. Linear incision technique showed fewest complications.
  
  
  CONCLUSIONS
  OHD implantation is a procedure with few major complications. Adverse skin reaction is the most common complication. Children lose the implant more frequently than adults. Elderly patients have less adverse skin reactions/skin overgrowth. Discomfort leading to abutment removal is a concern especially among adults.
authors.affiliation: *Department of Otorhinolaryngology, Head and Neck Surgery, Copenhagen University Hospital Rigshospitalet; and †Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Nadia
authors.initials: N
authors.lastname: Calvo Bodnia
authors.forename: Soren
authors.initials: S
authors.lastname: Foghsgaard
authors.forename: Martin
authors.initials: M
authors.lastname: Nue Møller
authors.forename: Per
authors.initials: P
authors.lastname: Cayé-Thomasen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001844:Bone Conduction / Q000502:physiology*; D002648:Child; D004868:Equipment Failure; D005260:Female; D006309:Hearing / Q000502:physiology*; D006310:Hearing Aids; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult